Antimicrobial resistance: Insights from an international conference

Our AMR Project Officer, Rosie Hughes, recently presented RCVS Knowledge’s VetTeamAMR resources to the AACTING* Conference in Vienna, one of Europe’s leading events discussing the responsible use of antimicrobials in veterinary practice. 

I recently visited the impressive city of Vienna for the fourth international AACTING* conference on 1-2nd Feb, which brought together veterinary professionals from all over the world to discuss antimicrobial consumption in animals. On behalf of RCVS Knowledge, I had the privilege to present at this year’s conference, promoting the important work we have been doing to support antimicrobial stewardship (AMS) in clinics across the UK. 

In my talk, I presented our approach to supporting veterinary teams to improve how they use antimicrobials through our Companion Animal and Equine antibiotic audit tool, our extensive learning platform, and our annual antimicrobial stewardship awards. I particularly focused on the use of data for auditing of antimicrobial use, stressing that it is only one part of the puzzle and needs to form part of a holistic approach. I also saw a range of expert speakers present on their current work – from national action plans to individual research PhDs.   

The theme of the conference focused on quantification, benchmarking, and stewardship. Antimicrobial resistance (AMR) is a global concern, affecting us all equally if we do not take action. The event was a wonderful opportunity for collaboration between veterinary professionals across the world, and to learn lessons from each other on the best approaches to tackling this major issue.  

The first day featured talks on a range of topics mainly focusing on the current data collection strategies for food producing animals that various countries are implementing globally, and the challenges they have faced. The first keynote presentation of the day summarised an overview of antibiotic surveillance “The past, present and future of European surveillance of antimicrobial consumption in animals” by Cristina Ribeiro-Silva from the European Medicines Agency (EMA).  

As well as informing us on the protocols in place on surveillance, she started by asking ‘Why do we care?’ when it comes to monitoring antimicrobial use in animals. With such a massive issue requiring global cooperation, it’s always important to take a step back and reflect on why we want to implement positive change. She highlighted the statistics from the O’Neill report (2016) that estimates AMR will cause around 10 million human deaths per year by 2050 if we do not act. She also noted that this worst-case scenario will see the loss of recent improvements in modern medicine, and the loss of treatment options such as chemotherapy and surgery. With the necessity for action thoroughly underlined, she went on to discuss the 4 major areas of importance when tackling AMR – collaboration, data collection, promoting responsible use, and supporting development of new therapies. 

The second keynote presentation was on stewardship models “A Model for Change? Implementing a national Antimicrobial Stewardship programme in Wales” by Gwen Rees, Aberystwyth University, UK. Gwen highlighted that voluntary change does work, and can result in reductions in antimicrobial use, especially alongside changing regulations. She discussed the importance of behaviour change theory which argues that people need 3 separate motivations to act – competence, relatedness, and autonomy. This needs to be considered when developing training or promoting stewardship programmes for veterinary engagement. 

The second day saw a focus on companion animals, and the keynote presentation “Recommendations to collect and analyse data of antibiotic use in in companion animals” by Roswitha Merle, Free University of Berlin, Germany, highlighted the specific challenges to data collection in this sector, in comparison to production animals. The major challenge is the lack of ‘population data’ in companion animals at a national level, compared to production animal where herd level data is more readily known.  

The second challenge is the range of sizes in one species, for example mature dogs range from around 2kg up to 150kg, so creating a defined weight for this species can be contentious. We know it is just as important to gather accurate levels of antimicrobial use, but more work is needed in standardising an approach to data collection, including standardising the metrics for measuring use. It is bittersweet to learn that the UK is not alone in identifying these issues but given that we have not yet reached an international standard, more collaboration is key. 

Considering the recent introduction in the European Union of mandatory reporting on sales and use data per species, it is even more important for collaboration and to streamline the approach to antimicrobial surveillance in the veterinary industry. The UK has made some great strides forward in this area but needs to be prepared for increased demands for collection of data based on usage to get in front of possible legislative changes. Find out the steps you can take to get involved at rcvsknowledge.org/amr 
 
*AACTING (Network on quantification of veterinary Antimicrobial usage at herd level and Analysis, Communication and benchmarking to improve responsible usage)