Resistance & Food Safety There are public concerns that people may acquire foodborne illnesses that cannot be appropriately treated with antibiotics as a result of antibiotic-resistant bacteria that are derived from food animals that have been treated with antibiotics
MUNGKINKAH INDONESIA BEBAS ANTIBIOTIK? Drh. Lia Mundiany Technical Manager, Elanco Animal Health Mundiany_lia@elanco.com
BUT... Need to consider animal welfare
Why are there fewer New Veterinary Products in the Market today?
Prudent Use Guidelines Recommendations for veterinarians by veterinarians for using antibiotics in a way that maintains animal health while at the same time minimizing the selection of resistant bacteria Office International des Epizooties (OIE) Terrestrial Animal Health Code 2003. Appendix 3.9.3: Guidelines for the responsible and prudent use of antimicrobial agents in veterinary medicine. Federation of Veterinarians in Europe (FVE) Antibiotic Resistance and Prudent use of Antibiotics in Veterinary Medicine Veterinary Medicines Directorate (VMD) Code of Practice Document on the Responsible Use of Animal Medicines on the Farm
Update from Europe
Responsible Use vs. Precautionary Principle The Danish Experiment 1995 National ban on avoparcin 1998 National ban on virginiamycin 1999 Voluntary agreement to discontinue antibiotic growth promoter (AGP s) for finishing swine 2000 Voluntary ban of AGP in piglets
Has the Danish Experiment Been Beneficial? 1. Decrease antibiotic use? 2. Public Health Benefit? Reduced illness Reduced resistance in human isolates 3. Animal Health?
Indonesia Situation
Update from US Perubahan peraturan antibiotik sebagai dampak dari implementasi kebijakan FDA
Panduan untuk Industri #213 Produsen diminta secara sukarela untuk : Mengeluarkan klaim weight gain/efisiensi pakan (AGP s) dari label kelompok medically important antimicrobials Mengganti penggunaan AGP dengan indikasi therapeutic dengan syarat dilengkapi dengan data keamanan (safety data) dan efikasi yang baru.
KONSEP ANALISIS RESIKO ANTIBIOTIK PADA PAKAN HEWAN
3 Langkah RA Proses Antibiotika tersebut harus menyebabkan resistensi terhadap bakteria foodborne Release Seseorang akan mengkonsumsi produk hewani yang terkontaminasi oleh bakteri yang sama, yaitu bakteri yang memiliki resistensi antibiotik Exposure Orang yang terinfeksi bakteri tersebut akan jatuh sakit dan tidak dapat ditangani dengan menggunakan antibiotika secara umum karena mengalami problem resistensi Consequence
Monensin Risk The use of monensin in food animals does not create a risk to human health because none of the risk criteria are met. An antibiotic must select for foodborne bacteria that acquire antibiotic-resistance A person must ingest meat from a treated animal that is contaminated The person that ingests these bacteria must become sick with a bacterial infection
RISK COMPARISON OF Some MARCROLIDE Perspectives ANTIBIOTICS TYLOSIN* AND TILMICOSIN*
RISK COMPARISON OF MARCROLIDE ANTIBIOTICS TYLOSIN* AND TILMICOSIN* Other Perspectives
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Kesimpulan: Pelarangan, pembatasan, ataupun perijinan penggunaan AGP sebaiknya berdasarkan konsep risk analysis Dalam melakukan penilaian resiko AGP terhadap kesehatan manusia diperlukan kerjasama dengan berbagai pihak seperti lingkup kesehatan hewan, kesehatan masyarakat, industri, kesehatan manusia, para ahli, dsb. Jika pelarangan AGP tidak dapat dihindarkan, maka pemerintah perlu mempersiapkan solusi alternatif yang aman digunakan dan biaya terjangkau sehingga Indonesia tetap dapat bersaing baik di pasar lokal maupun regional.
Responsible use does not simply equate to using fewer antimicrobials. Use the right drug in the right amount by the right route for the right period of time Jackie Atkinson, Director of Authorisations Veterinary Medicines Directorate United Kingdom January 21, 2012
If Change outside your organization is faster than inside your organization, the end is near (Jack Welch)