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Édition scientifiqueFebruary 2011

Sales survey of Veterinary Medicinal Products containing Antimicrobials in France - 2009

Édition scientifiqueFebruary 2011

Sales survey of Veterinary Medicinal Products containing Antimicrobials in France - 2009

The French Agency for Veterinary Medicinal ProductsLa Haute Marche - Javené - BP 90203 F-35302 Fougères Cedex - Francewww.anmv.anses.fr

National agency for veterinary Medicinal products

Sales survey of Veterinary Medicinal Products containing

Antimicrobials in France - 2009

Fougères, February 2011

G. Moulin and A. Chevance, Anses-ANMV

With the participation of Claire Chauvin, Anses-Ploufragan

1

Summary

The French monitoring system of veterinary antimicrobials was initiated in 1999. It iscoordinated by the French Agency for Veterinary Medicinal Products (Anses/ANMV), incollaboration with the French Veterinary Medicine Industry association (SIMV), and isperformed according to the OIE guideline on monitoring of antimicrobials (in AnimalTerrestrial Code 2009 – Chapter 6.8).

The monitoring is based on a questionnaire sent to each applicant who has registered aveterinary medicinal product containing antimicrobials. In 2009, the applicants were requiredto provide information about the repartition between species for each commercialpresentation in addition to the number of sold units.

Sales in weight of active ingredients

In 2009, the total sales volume accounts for 1 067.35 tons of antimicrobials.

As for previous years, four antimicrobial classes (Tetracyclines, Sulfonamides, Penicillins,

Macrolides) represent more than 80 % of the tonnage of sold antimicrobials. Tetracyclines

alone represent around half of the overall. Fluroquinolones and Cephalosporins volumes are

relatively low.

In 2009, the total antimicrobial sales have decreased of 13 % (159 tons) compared to 2008

and the sales have decreased of 19.3 % (255 tons) compared to 1999. The 2009 sales

represent the lowest sales volume recorded during the 11 years period.

This decrease is mainly due to the sales of antimicrobials belonging to Tetracyclines

(decrease of 22.2 % i.e. 139 tons) and to Sulfonamides (decrease of 32.0 % i.e. 86 tons).

Compared to 1999, the sales of Fluoroquinolones have increased of 48.94 % (i.e. 1.61 tons)

and the sales of Quinolones have decreased of 63.3 % (i.e. 12.99 tons). Compared to 2008,

the sales of Fluoroquinolones have stabilized in 2009 (+0.09 %)

Compared to 1999, the sales of 3rd and 4th generation Cephalosporins have increased of

105.6 % (i.e. 0.94 ton) and the sales of 1st and 2nd generation Cephalosporins have

increased of 28.4 % (i.e. 1,5 tons). Compared to 2008, the sales of 3rd and 4th generation

Cephalosporins have decreased of 13.7 % (i.e. 0.29 ton).

Sales in weight of active ingredients per Kg of animal bodyweight

When taking into account the weight of animals treated, the decrease is only of 11.83 %

compared to 1999.

In 2009, sales correspond to an equivalent of 67.73 mg/Kg of animal weight produced.

The sold tonnages per class do not represent accurately the use of antimicrobials as

differences in dosages and durations of administration are not taken into account.

Antimicrobials belonging to the new classes generally require a lower weight of active

ingredient to treat one animal than an old antimicrobial.

2

Weight of animal treated with antimicrobials

To evaluate the exposure to antimicrobials, the weight of animal treated has been evaluated

for each substance administrated orally and parenterally. For the intra-mammary route, the

number of treatments for each medicinal product has been calculated.

The weight of animals treated by parenteral route decreases of 14.6 % in 2009 compared to1999.

The weight of animals treated by oral route increases of 12.8 % in 2009 compared to 1999.However, a decrease is noticed for the 2 last years (a decrease of 14.4 % in 2009 comparedto 2007).

The number of animals treated by intra-mammary route decreases of 15.4 % compared to

2008 and of 28.7 % compared to 1999.

Exposure to antimicrobials

The antimicrobial exposure index (ALEA: Animal Level of Exposure to Antimicrobials) isobtained by dividing the weight of animal treated by the weight of the animal populationpotentially treated.The ALEA index is an estimate that is strongly correlated to the number of animal treated in

the population and is a good output to evaluate the exposure to antimicrobials.

When comparing 2009 and 1999 results, the ALEA index representing the exposure to

antimicrobials (for the oral and parenteral routes), irrespective of classes and species,

increases of 12.6 %. Compared to 2008, the ALEA index decreases of 3.9 %.

The evolution on the last two years shows a change in the trend observed until 2007, this

reduction of the exposure has to be confirmed the next years.

Between 1999 and 2009, 16 new marketing authorizations of veterinary medicine products

with Fluoroquinolones have been granted (18 in 1999 vs. 34 in 2009), over this same time,

0,000

0,100

0,200

0,300

0,400

0,500

0,600

0,700

0,800

0,900

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

Evolution of the exposure to antimicrobialsOral and parenteral routes (ALEA)

Oral route (including premixes) Premixes

Parenteral route Total (oral and parenteral routes)

3

the level of exposure has increased of 93.6 % for Fluoroquinolones and has decreased of

53.8 % for Quinolones. Compared to 2008, the level of exposure to Fluoroquinolones has

decreased of 0.85 %.

Compared to 1999, the number of marketing authorizations of veterinary medicine products

with 3rd and 4th generation Cephalosporins has doubled (6 in 1999 vs. 12 in 2009). Over this

same time, the level of exposure to 3rd and 4th generation Cephalosporins has increased of

254.7 % and the level of exposure to 1st and 2nd generation Cephalosporins has increased of

43.8 %. Compared to 2008, the level of exposure to 3rd & 4th generation Cephalosporins has

decreased of 14.8 %.

Discussion

The methodology implemented in this antimicrobials sales survey does not allow to describe

with precision the off label use, even if the new approach implemented in 2009 (estimate of

the repartition between species by MA holders) takes partly into account this type of use.

Complementary field studies have been or should be performed in order to complement the

information obtained with this national antimicrobials sales survey. The important decrease of

the sold tonnage observed between 1999 and 2009, is mainly due to the use of new

antimicrobials replacing antimicrobials belonging to older classes like Tetracyclines and

Sulfonamides.

Fluoroquinolones and Cephalosporins are considered as critically important antimicrobials for

human health and the increase of their use in veterinary medicine is worrying. According to

European recommendations (European Medicine Agency reflection paper ion the use of

Cephalosporins and Fluoroquinolones) these antimicrobials should be second intent

antimicrobials and reserved to curative treatment.

The data collected allow to follow the evolution of the antimicrobial sales and to have an

estimation of their use in veterinary medicine. Information is one indicator to evaluate the

impact of actions implemented in term of responsible use of antimicrobials.

4

Contents

Introduction .............................................................................................................................6

1. Material and methods.........................................................................................................6

2. Results for 2009................................................................................................................12

2.1. Results presented by antimicrobial class and route of administration..........................12

2.1.1. Results expressed in weight of active ingredient...........................................12

2.1.2. Results expressed as proportion of antimicrobial treatment ..........................14

2.2. Results presented by animal species ..........................................................................15

2.2.1. Results presented by category of animals.....................................................15

2.2.2. Results presented by target species .............................................................16

3. Evolution of antimicrobial sales between 1999 and 2009..............................................18

3.1. Overall evolution of antimicrobial sales .......................................................................18


3.1.2. Results expressed in weight of animal treated ..............................................18

3.2. Evolution of antimicrobial sales per antimicrobial class ...............................................20


3.2.2. Results expressed in weight of active ingredient related to animal

population...............................................................................................................21

3.2.3. Results expressed in weight of animal treated ..............................................23

3.2.4. Results expressed as Animal Level of Exposure to Antimicrobials

(ALEA)....................................................................................................................24

3.2.5. Comparison of different outputs to describe the evolution of

antimicrobial sales .............................................................................................................25

3.3. Evolution of antimicrobial sales per animal species.....................................................26

4. Discussion ........................................................................................................................31

5. Conclusion........................................................................................................................32

5

Annex ....................................................................................................................................33

Annex 1: Parameters for calculation of animal body weight potentially treatedby antimicrobials between 1999 and à 2009

Annex 2: Amount of active ingredient per substance to treat orally one ton of

bodyweight)

Annex 3: Comparison between the bodyweight treated by ingredient or by

medicinal product

Annex 4: Repartition of antimicrobial sales by antimicrobial class for each

species

Annex 5: Evolution of bodyweight treated for bovine, pig, poultry, dogs and

cats

6

Introduction

Antimicrobial resistance is a public health issue concerning both human and veterinary

medicine. Sales monitoring is one of the basic source of information to be used for risk

assessment and risk management.

The National Agency for Veterinary Medicinal products (French agency for food, environment

and occupational health safety previously called French Food Safety Agency) has initiated a

sales survey for veterinary antimicrobials products in 1999. This survey is performed

according to the OIE guideline on monitoring of antimicrobials (in Animal Terrestrial Code

2009 – Chapter 6.8).

This survey is based on marketing authorization holders’ declarations following an

agreement with the SIMV (Syndicat de l’industrie du médicament vétérinaire et réactifs).

Data should be compared to other sources of information such as annual turnover of

applicant supplier medicinal veterinary products and farm surveys on antimicrobial

consumptions.

The present report describes the veterinary antimicrobial sales for 2009 and includes a study

on the previous year’s results.

1. Material and Methods

1-1. Basic sources of information

- Information provided by the Marketing Authorization Holder

The monitoring is based on a questionnaire sent annually to each Marketing Authorisation

Holder who has registered in France a veterinary medicinal product containing

antimicrobials. Marketing Authorisation Holders are asked to declare the number of units sold

for each commercial presentation of each veterinary medicinal product. In 2009, the

applicants were required to provide also information about the repartition between species.

These figures should be supplied for the period from 1st January to 31st December of the

previous year and cover all Medicinal products sold.

- Data about the French animal population

In order to take into account fluctuations in animal population in the interpretation of data,

information published by Agreste1 are used for food producing animals.

For pets, data are provided by FACCO2 (Employers' federation of Food Manufacturers for

Dogs, Cats, Birds and other familiar animals), data are available every two years.

1 http://agreste.agriculture.gouv.fr/

7

For fishes, data provided by Aquamedia3 are used.

- Information about the posology and the treatment duration

The dose and treatment duration retained for each active ingredient for the oral route

administrated to food animal producing are detailed in annex 2. For each intramammary and

injectable product, the dosage and duration of administration from the French SPC have

been retained.

1-2. Data validation

In order to check for any declaration errors, sales volumes declarations are compared to

annual turnover declarations provided independently by marketing authorisation holders. Any

difference in declarations is investigated.

1-3. Calculation and interpretation

The sales data for each presentation are cross-referenced with data available in the French

Agency of Veterinary Medicinal Products database (qualitative and quantitative composition,

pharmaceutical form, target species…).

Calculations are performed to express the sales in weight of active ingredient. For someactive substances expressed in IU, a conversion factor (OMS standard value) has beenused:

3200 IU for 1 mg of Spiramycin8403 IU for 1 mg of Polymyxin B20500 IU for 1 mg of Colistin sulphate12700 IU for 1 mg of Colistine méthane sulphonate

74 IU for 1 mg of Bacitracin

820 IU for 1 mg of Dihydrostreptomycin

920 IU for 1 mg of Erythromycin

620 IU for 1 mg of Gentamicin.

These conversion factors have been updated for the survey 2009 taking into account

recommendations of the European Medicines agency (EMA) in the framework of the

European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) project.

