Health Interventions in Light of New Antibiotic Regulations Chris Rademacher, DVM Clinical Associate Professor ISU Swine Extension Veterinarian Iowa State University
Agenda Effects of new regulations on antibiotic use What about non antibiotic alternatives? Judicious Use Examples ISU VDL Lab Update
2016 FDA Antibiotic Sales and Distribution Report Each year, the Food and Drug Administration (FDA) reports the amounts of antimicrobials (by class) that were sold or distributed Does not reflect actual usage Metrics reported include drug class, medical importance, route of administration, indication, and dispensing status, as well as species-specific estimates of these sales and distribution This is the first year that the report was reported by livestock species.
Summary from 2016 report Domestic sales and distribution of antimicrobials approved for use in food-producing animals decreased by 10% from 2015 through 2016. 1 year prior to any mandated changes regarding VFD and prescriptions. Medically important antibiotics decreased by 14%
Veterinarian VFD Survey (n=41 vets) Expected % Reduction in Antibiotic Usage due to VFD (n=41 vets) 9 8 7 6 5 4 3 2 1 0 0% 1% to 10% 11% to 20% 21% to 30% 31% to 40% 41% to 50% 51% to 60% 61% to 70% 71% to 80% 81% to 90% 91% to 100%
Veterinarian VFD Survey (n=41 vets) How did growth promotion uses change? 60.0 50.0 40.0 30.0 53.8 20.0 10.0 15.4 22.5 7.1 0.0 Eliminated all uses of antibiotics for growth promotion Eliminated some uses of antibiotics for growth promotion Moved to non-medically important growth promotants Other*
Veterinarian VFD Survey (n=41 vets) Changes to deal with fewer antibiotics 35.0% 30.3% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 18.2% 21.2% 14.1% 6.1% 5.1% 3.0% 2.0%
%, Significant ADG response What about antibiotic alternatives? Searched scientific publication databases Included articles since 1990 Had to evaluate production parameters ADG or Mortality 100 90 80 70 60 50 40 30 20 10 0 2.2 2.2 0.0 0.0 2.7 1.1 1.0 0.6 11.1 1.4 39 1.5 58 11 14 0.0 4.9 34 22 25 9 1.5 2.4 1.1 16.7 43 0.6 44 Be very wary of antibiotic alternatives 87 81 73 72 73 11.1 without rigorous 65 scientific testing 56 33 29 3.4 66 (0) (-) (+) nr Gabler, Schweer, et al - ISU Department of Animal Science
Phase 2: Field Validation of Non-Antibiotic Growth Promotion 1300 head nursery with 21 day old weaned pigs in commercial nursery PRRS challenge with A.suis and Salmonella 2 housing types with same square footage 11 pigs per pen 31 pigs per pen 4 Treatments: Negative Control (no additives) - NC Positive Control (Antibiotic PC Zinc Oxide (3000 ppm) + Acidifier ZA Direct Fed Microbial + Resistant Starch - DR Gabler, Olson et al - ISU
Phase 2: Field Validation of Non-Antibiotic Growth Promotion Conclusions: Antibiotics still best effective in face of disease challenge independent of pen size Zinc + Acidifiers had some impact in larger pen sizes compared to other alternatives Non-antibiotic alternatives performed better in smaller pens than larger pens Gabler, Olson et al - ISU
Phase 2: Field Validation of Non-Antibiotic Growth Promotion Conclusions: No differences between any of the treatments or pen sizes for Feed Conversion Gabler, Olson et al - ISU
Judicious Use of Antibiotics So what does Judicious Use of Antibiotics mean? Antibiotics should be used for prevention, control or treatment only when there is an appropriate clinical diagnosis or herd history to justify their use. Limit antibiotic use for prevention, control or treatment to ill or at-risk animals, treating the fewest animals indicated. Support development of a scientific knowledge that provides the basis for judicious therapeutic antimicrobials use. So where are there some opportunities for us to be more judicious?
