正确使用抗生素的目标及管理（英文ppt）课件

Antibiotic use data: the long way from numbers to knowledge,Nico Bondt LEI, part of Wageningen UR International conference 15 november 2011,Content presentation,Antibiotic usage in perspective Objective for collection of antibiotic use data Monitoring in Europe and the Netherlands How to measure usage Trends in the Netherlands and Europe Example of country comparison Conclusions,Antibiotic usage in perspective - quantity,Outpatient human use in Europe: 1 to 3% (ECDC) Animal production Netherlands (LEI, 2011): Exposure pigs & calves: decreasing, but still high,13%,Antibiotic usage in perspective - pattern,Differences from human health perspectiveves,Antibiotic usage in perspective - quality,Quality of antibiotic usage prudence: Antibiotic use should be limited to situations where they are needed Selection of the right antibiotic Compliance with the prescription Adequate dose and duration source: Federation of Veterinarians of Europe,Objective for collection of antibiotic use data,To gain insight into: total amount of antibiotics sold level of exposure of animals to antibiotics quality of antibiotic use: prudence relationship between usage and antimicrobial resistance in animals and animal products risks of antimicrobial resistance in animals for human health,Objective for collection of antibiotic use data,To gain insight into: total amount of antibiotics sold level of exposure of animals to antibiotics quality of antibiotic use: prudence relationship between usage and antimicrobial resistance in animals and animal products risks of antimicrobial resistance in animals for human health,Monitoring in Europe,ESVAC first report September 2011: only 9 countries recent request EMA to provide sales data 2010 sent to 22 countries EU Regulation 726/2004 legal basis for national authorities to request sales data from pharmaceutical companies No obligation for EU countries to inform Brussels,Monitoring in the Netherlands - 1,National total sales data as from 1999 - FIDIN website: www.fidin.nl National usage data as from 2002 - MARAN website: www.maran.wur.nl Increasing interest individual farms & vets (2010) website: www.antibioticawijzer.nl (in Dutch) Centralized data collection (2011) VetCIS and private quality systems (IKB) Establishment of Animal Drug Authority (SDa),Monitoring in the Netherlands - 2,FIDIN total sales data + all sales (98%) + low administrative burden -/- no distinction between livestock sectors MARAN based on FADN sample farms + details per livestock sector + high quality of collected data + relationship with other farm characteristics -/- sample (appr. 400 farms),How to measure usage,Total sales in tonnes or in mg / kg mg antibiotics: adding up substances (e.g. oxy-doxy) kg of livestock: adding up different animal species Exposure: number of days under treatment Animal Defined Dose (ADD; Jensen et al, 2004) insight into antibiotic use per species dosage according to summ. of product characteristics? average live weight or weight at treatment?,Total sales in the Netherlands (gram per kg; FIDIN),Estimated exposure NL per species (dd/ay; LEI),www.maran.wur.nl,Sales patterns NL & other countries (EMA, 2011),report Trends in the sales () in nine European countries,Total sales NL and other countries (EMA, 2011),report Trends in the sales () in nine European countries,Note the differences in the scales,Example country comparison mg per kg,Own calculations based on data FIDIN, MARAN, DANMAP 2010,Example country comparison dds,primarily based on sales pattern,Comparison animal demographics (% live weight),important difference!,DK: 80% of sales,Differences in use per species (estimate!),+ 475%,+ 33%,+ 100%,Summary example country comparison,total sales (NL; mg/kg): + 118% estimated exposure (NL): + 83% estimated exposure per animal species (NL): pigs + 33% cattle + 100% veal calves - poultry + 475%,+ 40 - 50%,Conclusions about total sales data,Total sales data: usable numbers, rough knowledge! Start collecting data per species information per species needed to gain insight into exposure & risk differences between species more important than between countries Publications about total sales need improvement avoid oversimplified comparisons based on total sales data NL - DK: rel