2 http://www.facco.fr3 http://www.aquamedia.org

8

Repartition between species

It is difficult to give figures for each animal species as a same veterinary medicinal product

can be indicated for use in several species, therefore an estimation of sales per species has

to be performed.

In 2009, the applicants were required to provide information about the repartition betweenspecies for each commercial presentation.

We have received information about this repartition for 60.7 % of the presentations of

veterinary medicine products targeted to more than one species. Globally, including the

products targeted to only one species, information for 74 % of the presentations of marketed

products are available. Information is available for 88.2 % of the total sold tonnage.

For the veterinary medicine products without information on the species repartition, an

extrapolation of the repartition was done from antimicrobials of the same class and same

route of administration.

This methodology has been applied retrospectively to the sales between 1999 and 2009.

Expression of results

In this report, different outputs are provided:

- Results expressed in weight of the active ingredient (Wacti)

This way of expressing results is the most direct and usual way. However, if it enables to see

evolution during time, it does not represent accurately the use of antimicrobials as

differences in dosages and durations of administration are not taken into account. It does not

enable comparison between classes of antimicrobials and does not take also into account

changes in animal populations.

- Results in weight of the active ingredient related to the animal populationweight (Wacti/WAP)

This indicator improves the expression of antimicrobial sales in taking into account changes

in animal populations. However, it does not take into account the dose and treatment

duration. This constitutes a better estimate of the use and enables to give results expressed

in quantity of active by Kg of animal weight.

- Results expressed in Weight of Animal Treated (WAT)

The weight of animal treated with the antimicrobial class is obtained by dividing the sales

volume expressed in weight of active ingredient by (dose multiplied by Treatment duration).

The dose and treatment duration retained for the different substances administered orally to

food producing animals are presented in annex 2. For each intramammary and injectable

product, the dosage and duration of administration in the French SPC have been retained.

In this report, the weight of animal treated has been calculated by active ingredient, to

evaluate the exposure per class. As several veterinary medicine products are asociated, the

weight of animal treated assessed by active ingredient is higher than the weight of animal

9

treated estimated by product (see annex 3). The weight of animal treated is linked to the

recommended doses and treatment durations which may be different from those prescribed.

WAT takes into account the dose and duration of administration but doesn’t take into account

the weight of animal population.

This constitutes a better estimate of the use of the different antimicrobial classes than the

weight of the active ingredient and allows to estimate the relative part of the treatments

performed for each antimicrobial class.

- Results presented as exposure index (ALEA) (Animal Level of Exposure toAntimicrobials)

The antimicrobial exposure index is obtained by dividing WAT by the Potential Animal Weight

treated (WAP). It takes into account the animal population as well as dose and treatment

duration. As figures concerning the animal population are usually expressed in number of

animals, it is necessary to estimate a mean weight for each animal species in order to obtain

the potential weight to be treated (WAP= Weight of Animal Population). Calculated WAP are

provided in annex 1. The estimation of animal level of exposure to antimicrobials could be

improved in taking into account the weight of animal at treatment instead of the total weight

of animals in the country.

This index may also enable comparisons between countries.

The ALEA index is an estimate that is directly correlated to the number of animal treated in

the population.

Data

Wacti Weight Active declared Dose Number of mg active / Kg body weight Duration Number of days of treatment WAP Weight of animal population potentially treated(Total)

Outputs

Wacti Weight Active Wacti/WAP Weight Active declared/ Weight of animal population WAT Weight of animal treated : Wacti/(Dose*Duration) ALEA Animal Level of Exposure to Antimicrobials

10

Outputs Calculation Units

Takes into account Enables comparison between

Representative

of exposureSales Dose Duration

Animal

Pop

AM

Classes Species Countries

Animal

and

Human

Wacti Weight active Tons + - - - - + + + +

Wacti/WAP (1000*Wacti)/WAPmg/Kg Animal

weight + - - + - ++ ++ ++ ++

WATWacti/(Dose*duration) Tons + + + - +++ +++ +++ +++ +++

ALEAWAT/ Weight Animal

population

Ratio + + + + ++++ ++++ ++++ ++++ ++++

11

1-4. Main changes for the 2009 report in comparison to previous reports

The weights of active ingredients for some classes for the previous years may differ from

those provided in the previous reports, as new conversion (IU/mg) have been used for some

antimicrobials.

The repartition between species has been modified and is based on data provided by

marketing authorisation holders.

The weight of animal treated for injectable products has been assessed by active ingredient

and not by medicinal product.

12

2. Results for 2009

2.1. Results presented by antimicrobial class and route of administration

2.1.1 Results expressed in weight of active ingredient

Table 1: Distribution of each antimicrobials family per route of administration

(in tons of active ingredient)

Sales 2009 Oral Parenteral Intra-mammary

External Total(in tons)

Percentage

Aminoglycosides 29.15 39.74 2.30 0.21 71.40 6.69%

Cephalosporins 1 & 2G 5.02 0.12 1.45 0.05 6.64 0.62%

Cephalosporins 3 & 4G 0.00 1.59 0.23 0.00 1.83 0.17%

Other 17.07 0.71 0.34 0.00 18.12 1.70%

Fluoroquinolones 2.62 2.27 0.00 0.01 4.90 0.46%

Furans 0.02 0.00 0.00 0.00 0.02 0.00%

Macrolides 70.04 10.28 0.11 0.02 80.45 7.54%

Penicillins 51.32 51.35 2.84 0.38 105.89 9.92%

Phenicols 0.03 4.76 0.00 0.23 5.02 0.47%

Polymyxins 64.43 0.52 0.01 0.01 64.97 6.09%

Quinolones 7.52 0.02 0.00 0.00 7.54 0.71%

Sulfonamides 177.62 4.89 0.00 1.22 183.73 17.21%

Tetracyclines 476.85 8.43 1.27 2.07 488.61 45.78%

Trimethoprim 27.73 0.47 0.00 0.00 28.20 2.64%

Total (in tons) 929.41 125.15 8.55 4.23 1067.35 100.00%

Percentage 87.08% 11.73% 0.80% 0.40% 100.00%

In 2009, the total sales volume accounts for 1067.35 tons of antimicrobials. As for previous

surveys, 4 antimicrobial classes (Tetracyclines, Sulfonamides, Penicillins and Macrolides)

account for more than 80 % of the total antimicrobial sales. The Tetracyclines class

represents alone about half of the sales. Fluoroquinolones and Cephalosporins volumes are

relatively low.

13

The following table gives the relative distribution of each antimicrobial class per route of

administration.

Table 2: Relative distribution of each antimicrobials class expressed in percentage for each

route of administration (%)

Sales 2009 Oral Parenteral Intra-mammary

External

Aminoglycosides 3.14% 31.75% 26.90% 4.96%

Cephalosporins 1 & 2G 0.54% 0.10% 16.97% 1.18%

Cephalosporins 3 & 4G 0.00% 1.27% 2.73% 0.00%

Other 1.84% 0.57% 3.96% 0.00%

Fluoroquinolones 0.28% 1.82% 0.00% 0.24%

Furans 0.00% 0.00% 0.00% 0.00%

Macrolides 7.54% 8.22% 1.25% 0.47%

Penicillins 5.52% 41.03% 33.21% 8.98%

Phenicols 0.00% 3.80% 0.00% 5.44%

Polymyxins 6.93% 0.41% 0.14% 0.24%

Quinolones 0.81% 0.02% 0.00% 0.00%

Sulfonamides 19.11% 3.91% 0.00% 28.84%

Tetracyclines 51.31% 6.73% 14.83% 48.94%

Trimethoprim 2.98% 0.37% 0.00% 0.00%

Percentage 100.00% 100.00% 100.00% 100.00%

14

2.1.2 Results expressed in weight of active ingredient (Wacti)

and in weight of animal treated (WAT)

The weight of animal treated by the antimicrobial classes has been obtained by dividing the

weight of active ingredient of each active by the amount of antimicrobial required to treat one

kg of animal (recommended doses and treatment durations which may be different from

those prescribed).

The weight of animal treated has been summed up for each antimicrobial class and divided

by the sum of WAT of all classes of antimicrobials for the oral, the parenteral and the intra-

mammary routes.

Results obtained in weight of active ingredients and in weight of animal treated expressed in

percentage are compared in the following table.

Table 3. Comparison by route of administration of the results obtained using the Weight of

active ingredients (Wacti) and the relative Weight of Animals Treated (WAT).

Oral Parenteral Intra-mammary

Sales 2009 Wacti WAT Wacti WAT Wacti WAT

Aminoglycosides 3.14% 2.64% 31.75% 17.20% 26.90% 19.69%

Cephalosporins 1 & 2 G 0.54% 0.11% 0.10% 0.04% 16.97% 14.22%

Cephalosporins 3 & 4 G 0.00% 0.00% 1.27% 7.66% 2.73% 6.49%

Others 1.84% 2.63% 0.57% 0.78% 3.96% 22.28%

Fluoroquinolones 0.28% 1.34% 1.82% 7.59% 0.00% 0.00%

Furans 0.00% 0.01% 0.00% 0.00% 0.00% 0.00%

Macrolides 7.54% 3.64% 8.22% 13.26% 1.25% 0.73%

Penicillins 5.52% 10.98% 41.03% 32.97% 33.21% 19.12%

Phenicols 0.00% 0.01% 3.80% 3.61% 0.00% 1.29%

Polymyxins 6.93% 35.05% 0.41% 2.45% 0.14% 0.00%

Quinolones 0.81% 1.23% 0.02% 0.01% 0.00% 0.00%

Sulfnamides 19.11% 9.66% 3.91% 1.59% 0.00% 0.00%

Tetracyclines 51.31% 27.11% 6.73% 11.64% 14.83% 16.18%

Trimethoprim 2.98% 5.59% 0.37% 1.20% 0.00% 0.00%

Percentage 100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

Results expresses in weight of animals treated give a better picture of the use of

antimicrobials.

For the oral route, sales expressed in the weight of animal treated show that treatments with

Polymyxins are the most frequent treatments used followed by Tetracyclines.

For the parenteral route, Penicillins are the most frequent treatments used followed by

Aminoglycosides, Macrolides, and Tetracyclines.

The weight of animal treated with Fluoroquinolones and 3rd & 4th generation Cephalosporins

represent respectively 7.59% and 7.66 % of the total weight of animal treated with injectable

products.

15

2.2. Results presented by animal species

2.2.1 Results presented by category of animals

A first way of approaching the repartition between species is to present data using categories

of animals according to veterinary medicinal products indications (Food producing animals,

Companion animals, Food producing and companion animals).

This enables to have a first estimate of the use of antimicrobials in these different categories.