Judicious Antibiotic Use Goal Right pig Right drug Right concentration of the drug within the pig Generally, we want to have sustained concentration of drugs within the pig for maximum efficacy Slides courtesy of Dr. Paisley Canning Swine Medicine Education Center
Individual pig variation associated with water medication Case study
Study set up 60 pigs in individual pens with individual tube waterers Gave water medication for 5 days in the water at label dose Collected water samples Record daily water disappearance
Information about the medication We used normal, healthy pigs The medication was targeted towards treating lameness, arthritis and getting drug into the joint tissue Treatment goal: Get the drug to the right place and sustain it at high enough levels to kill the pathogen
Concentration ng/ml Amount of drug in the joint fluid 16 14 12 10 8 6 4 2 0 These pigs have some drug in their joints 0 12 24 36 These 48 pigs 60 have 72 NO 84drug 96in 108 their 120 Hours joints! 22
Concentration ng/ml Amount of drug in the joint fluid 16 14 12 10 8 6 4 2 0 Need to maintain drug concentrations above this line So much variability that most pigs don t stay above the line! = Reduced treatment success 0 12 24 36 48 60 72 84 96 108 120 Hours 23
Let s compare this to injectables!
Draxxin (lung concentrations) Above MIC for more than 8 days!
Water medication Huge variation between individual pigs Some pigs were not getting enough medicine to sustain it in their blood and joints Healthy pigs vs sick pigs? 26
Healthy and in pen alone
Sick Pigs with lots of competition for water
Respiratory Treatment Trial Pigs arrive at R&D Site from a sow farm experiencing PRRS outbreak. Question to Answer: Does how early you treat sick pigs really matter?
A Pig Acutely ill (<24 hours) Just off-feed Depressed
B Pig Sick for 1-2 days Rough hair coat Starting to see the backbone Evidence of weight loss ( gaunt)
C Pig Sick for 3-4 days Very thin Backbone is clearly seen.
Effect of Timeliness of Treatment on Mortality 35.0 30.0 25.0 20.0 Mortality, (ChiSq) % 31.6 The earlier you treat a sick pig, the better the response First 24 days after treatment 15.0 10.0 6.7 9.6 Mortality, (ChiSq) % 5.0 0.0 A B C A = Good pig just starting to look sick B = Pig has been sick for 1-2 days C = Pig has been sick for 3-5 days
Vaccinations Routine vaccinations that should be considered either with or without antibiotics (growing pigs): PRRS Mycoplasma PCV2 Ileitis (Uses antibiotics to control) BI water delivered vaccine Merck Injectable vaccine
PRRS Stabilization Project Performance Summary System A System A Feeder Pig vs No-Vacc System B System C Program ROI 4:1 Nursery ADG 23% increase - 7% increase 10% decrease Nursery Mortality 63% decrease - 23% decrease 38% decrease Finishing ADG 6% increase 5% increase 7% increase 2% increase Finishing Mortality 33% decrease 32% decrease 35% decrease 30% decrease 6% increase W-F ADG Goal: W-F Produce Mortality PRRS negative pigs and then vaccinate 45% decrease them to minimize growing pig losses Comparing 15-18 months before to 15-18 months after the project was initiated.
Vaccinations Other growing pig vaccines to consider (but value and efficacy more in question): H. parasuis (commercial and autogenous) S. suis (autogenous) APP A.suis (autogenous very effective) Erysipelas (not a big problem anymore) Influenza A virus (SIV)
New Influenza Vaccine Boehringer-Ingleheim has received approval in the U.S. for Inglevac Provenza Modified live influenza vaccine (MLV) 1 st ever MLV Influenza A Vaccine for swine H1N1 and H3N2 strains Has the potential to increase the efficacy of vaccinating growing pigs due to lack of maternal interference with vaccination. Vaccinate prior to weaning
New VDL Building Project Long-Term Facility Infrastructure Solution
ISU VDL Facility Infrastructure Designed in 1973-74 and Populated in 1976 Located within the CVM Building VDL 1974 10 Faculty & 20 Technical Staff
Food Animal Industries Changed Dramatically Demand Globally for High Quality Protein Based Diets Advances in Logistics
FY 2017: 25 Faculty & 125 Staff 85,923 Cases 1.28 M Tests ISU VDL 2017
New VDL Capital Appropriations Request RIIF = Rebuild Iowa Infrastructure Fund ($20 M for 5 years) + ($24 M Donor & University) Multi-Generational Impacting Infrastructure Project Direct impact on: Animal Health, Food Safety, & Public Health Iowa and US Agricultural Industries Time Sensitive = Subject to ISU & BOR Priorities Local Stakeholder Engagement Most Critical Factor Specific Ask = $5M in Planning Funds in FY2019
Post-Card To Send to Local State Senator or Representative.
Questions?? Chris J. Rademacher, DVM Swine Extension Veterinarian Iowa State University 2225 Lloyd Veterinary Medical Center Ames, IA 50011 (: (515) 294-8792 *: cjrdvm@iastate.edu Follow on Twitter: @cjrdvm www.ipic.iastate.edu