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Prof. dr. J.Fink-Gremmels DVM, PhD, Dip ECVPT President EAVPT J.Fink@uu.nl

EPP: Antimicrobial resistance: urgent need to act in human & veterinary medicine. Implementing the One Health Concept. Prof. dr. J.Fink-Gremmels DVM, PhD, Dip ECVPT President EAVPT J.Fink@uu.nl. 22-04-2015 MP-EU. Medical Faculty Part. Veterinay Faculty, Utrecht University

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Prof. dr. J.Fink-Gremmels DVM, PhD, Dip ECVPT President EAVPT J.Fink@uu.nl

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  1. EPP: Antimicrobial resistance: urgent need to act in human & veterinary medicine Implementing the One Health Concept Prof. dr. J.Fink-Gremmels DVM, PhD, Dip ECVPT President EAVPT J.Fink@uu.nl 22-04-2015 MP-EU

  2. Medical Faculty Part Veterinay Faculty, Utrecht University Part of Utrecht Life Sciences

  3. The point of departure: the global emergence of AMR Global trade and global mobility have become major drivers of the spread of infectious diseases AND antimicrobial resistance Humans & animals share the same bacteria and often also the same resistance genes Wendlandt et al., 2015

  4. The antibiotic eco-system: need for a multi-actor approach Human health care Community & Hospital (ICU) Animal health care Industry Agriculture FAO-WHO-OIE Tripartite action plan

  5. Antibiotic use in veterinary medicine Raising awareness & implementing the an action plan Human (humane) responsibility for animal health and wellbeing Animal health care & (global) food demands Urgent need to act in veterinary medicine: Enforcement of triple R Reduction – Refinement - Replacement See also EIP-AGRI Focus Groups

  6. The triple R action plan • Reduction:The use of antimicrobial as herd managment tools is no longer accepted • Improvement of hygiene programmes  biosecurity • Improvement of disease prevention  vaccination • Improvement of health monitoring &diagnostics (sensor based disease monitoring) • Improvement of immune competence: feed quality – life cycle management Creating Awareness – improving sustainability Action points 1 & 2 FAO/WHO/OIE

  7. Reduction of antibiotic use (ADD): the primary target In the Netherlands between 2009 (reference) and 2013: a decrease of the antibiotic use by 58%was achieved, with a further decline in 2014 The point of concern: Extreme reduction without accompanying measures endangers animal welfare!

  8. The triple R action plan Refinement: Re-evaluating current prescription attitudes • Diagnosis-based prescriptions (capacity building) • Pathogen-susceptibility testing (rapid diagnostics) • Onset of treatment (cure rate) • Duration of treatments – need of supportive treatments • Ranking of antibiotics (critical important – specialist oversight) • Meeting expectations? • Expectation of (human) patients • Expectations of farmers CONTINUING EDUCATION & COMMUNICATION CAPACITY BUILDING

  9. Refinement: Avoidance of collateral damage: Intra-intestinal antibiotics concentrations: The gut microbiota are an undesirable target Long persistence in the intestines ….selecting for resistant bacterial populations Impairment of the microbiome results in immune-mediated diseases (allergies, diabetes, inflammatory bowel diseases 1000 000 000 000 000 bacteria; > 500 species 10 x more than body cells Reservoir for resistant bacteria / resistance genes

  10. The triple R action plan • Replacement: • Improvement of hygiene programmes  biosecurity • Improvement of disease prevention  vaccination • Improvement of health monitoring & diagnostics • Improvement of immune competence: feed quality – life cycle management Animal health care Starts at the 1st day of life Chang in mind-set: From Cure to Care

  11. From cure to care: options & opportunities Vaccines (including PNAG-like surface antigen antibodies) Bacteriophages non-antibiotic antibacterials (ZnO) Prebiotics Probiotics Phytobiotics Bacteriocines Quorum sensing modulators Peptides Defensin inducers Killing factors (complement opsonins) Hygiene programs Biosecurity Improvement of animal health – reduces the need for antibiotics Building strategic cooperation

  12. One health – our responsibility Food Safety & Food Security Thank you!

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