Table 4. Repartition for each antimicrobials class by animal category (in tons of active

ingredient)

Sales 2009Food

animals

Food animals and

companion

animals

Companion

animals

Total (in

tons)

Aminoglycosides 43.25 27.65 0.50 71.40

Cephalosporins 1 & 2G 1.51 - 5.14 6.64

Cephalosporins 3 & 4G 1.74 - 0.08 1.83

Others 15.74 0.66 1.72 18.12

Fluoroquinolones 4.37 0.14 0.39 4.90

Furans - - 0.02 0.02

Macrolides 78.98 0.20 1.27 80.45

Penicillins 67.64 32.28 5.98 105.89

Phenicols 4.76 0.15 0.11 5.02

Polymyxins 64.85 0.11 - 64.97

Quinolones 7.53 - 0.01 7.54

Sulfonamides 177.89 2.86 2.98 183.73

Tetracyclines 487.77 0.45 0.40 488.61

Trimethoprim 27.90 0.26 0.04 28.20

Total (in tons) 983.93 64.76 18.65 1067.35

Antimicrobials intended for food producing animals only account for more than 92 % of the

total antimicrobials sales. Furans are only intended for use in companion animals.

16

2.2.2 Results per species

Sales by species have been expressed in percentage of total weight of active ingredient and

in percentage of total weight of animal treated, detailed tables are available in annex 4.

Table 5. Antimicrobials sales repartition by species according to different outputs

CattleCat -Dog

Horse Fish RabbitSheep-Goat

Swine Poultry Others Total

Wacti % 16.07 % 1.83 % 0.51 % 0.24 % 7.82 % 7.18 % 43.87 % 22.46 % 0.01 % 100 %

WAT % 29.31 % 3.24 % 1.24 % 0.09 % 3.37 % 4.73 % 32.91 % 25.10 % 0.01 % 100 %

- Wacti Weight of active ingredient

This output allows to estimate that nearly 44 % of the sold tonnage of antimicrobials is

intended for pigs, more than 22 % is intended for poultry.

When expressed in active ingredients, results are not representative of the “exposure” to

antimicrobials of the animal species.

- WAT Weight of animal treated: Wacti/(Dosage*Duration)

Nearly 30 % of the weight of animal treated relates to cattle, almost 33 % to swine and 25 %

to poultry.

Expressing results in weight of animals treated takes into account posology and duration of

treatments but does not take into account the population treated.

When the mass of the population potentially treated is taken into account this gives a better

picture of the use of antimicrobials in the different species (e.g. table 6).

Table 6. Antimicrobials sales by species expressed in mg/Kg and in ALEA

CattleCat -

DogHorse Fish Rabbit

Sheep-

GoatSwine Poultry Others Total

Wacti/Wap mg/Kg 17.83 122.18 23.65 53.46 902.56 119.42 153.57 127.11 4.05 67.73

ALEA 0.33 2.17 0.58 0.19 3.90 0.79 1.16 1.43 0.04 0.68


17

- ALEA Index of animal level of exposure to antimicrobials

The ALEA factor represents the best the exposure to antimicrobials as it takes into account

the dose administered, the duration of treatment as well as the animal population potentially

treated.

If the ALEA is equal to 1, it means that the weight of animal treated is exactly the same than

the weight of population animal. An ALEA of 33 % for cattle means that in 2009, the sales

intended for cattle have been used to treat 33 % of the bodyweight of cattle produced in

France

This shows that cats and dogs, rabbits, pigs and poultry are the most exposed species to

antimicrobial treatments.

These figures should be taken with caution as the use in young and older animals can be

different. So for cattle, the antimicrobials administrated by the oral route are intended only to

veals, our estimation shows that the ALEA for veals is close to the ALEAs for swine and

poultry.

The assessment of animal level of exposure to antimicrobials may be improved in taking into

account the weight of animal during the treatment instead of the total weight of animals in the

country.

18

3. Evolution of antimicrobial sales between 1999 and 2009

3.1. Overall evolution of antimicrobial sales

3.1.1. Results expressed in weight of active ingredient

Table 7. Evolution of weight of active ingredient according to the route of administration (Wacti)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Oral 1 135.81 1 203.66 1 201.33 1 164.68 1 144.69 1 127.54 1 170.59 1 104.34 1 237.81 1 078.38 929.41

includingpremixes

826.88 851.25 798.34 710.8 671.29 641.57 651.84 621.41 705.57 618.33 514.30

Parenteral 167.41 169.11 166.13 158.39 152.55 140.88 143.11 145.54 133.84 133.27 125.15

Intra-mammary 12.82 13.29 12.70 12.76 12.76 11.26 11.17 10.84 10.36 10.37 8.55

External 6.03 5.65 5.71 5.34 5.25 4.52 4.6 4.47 4.55 4.47 4.23

Total (in tons) 1 322.07 1 391.70 1 385.87 1 341.18 1 315.25 1 284.21 1 329.47 1 265.19 1 386.56 1 226.49 1 067.35

During the 11 years survey, the total antimicrobial sales range between 1 067.35 and1 391.70 tons.2009 sales represent the lowest sales volume recorded during the 11 years period. In 2009,

the total antimicrobials sales have decreased from 12.98 % compared to 2008 and from

19.27 % compared to 1999, these decrease is principally due to a decrease of oral

administered antimicrobials.

3.1.2 Results expressed in weight of animal treated 4

The weight of animal treated can be calculated by active ingredients or by medicinal product.

The calculation by active ingredient is an estimate of the exposure to each active ingredient

and is representative of the exposure to antimicrobial or to the antimicrobial family

considered. The calculation by medicinal product is an estimate of the number of treatments

administered (a medicinal product may contain one or several antibiotics) and is

representative of the number of prescriptions of medicinal products containing antimicrobials.

The expression by medicinal product or by active ingredient has a low impact regarding the

global evolution as shown when comparing for the parenteral route, weight of animal treated

expressed by active ingredient or by medicinal product (annex 3). In the remainder of this

report, results expressed in weight of animal treated (WAT) have been calculated for each

active ingredient and are representative of the evolution of the exposure to antibiotics.

4 Excluding external route

19

Table 8. Evolution of WAT according to the route of administration

WAT 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

IntonsofWAT

Oral 6 724 870 7 433 466 7 701 545 7 966 744 7 983 600 7 877 316 8 397 713 8 188 646 8 861 289 7953 422 7 585 251

includingpremixes 3 136 547 3 155 024 2 996 375 2 774 720 2 628 494 2 482 174 2 506 340 2 417 094 2 739 454 2 324 516 2 125 688

Parenteral 3 667 945 3 695 392 3 682 501 3 570 065 3 577 668 3 334 326 3 462 810 3 615 217 3 366 860 3 344 192 3 130 936

Total Oral +Parentéral

10 392 814 11 128 857 11 384 046 11 536 809 11 561 268 11 211 642 11 860 522 11 803 864 12 228 148 11 297 614 10 716 188

For intra-mammary products, results are expressed in number of animals treated by product.

Table 9. Evolution of the number of animals treated by intra-mammary route

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Innumberofanimalstreated

Intra-mammary 7 450 793 7 586 776 6 854 031 7 092 073 7 181 681 6 330 748 6 363 945 6 358 545 6 070 081 6 282 949 5 313 764

The weight of animal treated by parenteral route decreases from 14.6 % in 2009 comparedto 1999.

The weight of animal treated by oral route increases from 12.8 % in 2009 compared to 1999.However, a decrease is noticed for the 2 last years (a decrease of 14.4 % in 2009 comparedto 2007). For the premixes, the decrease is of 32.2 % compared to 1999.

The number of animals treated by intra-mammary route decreases of 15.4 % compared to

2008 and of 28.7 % compared to 1999.

20

3.2. Evolution of antimicrobial sales per antimicrobial class

3.2.1 Results expressed in weight of the active ingredient

Table 10. Evolution of sales by antimicrobial class from 1999 to 2009 (Wacti in tons)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Aminoglycosides 81.52 89.78 92.31 90.25 84.08 81.38 82.11 81.25 110.95 107.13 71.40

Cephalosporins 1 & 2G 5.17 5.20 5.13 5.91 6.33 6.41 6.90 7.01 6.97 6.85 6.64


Others 17.51 20.13 20.18 22.10 21.34 21.45 20.61 20.16 20.86 18.68 18.12

Fluoroquinolones 3.29 3.69 4.06 4.19 4.44 4.29 4.36 4.82 4.69 4.90 4.90

Furans 0.04 0.04 0.03 0.03 0.03 0.03 0.02 0.02 0.02 0.02 0.02

Macrolides 77.29 89.58 102.34 109.29 103.41 97.52 100.91 104.15 94.90 92.34 80.45

Penicillins 113.16 120.59 117.99 122.76 116.48 106.04 110.08 114.05 115.44 105.52 105.89

Phenicols 4.74 5.12 4.94 5.95 4.63 5.21 5.01 6.39 6.18 5.30 5.02

Polymyxins 63.08 66.14 67.59 64.47 65.33 61.42 64.52 65.12 72.27 64.28 64.97

Quinolones 20.53 16.75 15.02 16.05 14.22 12.73 13.68 13.81 11.05 8.02 7.54

Sulfonamides 269.62 275.90 249.86 232.38 213.07 212.57 218.35 210.71 226.90 195.50 183.73

Tetracyclines 627.76 659.18 669.28 632.79 648.14 640.09 665.81 602.70 680.46 586.25 488.61

Trimethoprim 37.46 38.56 36.15 33.85 32.47 33.71 35.50 33.13 33.85 29.56 28.20

Total (in tons) 1 322.07 1 391.70 1 385.87 1 341.18 1 315.25 1 284.21 1 329.47 1 265.19 1 386.56 1 226.49 1 067.35

In 2009, the weight sold of antimicrobials have decreased of 13.0 % (159 tons) compared to

2008 and of 19.3 % (255 tons) compared to 1999.

On the 11 years period, the 2 antimicrobial classes showing the more important decreases

are Tetracyclines (decrease of 22.2 % corresponding to 139 tons) and Sulfonamides

(decrease of 32.0 % corresponding to 86 tons)

Compared to 1999, Fluoroquinolone sales have increased (48.94 % corresponding to 1.61

tons) while Quinolones sales have decreased (63.3 % corresponding to 12.99 tons).

Compared to 2008, the sales of Fluoroquinolones have stabilized in 2009 (+0.09 %)

Compared to 1999, 3rd and 4th generation Cephalosporins sales have increased (105.6 %

corresponding to 0.94 ton) as well as 1st and 2nd generation Cephalosporins sales (28.4 %

corresponding to 1.47 tons). Compared to 2008, the sales of 3rd and 4th generation

Cephalosporins have decreased (- 13.7 corresponding to 0.29 ton).

21

3.2.2 Results expressed in weight of active ingredient related to

animal population

As figures concerning the animal population are usually expressed in number of animals, it is

necessary to estimate a mean weight for each animal species in order to obtain the potential

weight to be treated (WAP= Weight of Animal Population). Calculated WAP are provided in

annex 1.

