Monitoring antimicrobial use (AMU) is crucial, as it plays a key role in driving antimicrobial resistance (AMR). Animals account for a significant share of AMU, making it essential to accurately quantify AMU exposure at the species, farm, and country levels. In Pakistan, prophylactic use of antimicrobials remains common alongside therapeutic use. This study aimed to establish defined daily and course doses for both therapeutic and prophylactic use of antimicrobials in commercial broiler production in Pakistan. A list of antimicrobial products was compiled from the daily treatment records from 100 commercial broiler farms in Punjab, Pakistan. For each active substance (AS), a defined daily dose (DDDvetPK) was assigned for treatment, prevention or both, by averaging the recommended doses of all similar AS with the same administration route. A defined course dose (DCDvetPK) was calculated by multiplying the average recommended dose by the average treatment duration for each AS, based on the Summary of Product Characteristics (SmPC). A total of 41 AS, categorized into 17 antimicrobial classes, were identified from 139 antimicrobial products. The most frequently reported AS were colistin (polymyxins) at 15.9 %, amoxicillin (aminopenicillins) at 7.5 %, neomycin (aminoglycosides) at 7.3 %, enrofloxacin (fluoroquinolones) at 6.7 %, and tylosin (macrolides) at 6.4 % of the total treatments (n = 358) reported at farms. Notably, 51 % of AS were classified as critically important for human medicine by WHO. Among AS indicated for treatment in SmPC, the defined daily doses for Pakistan (DDDvetPK) varied substantially from the European Medicines Agency (EMA) values (DDDvet), with the top deviations being Tiamulin (+147.8 %), Sulfadimidine_TMP (+111.2 %), Flumequine (+88.6 %), Spiramycin (-87.8 %), and Tylosin (-84.3 %). This study presents a list of defined daily doses and defined course doses for AMU quantification in Pakistani broilers using dose-based indicators. The observed differences between Pakistani and EMA doses, and lack of EMA doses for preventive antimicrobials, suggest using Pakistani DDDvetPK values to quantify antimicrobial usage in Pakistan. A huge variation in recommended doses was reported in SmPC. There is an urgent need to establish a list of approved veterinary antimicrobials used in Pakistan, along with harmonization in recommended doses and maintenance of standardized SmPC by the drug regulatory authorities. Setting up a national-level list of defined daily doses is crucial to accurately monitor and quantify AMU.
Passive surveillance can be most effective in the early detection of disease outbreaks given that farmers observe their animals daily. The European Animal Health Law states that unexplained excess mortality should be reported to the veterinary authorities. In the Netherlands, in addition to notifications to the competent authority, Royal GD is commissioned a passive surveillance component that consists of a veterinary helpdesk and postmortem examination for early detection of emerging diseases. The aim of this study was to evaluate this voluntary passive surveillance component through excess mortality in cattle.
Weekly on-farm mortality was calculated using the cattle Identification and Registration records. Mortality was assessed on regional level for dairy, veal and other beef cattle using a Generalized Linear Model (GLM) (log-link, negative binomial). We used a cumulative sum of the model residuals to identify periods of excess mortality. The mortality was defined as excessive when above five times the standard error. The analysis was also conducted on herd level, but these models did not converge.
We checked for an association between the two passive surveillance components elements and excess mortality. A GLM (log-link, negative binomial) with the number of contacts or submissions per region as the dependent variables and excess mortality per region and year as independent variables was carried out.
Overall, the models showed significantly higher use of passive surveillance components in periods of excess mortality compared to non-excess periods. In dairy cattle the odds for contact or submission were between 1.72 (1.59–1.86) and 2.02 (1.82–2.25). For veal calves we found the odds of 2.19 (1.18–4.04) and 2.24 (1.78–2.83) relative to periods without excess mortality. Beef cattle operations, other than veal, showed only an increased odds for postmortem submissions in calves of 3.71 (2.74–5.01), submissions for cattle and contact in general was not increased for this farm type.
In conclusion, the voluntary passive surveillance component in the Netherlands is used more often in periods of excess mortality in cattle. The chance of getting a timely response is highest for dairy farms. For veal calf operations the chance of receiving a timely response is more likely for postmortem submissions. A comparison with passive surveillance for excess mortality in other countries was not possible because no literature could be found. However, the method of this study can be used by other countries to evaluate their passive surveillance. This would make comparison of the performance of passive surveillance in different countries possible.