France: ANSES assessment of the risks of emergence of antimicrobial resistance

In 2011 the French Ministry of agriculture launched a national plan, Ecoantibio 2017, to reduce the use of antibiotics in veterinary medicine over the 2012-2017 period and which aims to coordinate and potentiate the efforts of all those involved in the fight against antimicrobial resistance.

With this in mind, ANSES launched an internal request to conduct an assessment of the risks of emergent antimicrobial resistance due to patterns of antibiotic use in the veterinary sphere, in the various animal production sectors (ruminants, pigs, poultry, rabbits and fish), as well as in horses and household pets.

The Agency's experts emphasise that during preventive treatment, the risk of inducing resistance in the bacteria of commensal flora exists in all the treated animals, whereas the therapeutic benefit depends on the effective elimination of the pathogenic bacteria whose presence is only suspected. The benefit-to-risk ratio of preventive treatment therefore appears to be poor with regard to the risk of antimicrobial resistance, except for certain specific uses.

Metaphylactic treatment, which is suited to animals raised collectively, is considered by the experts to be a more acceptable type of use, since it may have a better benefit-to-risk ratio than preventive treatment when the modes of application are specified.

As concerns controlling high risk practices in veterinary antibiotic therapy, ANSES recommends:

• Discontinuing the use of preventive antibiotic therapy,
• Reserving the use of latest-generation antibiotics (3rd and 4th generation cephalosporins and fluoroquinolones) to special circumstances which should be clearly defined beforehand according to the sector and strictly regulated,
• Preferring use of narrow-spectrum antibiotics, and carefully targeting the bacteria in question.

In addition, ANSES highlights the need to assess the impact of measures used to fight antimicrobial resistance through the use of specific surveys and monitoring methods. Furthermore, it emphasises that the fight against antimicrobial resistance also involves making methods available that effectively target specific antibiotic treatments and developing alternatives to the use of antibiotics under surveillance.