Table 11. Evolution of weight of animal population for the main species (in tons)

Table 12. Evolution of sales by antimicrobial class from 1999 to 2009 related to weight of

animal population (Wacti/WAP) mg/Kg

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 1.02 1.15 1.13 1.27 1.27 1.29 1.30 1.28 1.31 1.17 1.15


Furans 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Macrolides 4.49 5.12 5.71 6.30 6.16 5.87 6.35 6.63 5.98 5.78 5.11

Penicillins 6.58 6.89 6.58 7.08 6.94 6.38 6.93 7.26 7.27 6.61 6.72

Phenicols 0.28 0.29 0.28 0.34 0.28 0.31 0.32 0.41 0.39 0.33 0.32

Polymyxins 3.67 3.78 3.77 3.72 3.89 3.69 4.06 4.14 4.55 4.03 4.12

Quinolones 1.19 0.96 0.84 0.93 0.85 0.77 0.86 0.88 0.70 0.50 0.48

Sulfonamides 15.67 15.78 13.94 13.40 12.69 12.79 13.75 13.41 14.29 12.24 11.66

Tetracyclines 36.48 37.69 37.33 36.48 38.61 38.51 41.92 38.35 42.86 36.71 31.01

Trimethoprim 2.18 2.20 2.02 1.95 1.93 2.03 2.23 2.11 2.13 1.85 1.79

Total (in mg/Kg) 76.82 79.57 77.29 77.32 78.35 77.25 83.71 80.49 87.33 76.81 67.73

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

10 285 016 10 462 230 10 746 167 10 437 034 9 982 250 9 859 000 9 143 431 9 420 210 9 526 948 9 700 673 9 620 022Cattle

3 202 499 3 214 804 3 306 399 3 247 556 3 219 822 3 174 154 3 110 997 3 086 594 3 100 280 3 100 153 3 049 116Swine

2 421 512 2 470 977 2 536 974 2 335 402 2 285 308 2 289 904 2 315 744 1 932 728 2 025 204 1 942 188 1 886 008Poultry

57 320 59 630 59 050 59 800 56 500 59 500 59 500 48 467 48 959 48 872 48 872Fish

156 300 157 500 169 600 170 380 167 800 167 410 167 410 161 360 161 360 159 800 159 800Cat-dog

749 764 757 235 741 735 728 090 713 644 704 974 718 011 704 067 673 747 653 805 641 911Sheep-goat

112 038 109 133 108 549 106 489 100 312 103 170 102 401 101 516 103 136 102 972 92 471Rabbit

224 878 257 788 261 240 257 977 262 136 264 983 239 346 237 066 262 983 259 503 260 470Others

Total 17 209 326 17 489 296 17 929 713 17 345 728 16 787 772 16 623 095 15 882 603 15 717 771 15 877 027 15 967 966 15 758 670

22


Results expressed in weight of active ingredient taking into account the animal population

show nearly the same trends than results expressed in weight of active ingredient. The sales

of 1st and 2nd generation Cephalosporins increase of 40.5 %, the sales of 3rd and 4th

generation Cephalosporins increase of 124.3 % and the sales of Fluoroquinolones increase

of 62.6 %.

For all the antimicrobial classes; except Penicillins, Fluoroquinolones and Polymyxins, the

sales expressed in weight of active ingredient related to the animal population have

decreased between 2008 and 2009.

23

3.2.3 Results expressed in Weight of animal treated (WAT)

Table 13. Evolution of sales by antimicrobial class from 1999 to 2009 expressed in Weight of

animal treated (WAT) in tons (parenteral and oral treatments only)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Aminoglycosides922 440 988 743 989 469 962 768 889 765 887 627 881 302 872 726 996 212 952 316 739 166

Cephalosporins 1 & 2G6 925 6 917 7 863 8 060 8 691 9 026 9 811 9 807 9 805 9 544 9 121

Cephalosporins 3 & 4G73 831 111 297 119 836 136 105 156 278 165 155 197 707 242 681 261 260 285 150 239 780

Other175 196 197 055 207 472 227 324 209 858 202 052 214 846 225 313 234 244 230 645 223 510

Fluoroquinolones191 422 200 098 248 429 286 614 312 744 298 586 317 789 343 131 327 917 341 044 339 440

Furans1 168 1 104 956 867 873 796 710 646 657 602 489

Macrolides608 368 651 987 697 082 767 132 747 607 722 773 778 189 777 012 679 574 736 774 691 295

Penicillins1 999 127 2 157 071 2 131 015 2 119 091 2 114 225 1 901 595 1 980 102 2 042 995 2 065 517 1 876 987 1 864 915

Phenicols108 003 116 246 110 959 140 365 107 774 122 729 117 544 146 391 134 945 114 232 114 179

Polymyxins2 073 832 2 278 841 2 372 841 2 379 767 2 469 545 2 387 275 2 598 247 2 675 125 2 829 216 2 689 975 2 735 746

Quinolones230 536 202 622 185 702 187 012 168 192 150 209 159 541 161 560 130 806 96 102 93 375

Sulfonamides1 015 580 1 068 486 976 088 935 771 851 094 860 377 892 264 880 057 1 011 015 879 127 782 311

Tetracyclines2 415 219 2 552 947 2 743 673 2 797 483 2 963 281 2 934 857 3 123 866 2 887 756 3 013 761 2 606 784 2 420 927

Trimethoprim571 169 595 441 592 658 588 451 561 339 568 583 588 603 538 663 533 218 478 333 461 934

In tons of WAT 10 392 814 11 128 857 11 384 046 11 536 809 11 561 268 11 211 642 11 860 522 11 803 864 12 228 148 11 297 614 10 716 188

When comparing 2009 and 1999 results, the weight of animal treated (WAT) increases of

3.1 %.

Compared to 1999, the weight of animal treated with Fluoroquinolones has increased of

77.3 %, and the weight of animal treated with first generation Quinolones has decreased of

31.9 %. Compared to 1999, the weight of animal treated with 3rd & 4th generation

Cephalosporins has increased of 224.8 % and of 31.7% for 1st and 2nd generation

Cephalosporins.

Results expressed in WAT show also a decrease for all classes of antimicrobials in

comparison to 2008, except for Polymyxins (increase of 1.7 %).

In 2009 and compared to 2008, the weight of animal treated with Fluoroquinolones and with

3rd & 4th generation Cephalosporins both have decreased (minus 0.47 % for

Fluoroquinolones, and minus 15.9 % for 3rd & 4th generation Cephalosporins).

24

3.2.4 Results expressed as Animal Level of Exposure to

Antimicrobials (ALEA)

Table 14. Evolution of sales by antimicrobial class from 1999 to 2009 expressed in ALEA

(oral and parenteral routes only)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 0.010 0.011 0.012 0.013 0.013 0.012 0.014 0.014 0.015 0.014 0.014


Furans 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Macrolides 0.035 0.037 0.039 0.044 0.045 0.043 0.049 0.049 0.043 0.046 0.044

Penicillins 0.116 0.123 0.119 0.122 0.126 0.114 0.125 0.130 0.130 0.118 0.118

Phenicols 0.006 0.007 0.006 0.008 0.006 0.007 0.007 0.009 0.008 0.007 0.007

Polymyxins 0.121 0.130 0.132 0.137 0.147 0.144 0.164 0.170 0.178 0.168 0.174

Quinolones 0.013 0.012 0.010 0.011 0.010 0.009 0.010 0.010 0.008 0.006 0.006

Sulfonamides 0.059 0.061 0.054 0.054 0.051 0.052 0.056 0.056 0.064 0.055 0.050

Tetracyclines 0.140 0.146 0.153 0.161 0.177 0.177 0.197 0.184 0.190 0.163 0.154

Trimethoprim 0.033 0.034 0.033 0.034 0.033 0.034 0.037 0.034 0.034 0.030 0.029

ALEA 0.604 0.636 0.635 0.665 0.689 0.674 0.747 0.751 0.770 0.708 0.680

When comparing 2009 and 1999 results, the ALEA index, irrespective of classes and

species, increases of 12.6 %. Compared to 2008, the ALEA index decreases of 3.9 %.

The exposure to all generation Cephalosporins, Fluoroquinolones, Macrolides, Phenicols,

Polymyxins and Tetracyclines has increased; the exposure to Aminoglycosides, Quinolones,

Sulfonamides and Trimethorpim has decreased compared to 1999.

Compared to 1999, the level of exposure to Fluoroquinolones has increased of 93.6 %, in the

same time the exposure of Quinolones has decreased to 53.8 %. Compared to 2008, the

level of exposure to Fluoroquinolones has decreased of 0.85 %.

Compared to 1999, the level of exposure to 3rd & 4th generation Cephalosporins has

increased of 254.7 % and the level of exposure to 1st and 2nd generation Cephalosporins, has

increased of 43.8 %. Compared to 2008, the level of exposure to 3rd & 4th generation

Cephalosporins has decreased of 14.8 %.

25

3.2.5 Comparison of different outputs to describe the evolution of

antimicrobial sales

Table 15. Comparison between 2009 and 1999 sales with different indicators

Wacti Wacti/WAP WAT ALEA

Aminoglycosides -12.42% -4.35% -19.87% -12.49%Cephalosporins 1 & 2G 28.62% 40.46% 31.72% 43.85%Cephalosporins 3 & 4G 105.44% 124.35% 224.77% 254.67%Others 3.45% 12.97% 27.58% 39.32%Fluoroquinolones 48.91% 62.62% 77.33% 93.65%Furans -53.20% -48.89% -58.16% -54.31%Macrolides 4.09% 13.67% 13.63% 24.09%Penicillins -6.42% 2.19% -6.71% 1.87%Phenicols 5.91% 15.66% 5.72% 15.45%Polymyxins 2.99% 12.47% 31.92% 44.06%Quinolones -63.25% -59.87% -59.50% -55.77%Sulfonamides -31.86% -25.58% -22.97% -15.88%Tetracyclines -22.17% -15.00% 0.24% 9.46%Trimethoprim -24.72% -17.79% -19.12% -11.68%Evolution in 2009 related to 1999 -19.27% -11.83% 3.11% 12.60%

Table 15bis. Comparison between 2009 and 2008 sales with different indicators

Wacti Wacti/WAP WAT ALEA

Aminoglycosides -33.36% -32.47% -22.38% -21.35%Cephalosporins 1 & 2G -3.04% -1.75% -4.43% -3.16%Cephalosporins 3 & 4G -13.73% -12.59% -15.91% -14.79%Others -3.01% -1.72% -3.09% -1.81%Fluoroquinolones 0.03% 1.36% -0.47% 0.85%Furans -13.96% -12.81% -18.89% -17.81%Macrolides -12.88% -11.72% -6.17% -4.93%Penicillins 0.35% 1.69% -0.64% 0.68%Phenicols -5.29% -4.03% -0.05% 1.28%Polymyxins 1.07% 2.41% 1.70% 3.05%Quinolones -5.96% -4.71% -2.84% -1.55%Sulfonamides -6.02% -4.77% -11.01% -9.83%Tetracyclines -16.65% -15.55% -7.13% -5.90%Trimethoprim -4.61% -3.34% -3.43% -2.15%Evolution in 2009 related to 2008 -12.98% -11.82% -5.1% -3.9%

The comparison of sales, between 1999 and 2009 show different evolutions according to the

output chosen.

When comparing 2009 with 1999 results, the sales volume decreases of 19.27 %. When

taking into account the weight of the animal population potentially treated, the decrease is

only of 11.83 %. When expressing results in WAT, an increase of 3.11 % is seen. The ALEA

index representing the animal exposure shows an increase of 12.6 %.

26

This latter output shows that the exposure to 3rd & 4th generation Cephalosporins has been

multiplied by 3.5 between 1999 and 2009, and the exposure of animals to Fluoroquinolones

has been multiplied by 2.

When comparing 2009 results with 2008 results, the sales volume decreases of 12.98 %.

When taking into account the weight of animal population potentially treated, the decrease is

only of 11.82 %. When expressing results in WAT representing the number of treatments, a

decrease of 5.1 % is seen. The ALEA index representing the animal exposure shows a

decrease of 3.9 %.

