Total antimicrobial consumption by animals in Denmark has continued to decrease for the third consecutive year, according to the findings of the annual DANMAP report for 2016 from Statens Serum Institut, the National Veterinary Institute and the National Food Institute, the latter two of which are departments of the Technical University of Denmark.

In 2016, total antimicrobial consumption (in kilograms) by Danish animals was approximately 5% lower than the previous year, according to the DANMAP report. Consumption has decreased in pigs, cattle, poultry and fish.

Overall, veterinary antimicrobial use has decreased approximately 10% from 2013 to 2016, which is equivalent to a reduction of 12 metric tons of antimicrobials, the report says.

Reduced use in pig production

The decrease in the total consumption of antimicrobials in 2016 was primarily due to a 4% (3,349 kg) reduction in their use in pig production compared to 2015, the report says. Pig production in Denmark constitutes approximately 85% of the country's meat production, and around 75% of total veterinarian-prescribed antimicrobials are used for pigs, according to DANMAP.

"A reduction in the use of antimicrobials is necessary if we are to tackle the problem of antimicrobial-resistant bacteria. The Danish Veterinary & Food Administration has, in recent years, implemented several initiatives to limit consumption, and it is positive to see that the downward trend in consumption continues," National Food Institute head Flemming Bager said.

The use of medicinal zinc (as zinc oxide) decreased 4% in 2016 compared to 2015. This drop comes after a doubling in use between 2006 and 2015 (from 250 mt to 500 mt). Zinc oxide may lead to resistant bacteria in pigs, such as methicillin-resistant Staphylococcus aureus, according to the report. Furthermore, most of the zinc oxide ends up in the fields via the manure, where it is a potential environmental problem.

"The recent focus on the use of medicinal zinc in pig production and the correlation between antimicrobial resistance and consumption of medicinal zinc may have led to the reduced use in pigs. The European Commission will phase out the substance by June 2022, and consequently, we can expect a continued decrease in consumption in the coming years," Bager said.

Poultry, fish production use

Following two years with much higher antimicrobial consumption than normal due to several serious disease outbreaks in broiler production, consumption by poultry declined sharply -- by 36%, or 880 kg -- from 2015 to 2016, the report says. As such, consumption has returned to the pre-outbreak levels.

Antimicrobial consumption in Danish aquaculture production in 2016 was the lowest recorded in a decade. This was largely due to the cooler summer weather, which resulted in lower water temperatures that then led to fewer disease problems, the report explains.

Other developments

Despite an increase in antimicrobial consumption by companion animals from 2015 to 2016, the development over the past five years has been generally positive, with a decrease in the total consumption of approximately 11% (160 kg), according to the DANMAP report. Use of third- and fourth-generation cephalosporins, in particular, has fallen steadily over the past five years.

"It is positive to note that the consumption of cephalosporins in pets has dropped significantly in recent years. Since cephalosporins are among the antimicrobial agents that are critically important for the treatment of humans, it is especially important that they are used only when the veterinarian has no other treatment options," Bager explained.

"It is very important to continue to work towards reducing the use of antimicrobials in pets, as most of the veterinary consumption of critically important antimicrobials is used in pets, who come into close contact with people," he added.

Use of critically important antimicrobials -- such as cephalosporins and fluoroquinolones -- in animal production is still very low.

"The Danish Veterinary & Food Administration has had a very restrictive approach to the use of fluoroquinolones in production animals for many years, and Danish pork and cattle producers are voluntarily phasing out the use of third- and fourth-generation cephalosporins. These initiatives have been crucial for the Danish success in reducing the use of these antimicrobials," Bager said.

Since 1995, the DANMAP program has monitored the use of antimicrobials in humans and animals in Denmark and the occurrence of antimicrobial resistance in bacteria in animals, people and foods.

The annual DANMAP report is prepared by the National Food Institute and Statens Serum Institute and is available on the DANMAP website at https://www.danmap.org/Downloads.aspx.