How the Danes cut antibiotic consumption

Stuart Lumb looks at the history of antibiotic use in pig production in Denmark and the steps taken to control it

The Danes have always taken a responsible attitude to the use of antibiotics. Back in the 1960s when other countries were shovelling antibiotics into their pigs as an easy way to cure disease problems, the Danes were adopting a much more careful approach in terms of the use of drugs in their pig industry.
I spent a year carrying out pig research at the Agricultural University in Copenhagen during that period, when the pig department was headed up by Professor Hjalmar Clausen, the legendary father of the Danish pig industry. My research project involved feeding piglets weaned at two days of age on skimmed milk diets. This was actually being carried out commercially in Germany at the time, using bought-in piglets reared in tiered cages.
My supervisor, Henning Nielsen, decided that to help our trial piglets thrive we needed to supplement the diets with Aureo SP 250, a cocktail of 100ppm aureomycin, 100ppm streptomycin and 50ppm penicillin. I well remember when we met with Prof Clausen to present our proposal. He practically exploded at the idea of the proposed medication, but after he calmed down he did agree to it, albeit somewhat reluctantly.
There had been concerns for many years in Denmark about antimicrobial resistance and threats to human health, and in 1995 the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP) came into being, established on the initiative of the Danish Ministry of Health and the Danish Ministry of Food, Agriculture and Fisheries.
DANMAP reports are published annually, in Danish and English, with the 2012 publication running to no less than 130 pages, a hefty tome by any standards, and free to access on the internet. The significance to pig producers is that they’re all listed on the DANMAP/Vetstat database in terms of their consumption of antimicrobials, as are all the vets (for which the amount and type of drugs they prescribe is given).
The data is extremely detailed, showing the exact amounts of antibiotics prescribed monthly for different disorders and by category of pig. Individual herd data can be compared to national and regional data sets and so on. Another feature of Danish production that differs from the UK is that farmers get a prescription from their vet, which is then taken to the local pharmacy for dispensing.
The profile of antimicrobial use in the Danish pig herd was explored in detail at the 2013 DSM Monogastric Conference at Morley, Derbyshire, where Dr Margit Andreasen, of Boehringer Ingleheim, Denmark, presented a paper on the country’s approach to reducing antibiotic consumption in pig production.
In the early 1990s antimicrobial use (prescribed and AGPs) in the Danish industry was steadily increasing, and a ban on giving AGPs to finishers was introduced in 1998, resulting in a drop in total microbials used the following year. This was short lived, however, as the amounts of prescribed antimicrobials increased through the early 2000s.
Antimicrobials consumption steadily increased through to 2009, which was causing concern; although pig production nationally was increasing so it could be argued that consumption per pig was not increasing, just that a larger pig herd would need more antimicrobials because of the increased number of pigs.
However, the increase caused considerable disquiet and in 2010 the authorities introduced the “Yellow Card” scheme to decrease antimicrobials usage. In addition, a ban was introduced on the use of cephalosporins in 2010. Threshold limits for antimicrobial use for sows, weaners and finishers were also introduced which, incidentally, were being exceeded by around 10% of producers.
In July 2010 letters were sent to 1,249 producers who were close to, or exceeding, the permitted levels. Producers had the chance to challenge the data relating to drug use on their units, before government legislation was enacted in November of that year.
Roughly half those producers breathed a sigh of relief, but 500 producers received an unwelcome early Christmas present in the shape of a yellow card. The consequences of the card are that the herd is audited for nine months, plus the antibiotic use on the farm must be reduced to below the permitted levels. The yellow card status of the herd is then re-evaluated. Another sanction that exists is that a producer may be given a red card; in this case stocking rates may have to be reduced, which effectively reduces antibiotic use.
The yellow card concept has been in place now for nearly three years, and drug consumption dropped by 20% in 2011, with water medication showing the biggest decline. In 2012 overall consumption levelled out, although there was a 5% spike in January 2013. Interestingly, because of all the detailed recording, producers know exactly how much medication they are using and can fine tune things so that they don’t get shown the dreaded yellow card.
In contrast to the downward trend in microbials consumption, the use of vaccines has increased by between 20% to 30%. Denmark didn’t suffer as badly as England with PMWS, and this is reflected in the relative PCV2 vaccination rates, with English levels being more than double than the Danish ones.
Dr Andreasen stated that the lowering of microbial use was due to the following factors: the unique Danish SPF health management system; high levels of management; the Danish co-op system; the immediate application of new production technology; vaccination strategies; and eradication programmes.
Looking to the future, she also mentioned several political initiatives in the pipeline to further address antimicrobial use. These included: taxes on broad-spectrum antimicrobials; no taxes on vaccines; restricted use of oral medication; more frequent veterinary visits (fortnightly); and more regulatory lab diagnostics.
It would appear that these initiatives are being imposed on Danish producers, and they will not benefit financially from them. Where they will benefit, however, is in terms of a better press and an improved, more-responsible image in the eyes of Danish consumers.
The Danish pig industry takes great pride in developing new initiatives within the EU. In this context, Brussels is looking very closely at the DANMAP/Vetstat initiative as a blueprint for other EU members, so yellow cards might soon be appearing in the UK, in places other than on a football pitch.

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