3.3. Evolution of Antimicrobial sales per animal species for the oral and parenteral

routes

Results expressed in Weight of animal treated for the main target species

Details figures regarding the evolution of sales by antimicrobial classes in weight of animal

treated for cattle, cats and dogs, swine and poultry productions are provided in annex 5.

.

Table 16. Evolution of the use of antimicrobial classes in

1999 2000

Aminoglycosides 16.71% 16.96%

Cephalosporins 1 & 2G -

Cephalosporins 3 & 4G 1.73% 2.62%

Other 1.57% 1.45%

Fluoroquinolones 2.38% 2.33%

Furans -

Macrolides 10.96% 11.00%

Penicillins 31.57% 30.94%

Phenicols 3.08% 3.20%

Polymyxins 8.46% 8.69%

Quinolones 1.76% 1.75%

Sulfonamides 6.21% 6.12%

Tetracyclines 14.02% 13.48%

Trimethoprim 1.56% 1.46%

Percentage 100.00% 100.00%

According to the estimations, during the last

Penicillins, and Quinolones in the

decreased, whereas the parts of 3

Macrolides and Polymixins increased.

0,00%5,00%

10,00%15,00%20,00%25,00%30,00%35,00%

Bovine: distribution of antimicrobial

Evolution of the use of antimicrobial classes in cattle (except extern

mammary routes)

2000 2001 2002 2003 2004 2005

96% 16.68% 15.54% 15.39% 15.81% 14.84% 14

- - - - - -

62% 2.90% 3.25% 3.98% 4.31% 4.83%

45% 1.21% 1.21% 1.30% 1.30% 1.20%

33% 3.42% 4.27% 5.19% 4.75% 4.98%

- - - - - -

00% 11.23% 12.08% 12.87% 12.47% 13.13% 12

94% 30.61% 27.50% 25.12% 25.06% 24.26% 23

20% 3.08% 3.82% 3.11% 3.61% 3.30%

69% 9.08% 9.55% 9.81% 9.52% 9.76%

75% 1.64% 1.49% 1.43% 1.25% 1.44%

12% 5.64% 5.26% 4.93% 5.23% 5.23%

48% 12.81% 14.10% 15.01% 14.73% 15.21% 14

46% 1.70% 1.93% 1.86% 1.96% 1.82%

00% 100.00% 100.00% 100.00% 100.00% 100.00% 100

According to the estimations, during the last 11 years, the parts of Aminoglycosides,

Quinolones in the bodyweight of bovines treated with antimicrobials have

decreased, whereas the parts of 3rd and 4th generation Cephalosporins, Fluoroquinolone

increased.

Bovine: distribution of antimicrobial classes in WAT %

27

external and intra-

2006 2007 2008 2009

14.74% 18.19% 18.24% 13.81%

- - - -

5.27% 5.52% 6.35% 5.84%

1.11% 1.08% 1.07% 1.03%

5.54% 5.06% 5.32% 5.67%

- - - -

12.52% 10.35% 12.39% 13.47%

23.99% 22.91% 22.02% 23.36%

4.02% 3.69% 3.14% 3.08%

9.99% 10.21% 10.42% 11.65%

1.43% 1.06% 0.78% 0.92%

5.14% 6.73% 6.84% 5.54%

14.61% 13.77% 11.82% 13.91%

1.65% 1.44% 1.60% 1.70%

100.00% 100.00% 100.00% 100.00%

, the parts of Aminoglycosides,

with antimicrobials have

generation Cephalosporins, Fluoroquinolones,

Table 17. Evolution of the use of antimicrobial classes

1999 2000




Other 12.59% 10.80%


Furans 0.55% 0.54%









Percentage 100.00% 100.00%

According to the estimations, during the last

Cephalosporins, of others antimicrobials and of

cats treated with antimicrobials have increased.

0,00%5,00%

10,00%15,00%20,00%25,00%30,00%35,00%40,00%45,00%

Dogs and cats : Distribution of antimicrobial classes expressed in WAT %

Evolution of the use of antimicrobial classes in dogs and cats

(except external route)

2001 2002 2003 2004 2005 2006

8.47% 8.01% 7.16% 7.56% 6.41% 5.60%

3.86% 3.75% 3.56% 3.67% 3.54% 3.15%

0.00% 0.00% 0.00% 0.00% 0.00% 0.20%

9.93% 12.70% 11.68% 12.38% 18.84% 23.99%

20.51% 21.91% 18.75% 20.37% 16.51% 13.51%

0.47% 0.40% 0.36% 0.32% 0.26% 0.21%

3.21% 3.64% 2.62% 2.76% 2.29% 2.69%

37.47% 34.38% 43.41% 40.10% 41.42% 41.70%

0.22% 0.21% 0.19% 0.18% 0.17% 0.15%

0.81% 0.73% 0.67% 0.58% 0.51% 0.44%

0.33% 0.47% 0.32% 0.24% 0.23% 0.03%

9.42% 8.89% 7.23% 7.71% 5.87% 5.12%

3.67% 3.57% 3.12% 3.20% 3.28% 2.64%

1.64% 1.33% 0.94% 0.93% 0.67% 0.56%

100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

According to the estimations, during the last 11 years, the parts of 3rd

, of others antimicrobials and of Penicillins in the bodyweight

with antimicrobials have increased.


28

in dogs and cats

2006 2007 2008 2009

60% 5.18% 5.01% 4.40%

15% 2.92% 2.82% 2.63%

20% 1.11% 1.32% 1.46%

99% 25.35% 27.18% 27.65%

51% 14.33% 13.81% 15.20%

21% 0.20% 0.18% 0.14%

69% 1.75% 1.64% 1.53%

70% 40.47% 39.81% 39.90%

15% 0.13% 0.11% 0.09%

44% 0.34% 0.35% 0.30%

03% 0.10% 0.02% 0.05%

12% 4.91% 4.81% 3.92%

64% 2.72% 2.50% 2.35%

56% 0.50% 0.45% 0.38%

00% 100.00% 100.00% 100.00%

and 4th generation

bodyweight of dogs and


Table 18. Evolution of the use of antimicrobial classes in pigs

1999 2000


Cephalosporins 1 & 2G - -


Other 1.86% 2.34%


Furans - -









Percentage 100.00% 100.00%

According to the estimations, during the last 11 years,

Sulfonamides, Trimethoprim, Penicillins, Quinolones and Tetracyclines

pigs treated with antimicrobials have decreased, whereas the parts of 3

Cephalosporins, Fluoroquinolones,

0,00%

5,00%

10,00%

15,00%

20,00%

25,00%

30,00%

35,00%

Porcine: Distribution

Evolution of the use of antimicrobial classes in pigs (except

2001 2002 2003 2004 2005 2006

5.59% 5.56% 5.10% 4.98% 4.88% 4.64%

- - - - -

0.36% 0.42% 0.48% 0.52% 0.68% 1.28%

2.65% 2.98% 2.64% 2.44% 2.20% 1.91%

1.19% 1.36% 1.49% 1.48% 1.69% 1.76%

- - - - -

4.83% 5.57% 5.19% 5.17% 5.11% 5.41%

12.65% 12.97% 11.72% 11.54% 11.48% 12.01%

0.01% 0.00% 0.00% 0.00% 0.00% 0.00%

29.70% 29.41% 31.75% 31.27% 31.45% 31.74%

1.12% 1.00% 0.77% 0.89% 0.90% 0.84%

6.67% 6.78% 6.00% 6.53% 6.30% 6.66%

29.83% 28.31% 29.68% 29.59% 30.04% 28.35%

5.40% 5.64% 5.18% 5.59% 5.29% 5.40%

100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

According to the estimations, during the last 11 years, the parts of Aminoglycosides,

, Penicillins, Quinolones and Tetracyclines in the bodyweight of

with antimicrobials have decreased, whereas the parts of 3rd

Cephalosporins, Fluoroquinolones, Macrolides, Phenicols and Polymixins have increased.

Porcine: Distribution ofantimicrobial classes expressed in WAT %

29

external route)

2006 2007 2008 2009

64% 4.19% 4.06% 4.22%

- - - -

28% 1.28% 1.39% 1.35%

91% 1.76% 1.82% 1.69%

76% 1.39% 1.82% 1.94%

- - - -

41% 4.81% 4.81% 4.89%

01% 11.43% 10.94% 12.45%

00% 0.00% 0.03% 0.47%

74% 33.32% 33.84% 33.73%

84% 0.74% 0.72% 0.61%

66% 6.79% 6.98% 7.02%

35% 28.97% 28.07% 26.09%

40% 5.32% 5.52% 5.54%

00% 100.00% 100.00% 100.00%

the parts of Aminoglycosides, of

in the bodyweight ofrd and 4th generation

Polymixins have increased.

ofantimicrobial classes expressed in WAT %

Table 19. Evolution of the use of antimicrobial clas

1999 2000




Other 1.07% 1.15%


Furans 0.00% 0.00%









Percentage 100.00% 100.00%

According to the estimations, during the last 11 years,

Quinolones, Sulfonamides, Tetracyclines and Trimetoprim in the bodyweight of poultry

treated with antimicrobials have decreased,

Polymixins have increased.

The part of Fluoroquinolones in the bodyweight of treated poultry has

since 2005.

0,00%5,00%

10,00%15,00%20,00%25,00%30,00%35,00%40,00%45,00%

Poultry: Distribtion

Evolution of the use of antimicrobial classes in poultry (except

2001 2002 2003 2004 2005 2006

0.77% 0.58% 0.49% 0.48% 0.43% 0.39%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

1.26% 1.24% 0.98% 0.81% 0.66% 0.76%

1.48% 1.17% 1.16% 1.25% 1.06% 1.19%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

3.31% 3.33% 3.32% 3.53% 3.58% 3.60%

13.06% 15.45% 13.90% 12.73% 13.07% 14.09%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

31.49% 29.42% 29.97% 30.06% 31.42% 34.62%

2.68% 2.37% 2.27% 2.32% 2.05% 2.32%

9.27% 8.20% 7.63% 7.48% 6.87% 6.32%

29.50% 31.97% 34.28% 35.61% 35.49% 32.12%

7.17% 6.27% 5.99% 5.73% 5.37% 4.57%

100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

According to the estimations, during the last 11 years, the parts of Aminoglycosides

Tetracyclines and Trimetoprim in the bodyweight of poultry

with antimicrobials have decreased, whereas the parts of Macrolides, Penicillins and

Fluoroquinolones in the bodyweight of treated poultry has increase

Poultry: Distribtion of antimicrobial classes expressed in WAT %

30

except external route)

2006 2007 2008 2009

39% 0.38% 0.37% 0.42%

00% 0.00% 0.00% 0.00%

00% 0.00% 0.00% 0.00%

76% 0.76% 0.78% 0.69%

19% 1.32% 1.45% 1.49%

00% 0.00% 0.00% 0.00%

60% 3.23% 4.23% 3.29%

09% 16.20% 15.56% 15.19%

00% 0.00% 0.00% 0.00%

62% 33.36% 37.08% 40.52%

32% 1.76% 1.28% 1.37%

32% 6.29% 6.06% 5.81%

12% 32.56% 29.30% 27.39%

57% 4.14% 3.90% 3.84%

00% 100.00% 100.00% 100.00%

parts of Aminoglycosides,

Tetracyclines and Trimetoprim in the bodyweight of poultry

Macrolides, Penicillins and

increased gradually

of antimicrobial classes expressed in WAT %

31

4. Discussion

Results of antimicrobial sales monitoring should be taken into account with caution. In this

report different indicators have been used and describe different phenomena. It is always

important to use the appropriate indicator to describe a specific evolution.

The sales expressed in weight of active ingredient do not reflect the exposure to the different

classes because the antimicrobial therapeutic activity (the dose and duration of treatment) is

not taken into account. The expression of sales in 2009 in weight of animal treated shows a

none negligible use for some classes like Fluoroquinolones and Cephalosporins.

The methodology used for the repartition between species is different from previous reports

and takes into account data provided by applicants. For the veterinary medicinal products

without information on species repartition, we have extrapolated the repartition for

antimicrobials from the same class and same route of administration.

The sales of antimicrobials are expressed with different outputs, some are exact

measurements of the sales, others are based on estimations. The weight of active ingredient

and the weight of active ingredient per Kg of animal population are accurate measures not

based on estimates. The weight of animal treated (WAT) and the indicator of exposure

(ALEA) are estimated with the recommended doses and treatment durations which may be

different from those prescribed.

The weights of veals, rabbits, pigs and poultry are the weight at slaughter, these weights do

not correspond to the weight during treatments. The assessment of animal level of exposure

to antimicrobials would be improved in taking into account the weight of animal during the

treatment instead of the total weight of animals in the country.

The methodology implemented in this sales survey of antimicrobials does not allow

describing with precision the off label use, even if the new approach implemented in 2009

(estimation of the repartition between species by MA holders) takes partly into account this

type of use. Complementary field studies are or should be implemented in order to

complement the information obtained with this national sales survey of antimicrobials.

32

5. Conclusion

The 2009 sales, evaluated to 1067.35 tons, represent the lowest sales volume recorded

during the 11 years period.

To assess the exposure to antimicrobials, the weight of animal treated has been calculated

taking into account the recommended doses and treatment durations. When comparing 2009

and 1999 results, the weight of animal treated (WAT) increases of 3.1 %. According to our

estimations, compared to 1999, the exposure to antimicrobials has increased of 12.6 % in

2009. Compared to 2008, the ALEA index decreases of 3.9 %. This decrease of the sold

tonnage is mainly due to the use of new antimicrobials active in replacement of

antimicrobials belonging to older classes like Tetracyclines and Sulfonamides.

Fluoroquinolones and Cephalosporins are considered as critically important antimicrobials for

human health and the increase of their use in veterinary medicine is worrying. According to

European recommendations (European Medicine Agency reflection paper on the use of

Cephalosporins and Fluoroquinolones) these antimicrobials should be second intent

antimicrobials and reserved to curative treatment.

The evolution on the last two years shows a modification of the trend of increase observed

until 2007, this reduction of the exposure has to be confirmed the next years.

The data collected allow to follow the evolution of the antimicrobial sales and to have an

estimation of their use in veterinary medicine. Information is one indicator to evaluate the

impact of actions implemented in term of responsible use of antimicrobials.

33

Annex 1 : Parameters for calculation of animal body weight potentially treated by antimicrobials between 1999 and à 2009

Species

Mean weight 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

(Bodyweightin kg)

Companion animals (number of animals

Dogs 15 8 100 000 8 100 000 8 800 000 8 780 000 8 600 000 8 500 000 8 510 000 8 080 000 8 080 000 7 800 000 7 800 000

Cats 4 8 700 000 9 000 000 9 400 000 9 670 000 9 700 000 9 900 000 9 940 000 10 040 000 10 040 000 10 700 000 10 700 000

Birds 0,1 7 100 000 7 000 000 8 100 000 8 000 000 6 700 000 6 600 000 6 590 000 3 680 000 3 680 000 3 500 000 3 500 000

Low mammals 0,5 1 800 000 2 000 000 4 900 000 2 320 000 4 100 000 3 800 000 3 770 000 2 940 000 2 940 000 3 200 000 3 200 000

Race horses 450 269 400 348 294 343 300 345 900 344 500 350 600 349 652 346 337 345 406 346 494 347 513

Draught horses 850 79 700 70 170 74 800 75 400 75 200 76 000 76 575 76 535 76 825 73 743 74 324

Donkey 350 15 000 30 146 31 400 30 500 31 700 32 300 32 481 32 344 30 760 29 982 30 025

Sheep – goats (number of animals

Goats 50 1 075 000 1 156 000 1 242 000 1 208 000 1 240 000 1 218 000 1 224 759 1 227 819 1 226 355 1 283 124 1 335 678

Dairy ewes 60 1 297 000 1 379 706 1 325 000 1 309 000 1 307 000 1 300 000 1 349 910 1 334 715 1 314 564 1 349 110 1 374 332

Suckler ewes 80 5 157 000 5 199 858 4 902 000 4 781 000 4 648 000 4 583 000 4 730 533 4 590 146 4 320 716 4 136 127 4 005 712

Covered gimmers 45 937 000 917 000 900 000 922 000 887 000 866 000 847 078 810 625 774 5651 053 780 1 062 638

Non covered gimmers 20 348 000 329 000 327 000 325 000 346 000 344 000 363 365 331 323 316 372

Lambs 15 5 120 916 5 120 916 5 385 324 5 124 000 5 044 900 4 823 900 4 713 070 4 644 300 4 581 528 4 233 962 3 867 391

Other sheeps 45 1 771 000 1 689 000 1 789 000 1 784 000 1 785 000 1 805 000 1 805 653 1 838 377 1 733 165 1 650 198 1 640 429

Cattle (number of animals)

Dairy cows 650 4 424 000 4 153 000 4 195 000 4 128 000 4 026 000 3 948 000 3 957 858 3 877 817 3 869 936 3 863 435 3 747 886

Suckler cows 750 4 071 000 4 214 000 4 293 000 4 095 000 4 154 000 4 007 000 4 068 096 4 143 061 4 247 432 4 313 976 4 271 801

1 to 2 yrs dairy cows 350 1 350 846 1 418 000 1 433 000 1 396 000 1 388 000 1 347 0002 035 440 1 970 472

1 120 796 1 109 701 1 188 085

+ 2 yrs dairy cows 500 951 154 974 000 1 009 000 1 009 000 1 030 000 1 008 000 800 649 778 266 804 095

1 to 2 yrs suckler cows 450 980 827 1 044 000 1 085 000 1 009 000 959 000 962 0001 899 069 1 955 115

1 086 069 1 175 059 1 095 383

+ 2 yrs suckler cows 550 906 000 943 000 946 000 957 000 937 000 915 000 891 863 980 352 1 080 162

to 2 yrs other females 400 393 000 303 000 404 000 383 000 334 000 310 000535 667 531 663

295 220 304 547 294 743

+ 2 yrs other females 500 294 000 318 000 320 000 402 000 380 000 327 000 240 939 248 282 258 280

1 to 2 yrs bullocks575 577 000 598 000 598 000 686 000 606 000 550 000 481 770

+ 2 yrs bullocks

Non castrated cattle 650 971 562 918 000 1 105 438 906 509 754 000 774 000 633 675

0 to 1 yr cattle200

5 169 611 5 706 000 5 612 5625 494

4914 961 000 4 994 000

4 611368

4 947 374 5 002 669 4 989 176 4 816 839

1 to 2 yrs cattle 400 922 177 951 291 990 268 981 930

+ 2 yrs cattle 700 447 909 453 517 499 047 512 824

Veal calf 150 1 887 800 1 841 700 1 888 570 1 865 100 1 824900 1 749 500 848 793 778 995 779 912 794 831 753350

34

Annex 1 (suite) : Parameters for calculation of animal body weight potentially treated by antimicrobials between 1999 and à 2009

Species

Mean weight 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

(Bodyweight inkg)

Poultry (number of slaughtered animals)

Female rabbits 4 1 446 000 1 380 000 1 377 000 1 365 000 1 268 000 1 293 000 1 256 000 1 197 000 1 250 000 1 209 000 1 209 000

Rabbits 2,5 42 501 500 41 445 200 41 216 300 40 411 500 38 096 100 39 199 500 38 950 900 38 691 100 39 254 500 39 254 500 35 054 000

Broilers 1,2 777 100 000 735 200 000 782 500 000 728 700 000 736 100 000 694 300 000 717 200 000 636 200 000 699 500 000 711 900 000 718 400 000

Turkeys 10 105 581 000 113 863 000 112 382 000 98 624 000 95 632 000 93 900 000 93 900 000 72 800 000 70 200 000 62 900 000 58 000 000

Ducks 4 69 734 000 73 406 000 77 500 000 79 300 000 73 896 000 91 200 000 91 200 000 74 900 000 79 100 000 79 100 000 75 100 000

Guinea fowls 1,4 32 724 000 34 759 000 36 989 000 31 072 000 29 400 000 29 117 000 29 900 000 27 300 000 28 100 000 27 900 000 27 200 000

Laying hens 2 39 562 000 39 815 000 39 911 000 41 444 000 40 000 000 42 200 000 41 100 000 37 400 000 37 100 000 36 900 000 37 900 000

Pigeons 0,65 4 303 000 4 484 000 4 100 000 4 100 000 3 900 000 4 400 000 4 300 000 3 600 000 3 400 000 3 400 000 3 400 000

Quails 0,5 50 921 500 46 620 000 55 200 000 48 900 000 46 500 000 42 600 000 46 900 000 44 400 000 48 800 000 48 800 000 48 800 000

Gooses 8 481 000 610 000 617 000 709 000 710 000 567 000 500 000 678 000 633 000 656 000 656 000

Pigs (number of slaughtered animals) - - - - - - - -

Boars 350 610 000 579 000 582 000 582 000 547 000 521 000 491 939 484 950 471 395 445 213 418 876

Sows (number) 300 1 029 000 1 210 208 1 369 000 1 360 000 1 328 000 1 302 000 1 266 951 1 256 179 1 224 100 1 225 574 1 207 531

Porkers 105 25 531 000 25 225 000 24 813 000 25 102 000 25 066 000 24 772 000 24 368 984 24 190 550 24 457 730 24 539 585 24 192 857

Fish breeding (in kg) - - - - - - - -

Trouts 46 160 000 47 500 000 47 500 000 42 900 000 37 000 000 37 500 000 34 000 000 34 000 000 34 000 000 34 000 000 34 000 000

Carps 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000 6 000 000

Salmons - - - 5 000 000 8 000 000 10 000 000 1 200 000 1 900 000 1 800 000 1 800 000 1 800 000

Basses 3 150 000 3 600 000 3 000 000 3 500 000 3 700 000 3 800 000 4 300 000 5 000 000 4 764 000 3 874 000 3 874 000

Breams 1 000 000 1 400 000 1 700 000 1 500 000 1 100 000 1 300 000 1 900 000 1 900 000 1 392 000 2 153 000 2 153 000

Turbots 900 000 10 000 000 700 000 750 000 700 000 900 000 800 000 800 000 733 000 775 000 775 000

35

Annex 2: Amount of active ingredient per substance in g to treat orally one ton bodyweight)

Oraladministrationexcept Premix

Premix

AMINOGLYCOSIDE APRAMYCIN 200 105

DIHYDROSTREPTOMYCIN 500

FRAMYCETIN 60

GENTAMYCIN 20

NEOMYCIN 200 200

SPECTINOMYCIN 120 46,2

PENICILLIN AMOXICILLIN 50 100

AMPICILLIN 60 200

OTHERS CLAVULANIC_ACID 12

BACITRACIN 119,7 159,6

LINCOMYCIN 50 231

TIAMULIN 100 896

VALNEMULIN 112 112

FLUOROQUINOLONE DIFLOXACIN 50

ENROFLOXACIN 50

MARBOFLOXACIN 3

MACROLIDE ERYTHROMYCIN 60

JOSAMYCIN 45 45

SPIRAMYCIN 234,5 315

TILMICOSIN 100 300

TYLOSIN 250 560

PHENICOL FLORPHENICOL 50

POLYMYXINX COLISTIN 14,7 49

QUINOLONE OXOLINIC ACID 100 105

FLUMEQUIN 60 60

SULFONAMIDES SULFACLOZINE 180

SULFADIAZINE 175 460

SULFADIMERAZIN 80 500

SULFADIMETHOXINE 186,8 500

SULFAGUANIDINE 200

SULFAMETHOXPYRIDIAZINE 150 100

SULFAQUINOXALIN 40,32

TETRACYCLIN CHLORTETRACYCLIN 100 500

DOXYCYCLIN 50 100

OXYTETRACYCLIN 160 500

TETRACYCLIN 150 750

TRIMETHOPRIM TRIMETHOPRIM 40 100

36

Annex 3: Comparison between the bodyweight treated by ingredient or by medicinal product

Example of parenteral route

Table A3/1 : Comparison between the bodyweight treated by ingredient (WATai) or by medicine.(WATmed)Parenteral route, 1999 to 2009

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

WATai (tons) 3 667 945 3 695 391 3 682 501 3 570 065 3 577 668 3 334 326 3 462 810 3 615 217 3 366 860 3 344 192 3 130 936

WATmed (tons) 2 499 683 2 536 631 2 547 663 2 498 617 2 506 401 2 316 303 2 449 854 2 595 777 2 405 936 2 416 428 2 305 653

The bodyweight of animals treated expressed by medicinal product is around of 69.6 % of the bodyweight ofanimals treated expressed by active ingredient.

Table A3/2 : Evolution of the bodyweight treated according to the number of active ingredients (AI) permedicine

%WATai accordingto the number ofAIs 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

1 AI 38.3% 37.9% 38.6% 39.8% 40.3% 42.6% 43.0% 42.8% 44.4% 45.6% 48.3%

2 AIs 49.9% 50.8% 49.4% 48.5% 46.5% 40.5% 39.8% 40.5% 38.5% 37.9% 36.0%

3 AIs 11.8% 11.3% 12.0% 11.7% 13.2% 16.9% 17.3% 16.7% 17.1% 16.5% 15.7%

Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

On the 11 years survey period, the weight of animals treated with medicine containing only one activeingredient has increased.

In term of global evolution, the expression of bodyweight treated by active ingredient or by medicine haslittle influence.

Graphic 1: evolution of bodyweight treated by active ingredient (WATai) or by medicine (WATmed) for the

parenteral route

0

500 000

1 000 000

1 500 000

2 000 000

2 500 000

3 000 000

3 500 000

4 000 000

WATai

WATmed

37

Graphic 2: evolution of animal level of exposure to antimicrobials, when assessed by active ingredient

(ALEAai) or by medicine (ALEAmed) for the parenteral route

Table A3/3 : Comparison between animal level of exposure to antimicrobials assessed by ingredient

(ALEAai)or assessed by medicine.(ALEAmed)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

ALEAai 0.145 0.145 0.142 0.144 0.149 0.139 0.154 0.165 0.151 0.151 0.146

ALEAmed 0.213 0.211 0.205 0.206 0.213 0.201 0.218 0.230 0.212 0.209 0.199

0,000

0,050

0,100

0,150

0,200

0,250

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

ALEAai

ALEApa

38

Annex 4: The following tables give the repartition of antimicrobial sales by antimicrobial class for eachspecies

Table A4/1 : Antimicrobials sales by antimicrobial class and species in 2009 (tons of active ingredient)

Cattle Cat – Dog Horse Fish RabbitSheep-Goat

Swine Poultry Others

Aminoglycosides 34.14 1.10 1.10 - 12.45 4.28 16.09 2.24 0.01

Cephalosporins 1 & 2G 1.51 5.14 - - - - - - -

Cephalosporins 3 & 4G 1.43 0.04 0.06 - - - 0.30 - -

Other 1.03 1.73 0.00 - 5.62 0.00 8.11 1.63 0.00

Fluoroquinolones 1.77 0.41 0.00 - - 0.00 0.79 1.93 0.00

Furans - 0.02 - - - - - - -

Macrolides 15.93 1.27 0.01 - 0.49 0.10 48.01 14.63 0.02

Penicillins 43.28 6.16 2.42 - - 3.32 28.53 22.19 0.00

Phenicols 4.27 0.10 0.01 - - 0.05 0.58 - 0.02

Polymyxins 4.94 0.01 0.03 - 1.41 1.44 39.70 17.44 -

Quinolones 2.51 0.01 0.00 0.39 0.04 0.01 1.76 2.82 -

Sulfonamides 23.75 3.00 1.58 - 28.84 23.52 74.78 28.17 0.08

Tetracyclines 38.24 0.49 0.07 2.22 30.10 40.86 233.59 143.04 0.00

Trimethoprim 1.49 0.04 0.17 - 4.51 3.09 14.47 4.44 -

Total (in tons) 174.27 19.52 5.44 2.61 83.46 76.66 466.71 238.54 0.13

Table A4/2 : Antimicrobials sales by antimicrobial class and species in mg per kg

Cattle Cat – Dog Horse Fish RabbitSheep-Goat

Swine Poultry Others


Cephalosporins 1 & 2G 0.1566 32.1818 - - - - - - -


Other 0.1066 10.8313 0.0000 - 60.7957 0.0000 2.6595 0.8647 0.0001


Furans - 0.1161 - - - - - - -

Macrolides 1.6554 7.9188 0.0312 - 5.2535 0.1561 15.7457 7.7587 0.7408

Penicillins 4.4985 38.5326 10.5268 - - 5.1685 9.3583 11.7632 0.0800

Phenicols 0.4435 0.6318 0.0297 - - 0.0777 0.1888 - 0.6578

Polymyxins 0.5135 0.0768 0.1171 - 15.3014 2.2398 13.0186 9.2477 -

Quinolones 0.2609 0.0671 0.0191 7.9554 0.4522 0.0134 0.5770 1.4962 -

Sulfonamides 2.4690 18.8029 6.8882 - 311.8890 36.6475 24.5253 14.9364 2.5433

Tetracyclines 3.9753 3.0464 0.3049 45.5046 325.4641 63.6515 76.6101 75.8427 0.1102

Trimethoprim 0.1545 0.2759 0.7235 - 48.7958 4.8063 4.7466 2.3517 -

Total (in mg/kg) 18.1151 122.1768 23.6487 53.4600 902.5635 119.4321 153.0631 126.4767 4.4068

39

Table A4/3 : Antimicrobials sales by antimicrobial class and species in tons of WAT (weight of animalstreated) in 2009 (parenteral and oral treatment only)

Cattle Cat – Dog Horse Fish RabbitSheep-

GoatSwine Poultry Others

Aminoglycosides 433 841 15 280 15 063 0 71 752 43 119 148 724 11 342 44

Cephalosporins 1 & 2G 0 9 121 0 0 0 0 0 0 0

Cephalosporins 3 & 4G 183 365 5 069 3 739 0 0 0 47 607 0 0

Other 32 545 95 979 0 0 16 729 0 59 664 18 593 0

Fluoroquinolones 179 175 52 761 1 0 0 3 68 803 38 695 3

Furans 0 489 0 0 0 0 0 0 0

Macrolides 428 073 5 303 94 0 1 579 522 166 419 89 211 95

Penicillins 736 243 138 507 87 114 0 0 57 993 440 445 404 568 46

Phenicols 96 673 301 0 0 0 0 16 491 0 714

Polymyxins 366 027 1 051 2 744 0 30 087 56 162 1 189 773 1 089 901 0

Quinolones 28 926 179 73 4 877 697 143 21 680 36 800 0

Sulfonamides 174 038 13 612 14 349 0 109 181 67 049 247 497 156 170 414

Tetracyclines 445 038 8 162 1 428 4 448 69 681 243 641 919 767 728 738 25

Trimethoprim 53 729 1 336 8 827 0 61 167 38 277 195 251 103 346 0

Total (in tons) 3 157 674 347 149 133 432 9 325 360 871 506 911 3 522 119 2 677 365 1 342

Table A4/4 : Animal Level of Exposure to antimicrobials in 2009 by antimicrobial class and species

Cattle Cat – Dog Horse Fish RabbitSheep-

GoatSwine Poultry Others


Cephalosporins 1 & 2G - 0.0571 - - - - - - -


Other 0.0034 0.6006 0.0000 - 0.1809 0.0000 0.0196 0.0099 0.0000


Furans - 0.0031 - - - - - - -

Macrolides 0.0445 0.0332 0.0004 - 0.0171 0.0008 0.0546 0.0473 0.0031

Penicillins 0.0765 0.8667 0.3786 - - 0.0903 0.1445 0.2145 0.0015

Phenicols 0.0100 0.0019 - - - - 0.0054 - 0.0235

Polymyxins 0.0380 0.0066 0.0119 - 0.3254 0.0875 0.3902 0.5779 -

Quinolones 0.0030 0.0011 0.0003 0.0998 0.0075 0.0002 0.0071 0.0195 -

Sulfonamides 0.0181 0.0852 0.0624 - 1.1807 0.1045 0.0812 0.0828 0.0136

Tetracyclines 0.0463 0.0511 0.0062 0.0910 0.7535 0.3796 0.3017 0.3864 0.0008

Trimethoprim 0.0056 0.0084 0.0384 - 0.6615 0.0596 0.0640 0.0548 -

Total 0.3282 2.1724 0.5800 0.1908 3.9025 0.7897 1.1551 1.4196 0.0441

40

Annex 5: the following tables give evolution of bodyweight treated for the bovine, pig poultry productions and dogs and cats

Table A5.1. Evolution de l’utilisation des familles antibiotiques chez les bovins en WAT1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Aminoglycosides 578 721 613 297 596 965 564 214 526 959 531 761 522 537 531 184 660 134 649 351 433 841

Cephalosporins 1 & 2G - - - - - - - - - - -

Cephalosporins 3 & 4G 59 824 94 580 103 807 117 884 136 373 144 808 169 999 190 105 200 455 226 046 183 365

Other 54 357 52 351 43 393 44 044 44 399 43 774 42 222 39 870 39 046 38 116 32 545

Fluoroquinolones 82 471 84 146 122 411 155 011 177 674 159 560 175 467 199 528 183 735 189 881 179 175

Furans - - - - - - - - - - -

Macrolides 379 758 397 863 401 983 438 825 440 826 419 442 462 298 451 379 375 804 442 030 428 073

Penicillins 1 093 294 1 118 924 1 095 789 998 805 860 226 842 539 854 402 864 716 831 295 784 106 736 243

Phenicols 106 503 115 816 110 299 138 702 106 513 121 330 116 144 145 021 133 751 111 925 96 673

Polymyxins 292 939 314 251 325 114 346 705 335 876 320 014 343 555 360 115 370 479 371 091 366 027

Quinolones 60 836 63 363 58 785 54 127 49 032 41 975 50 844 51 480 38 484 27 867 28 926

Sulfonamides 215 030 221 260 201 924 191 057 168 890 175 866 184 058 185 305 244 265 243 656 174 038

Tetracyclines 485 745 487 462 458 500 511 901 513 876 495 343 535 697 526 618 499 728 426 842 445 038

Trimethoprim 53 980 52 886 60 979 70 085 63 828 66 071 64 089 59 353 52 146 57 097 53 729

Total in tons of body weight treated 3 463 458 3 616 200 3 579 950 3 631 361 3 424 471 3 362 483 3 521 314 3 604 674 3 629 322 3 568 009 3 157 674

Table A5.2. Evolution of Animal Level Exposition in cattle by antimicrobial classes (oral and parenteral routes)1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 0.0053 0.0050 0.0040 0.0042 0.0044 0.0044 0.0046 0.0042 0.0041 0.0039 0.0034


Furans - - - - - - - - - - -

Macrolides 0.0369 0.0380 0.0374 0.0420 0.0442 0.0425 0.0506 0.0479 0.0394 0.0456 0.0445

Penicillins 0.1063 0.1069 0.1020 0.0957 0.0862 0.0855 0.0934 0.0918 0.0873 0.0808 0.0765

Phenicols 0.0104 0.0111 0.0103 0.0133 0.0107 0.0123 0.0127 0.0154 0.0140 0.0115 0.0100

Polymyxins 0.0285 0.0300 0.0303 0.0332 0.0336 0.0325 0.0376 0.0382 0.0389 0.0383 0.0380

Quinolones 0.0059 0.0061 0.0055 0.0052 0.0049 0.0043 0.0056 0.0055 0.0040 0.0029 0.0030

Sulfonamides 0.0209 0.0211 0.0188 0.0183 0.0169 0.0178 0.0201 0.0197 0.0256 0.0251 0.0181

Tetracyclines 0.0472 0.0466 0.0427 0.0490 0.0515 0.0502 0.0586 0.0559 0.0525 0.0440 0.0463

Trimethoprim 0.0052 0.0051 0.0057 0.0067 0.0064 0.0067 0.0070 0.0063 0.0055 0.0059 0.0056

In ALEA 0.3367 0.3456 0.3331 0.3479 0.3431 0.3411 0.3851 0.3827 0.3810 0.3678 0.3282

41

Table A5.3.Evolution of bodyweight treated in cats and dogs by antimicrobial classes (oral and parenteral routes)1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009



Cephalosporins 3 & 4G - - - - - - - 631 3 743 4 448 5 069

Other 26 859 21 934 20 251 27 307 28 486 30 443 52 239 74 581 85 118 91 888 95 979


Furans 1 168 1 104 956 867 873 796 710 646 657 602 489

Macrolides 5 905 6 484 6 545 7 819 6 401 6 782 6 358 8 374 5 863 5 538 5 303

Penicillins 81 047 78 241 76 405 73 939 105 908 98 655 114 843 129 649 135 896 134 609 138 507

Phenicols 459 430 450 457 455 444 471 474 431 359 301

Polymyxins 1 826 1 721 1 650 1 580 1 636 1 426 1 406 1 367 1 152 1 181 1 051

Quinolones 249 804 682 1 004 781 579 637 82 329 60 179

Sulfonamides 22 643 22 347 19 209 19 123 17 644 18 970 16 264 15 918 16 485 16 273 13 612

Tetracyclines 8 071 7 785 7 479 7 686 7 616 7 874 9 083 8 217 9 134 8 455 8 162

Trimethoprim 4 096 3 772 3 346 2 864 2 290 2 284 1 869 1 746 1 681 1 534 1 336

Total in tons of body weight treated 213 390 203 182 203 934 215 041 243 992 246 001 277 256 310 899 335 817 338 131 347 149

Table A5.4. Evolution of Animal Level Exposition in cats and dogs by antimicrobial classes (oral and parenteral routes)1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009



Cephalosporins 3 & 4G - - - - - - - 0.004 0.023 0.028 0.032

Other 0.172 0.139 0.119 0.160 0.170 0.182 0.312 0.462 0.528 0.575 0.601


Furans 0.007 0.007 0.006 0.005 0.005 0.005 0.004 0.004 0.004 0.004 0.003

Macrolides 0.038 0.041 0.039 0.046 0.038 0.041 0.038 0.052 0.036 0.035 0.033

Penicillins 0.519 0.497 0.451 0.434 0.631 0.589 0.686 0.803 0.842 0.842 0.867

Phenicols 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.003 0.002 0.002

Polymyxins 0.012 0.011 0.010 0.009 0.010 0.009 0.008 0.008 0.007 0.007 0.007

Quinolones 0.002 0.005 0.004 0.006 0.005 0.003 0.004 0.001 0.002 0.000 0.001

Sulfonamides 0.145 0.142 0.113 0.112 0.105 0.113 0.097 0.099 0.102 0.102 0.085

Tetracyclines 0.052 0.049 0.044 0.045 0.045 0.047 0.054 0.051 0.057 0.053 0.051

Trimethoprim 0.026 0.024 0.020 0.017 0.014 0.014 0.011 0.011 0.010 0.010 0.008

In ALEA 1.365 1.290 1.202 1.262 1.454 1.469 1.656 1.927 2.081 2.116 2.172

42

Table A5.5. Evolution of bodyweight treated in swine by antimicrobial classes (oral and parenteral routes)1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 67 090 90 375 107 343 116 365 100 186 89 233 84 613 73 125 73 060 66 071 59 664


Furans - - - - - - - - - - -

Macrolides 143 163 160 866 195 504 217 690 197 140 188 811 195 972 207 278 199 468 174 453 166 419

Penicillins 463 009 506 966 511 835 507 245 445 054 421 113 440 532 459 744 473 500 398 348 440 445

Phenicols - - 210 142 - - - - - 1 064 16 491

Polymyxins 1 078 723 1 142 059 1 201 650 1 149 740 1 205 316 1 141 403 1 207 191 1 214 964 1 380 375 1 232 279 1 189 773

Quinolones 95 295 64 150 45 372 39 020 29 135 32 444 34 387 32 045 30 519 26 157 21 680

Sulfonamides 277 979 289 081 269 740 264 906 227 826 238 323 241 667 254 902 281 146 254 216 247 497

Tetracyclines 1 035 958 1 123 776 1 206 755 1 106 778 1 126 752 1 079 844 1 152 932 1 085 440 1 200 200 1 021 311 919 767

Trimethoprim 216 374 221 222 218 589 220 582 196 549 203 950 202 880 206 758 220 343 200 833 195 251


Table A5.6. Evolution of Animal Level Exposition in swine by antimicrobial classes (oral and parenteral routes)1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 0.0209 0.0281 0.0325 0.0358 0.0311 0.0281 0.0272 0.0237 0.0236 0.0213 0.0196


Furans - - - - - - - - - - -

Macrolides 0.0447 0.0500 0.0591 0.0670 0.0612 0.0595 0.0630 0.0672 0.0643 0.0563 0.0546

Penicillins 0.1446 0.1577 0.1548 0.1562 0.1382 0.1327 0.1416 0.1489 0.1527 0.1285 0.1445

Phenicols - - 0.0001 0.0000 - - - - - 0.0003 0.0054

Polymyxins 0.3368 0.3552 0.3634 0.3540 0.3743 0.3596 0.3880 0.3936 0.4452 0.3975 0.3902

Quinolones 0.0298 0.0200 0.0137 0.0120 0.0090 0.0102 0.0111 0.0104 0.0098 0.0084 0.0071

Sulfonamides 0.0868 0.0899 0.0816 0.0816 0.0708 0.0751 0.0777 0.0826 0.0907 0.0820 0.0812

Tetracyclines 0.3235 0.3496 0.3650 0.3408 0.3499 0.3402 0.3706 0.3517 0.3871 0.3294 0.3017

Trimethoprim 0.0676 0.0688 0.0661 0.0679 0.0610 0.0643 0.0652 0.0670 0.0711 0.0648 0.0640

In ALEA 1.1289 1.2033 1.2236 1.2038 1.1791 1.1499 1.2339 1.2403 1.3362 1.1741 1.1551

43

Table A5.7. Evolution of bodyweight treated in poultry by antimicrobial classes (oral and parenteral routes)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 21 256 26 581 30 698 33 318 27 662 22 768 19 927 21 956 22 041 20 660 18 593


Furans - - - - - - - - - - -

Macrolides 65 313 75 443 80 340 89 335 93 713 98 777 107 410 104 098 94 083 112 267 89 211

Penicillins 221 616 317 735 317 319 413 983 392 291 356 468 392 200 407 319 472 397 414 609 404 568

Phenicols - - - - - - - - - - -

Polymyxins 600 749 727 401 764 883 788 559 845 676 841 803 942 615 1 000 776 972 408 988 138 1 089 901

Quinolones 63 563 59 661 65 054 63 482 64 070 65 054 61 363 67 185 51 295 34 149 36 800

Sulfonamides 221 819 248 625 225 112 219 732 215 315 209 483 206 097 182 777 183 380 161 581 156 170

Tetracyclines 582 459 625 929 716 522 856 885 967 279 997 256 1 064 630 928 335 949 140 775 879 728 738

Trimethoprim 162 563 177 881 174 214 168 073 168 951 160 366 161 138 132 193 120 815 104 045 103 346


Table A5.8. Evolution of Animal Level Exposition in poultry by antimicrobial classes (oral and parenteral routes)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009




Other 0.0088 0.0108 0.0121 0.0143 0.0121 0.0099 0.0086 0.0114 0.0110 0.0106 0.0099


Furans - - - - - - - - - - -

Macrolides 0.0270 0.0305 0.0317 0.0383 0.0410 0.0431 0.0464 0.0539 0.0470 0.0578 0.0473

Penicillins 0.0915 0.1286 0.1251 0.1773 0.1717 0.1557 0.1694 0.2107 0.2361 0.2135 0.2145

Phenicols - - - - - - - - - - -

Polymyxins 0.2481 0.2944 0.3015 0.3377 0.3700 0.3676 0.4070 0.5178 0.4860 0.5088 0.5779

Quinolones 0.0262 0.0241 0.0256 0.0272 0.0280 0.0284 0.0265 0.0348 0.0256 0.0176 0.0195

Sulfonamides 0.0916 0.1006 0.0887 0.0941 0.0942 0.0915 0.0890 0.0946 0.0917 0.0832 0.0828

Tetracyclines 0.2405 0.2533 0.2824 0.3669 0.4233 0.4355 0.4597 0.4803 0.4744 0.3995 0.3864

Trimethoprim 0.0671 0.0720 0.0687 0.0720 0.0739 0.0700 0.0696 0.0684 0.0604 0.0536 0.0548

In ALEA 0.8204 0.9369 0.9574 1.1477 1.2347 1.2229 1.2955 1.4955 1.4570 1.3690 1.4196

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French Agency for Food, Environmental and Occupational Health & Safetyl27-31 avenue du général LeclercF-94701 Maisons-Alfort Cedex - Francewww.anses.fr

sales survey of veterinary medicinal products containing ... · annex 5: evolution of bodyweight...

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