Veterinary antimicrobial consumption patterns vary considerably across Europe. These differences are not only limited to the total amount consumed, but are also observed with regards to the relative proportion of the various antimicrobial classes used. Currently, most of the data on veterinary antimicrobials are reported at sales level without any information on the consumption by different animal species. This hinders a proper comparison of antimicrobial consumption at the species level between countries. However, it is imperative to improve our understanding on antimicrobial usage patterns at the species level, as well as on the drivers contributing to those differences. This will allow for development of tailored interventions with the lowest possible risk for human health, while ensuring effective treatment of diseased livestock. An important step to attain such an objective is to perform detailed comparisons of the antimicrobial consumption in each species between countries. We compared antimicrobial consumption estimates for cattle and pigs in Switzerland and Denmark, in order to distinguish species-specific patterns and trends in consumption from 2007 to 2013. Swiss data were obtained from a previous study that assessed methodologies to stratify antimicrobial sales per species; Danish antimicrobial consumption estimates were assembled from DANMAP reports. A decrease in antimicrobial consumption in mg per kg of biomass was observed for both countries (4.5% in Denmark and 34.7% in Switzerland) when comparing 2013 to 2007. For pigs and cattle, the overall consumption per kg of biomass of most antimicrobial classes was higher in Switzerland than in Denmark. Large variations in the relative consumption of different antimicrobial classes were also evident. Sulfonamides/ trimethoprim and tetracyclines were consumed in a higher proportion in Switzerland than in Denmark, whereas the relative consumption of penicillins was higher in Denmark. The differences observed in veterinary antimicrobial consumption are not solely related to animal demographic characteristics in these two countries. Other factors, such as the level of biosecurity and farming practices, veterinarians and farmers’ education or governmental/industry programs put in place might also partly explain these variations. These differences should be taken into account when aiming to implement targeted interventions to reduce antimicrobial consumption.

There is growing concern about development of antimicrobial resistance due to use of antimicrobials (AMs) in livestock production. Identifying efficient alternatives, including vaccination, is a priority. The objective of this study was to compare the herd-level amount of AMs prescribed for weaner pigs, between Danish sow herds using varying combinations of vaccines against Porcine Circovirus Type 2 (PCV2), Mycoplasma hyopneumoniae (MYC) and Lawsonia intracellularis (LAW). It was hypothesised that herds purchasing vaccines, use these to prevent disease, and hence reduce their AM consumption, compared to herds purchasing fewer or no vaccines against these pathogens. Data summarised over year 2013 were obtained from the Danish Central Husbandry Register and the Danish VetStat database, in which prescriptions of medication are recorded. All one-site indoor pig herds with >50 sows and >200 weaners were selected. AMs prescribed for weaners was measured in animal daily doses (ADD) and divided according to three indication groups (gastro-intestinal, respiratory indication or total use). The analysis was based on three multivariable linear regression models of the herd-level ADD for each indication group. The eight vaccination combinations (2x2x2) were included as one explanatory variable, and herd size, measured as the number of weaner pen places was included in the models as a potential confounder. Out of the 1513 herds in the study, 1415 had AMs prescribed for gastro-intestinal disorders, and 836 for respiratory disorders. PCV2 vaccines were purchased in 880 herds, MYC vaccines in 787 and LAW vaccines in 115 herds. Herds purchasing PCV2 and MYC vaccines had significantly more AMs prescribed than herds not purchasing vaccines or only purchasing LAW vaccines. In the present study, using register data covering 1 year, we found an association between use of vaccination and increased amount of AMs prescribed for weaners. This does not exclude that the vaccines work, just that we were unable to detect this. The findings might be explained by some herds experiencing clinical problems associated with MYC or PCV2 despite use of vaccination. In other herds, it might reflect that vaccines applied to weaners are used for disease prevention in finishers rather than in the weaners. Information about vaccination protocols and herd health status was not available at the time of the study. Hence, further studies are required to investigate causality of the associations between use of AMs, vaccination practices and other confounding on-farm factors.

Integrated antimicrobial resistance (AMR) surveillance programmes require regular evaluation to ensure they are fit for purpose and that all actors understand their responsibilities. This will strengthen their relevance for the clinical setting, which depends heavily on continued access to effective treatment options. Several evaluation tools addressing different surveillance aspects are available. The aim was to understand the strengths and weaknesses of three evaluation tools, and to improve guidance on how to choose a fit-for-purpose tool. Three tools were assessed: (a) AMR-PMP-the Progressive Management Pathway tool on AMR developed by the Food and Agriculture Organization (FAO) of the United Nations, (b) NEOH developed by the EU COST Action 'Network for Evaluation of One Health' and (c) SURVTOOLS developed in an FP7-EU project 'RISKSUR'. Each tool was assessed with regard to contents, required evaluation processes including stakeholder engagement and resource demands, integration coverage across relevant sectors and applicability. They were compared using a predefined scoring scheme and a strengths-weaknesses-opportunities-threats (SWOT)-like format for commenting. All three tools address multiple decision-making levels and aspects of stakeholder engagement. NEOH focuses on system features, learning, sharing, leadership and infrastructure, and requires a description of the underlying system in which AMR develops. AMR-PMP focuses on four areas: awareness, evidence, governance and practices and assesses the implementation degree of pre-chosen aspects within these areas. This requires less of the evaluator, but warrants participation of multiple stakeholders. SURVTOOL provides information and references on how to evaluate effectiveness, process and comprehensiveness of surveillance programmes. All three tools require veterinary epidemiology expertise and varying levels of evaluation methodology training to use appropriately. The tools covered AMR surveillance and One Health aspects to varying degrees. This study provides guidance on aspects to consider when choosing between available tools and embarking on an evaluation of integrated surveillance.

The objective of this paper is to provide a comparative review of three active surveillance and control programmes in the Danish cattle sector to highlight important differences for decision makers to develop successful programmes. The focus is on differences in purpose, principles, design and instruments applied to achieve the goals stated for each programme for bovine viral diarrhoea (BVDV), paratuberculosis andSalmonellaDublin. The purposes of the programmes are to reduce economic consequences and improve animal welfare, and forS. Dublin also to prevent zoonotic risk, with varying importance as motivation for the programmes over time. The targets of the BVDV andS. Dublin programmes have been to eradicate the diseases from the Danish cattle population. This goal was successfully reached for BVDV in 2006 where the programme was changed to a surveillance programme after 12 years with an active control programme. TheS. Dublin dairy herd-level prevalence decreased from 25% in 2003 to 6% in 2015, just before the milk quota system was abandoned. Over the last 5 years, the prevalence has increased to 8–9% test-positive dairy herds. It is mandatory to participate, and frequent updates of legislative orders were used over two decades as critical instruments in those two programmes. In contrast, participation in the paratuberculosis programme is voluntary and the goals are to promote participation and reduce the prevalence and economic and welfare consequences of the disease. The daily administration of all three programmes is carried out by the major farmers' organisation, who organise surveillance, IT-solutions and other control tools, projects and communication in collaboration with researchers from the universities, laboratories and, for BVDV andS. Dublin, the veterinary authorities. Differences among the programme designs and instruments are mainly due to the environmental component of paratuberculosis andS. Dublin, as the bacteria able to survive for extended periods outside the host. This extra diffuse source of infection increases the demand for persistent and daily hygiene and management efforts. The lower test sensitivities (than for BVDV) lead to a requirement to perform repeated testing of herds and animals over longer time periods calling for withstanding motivation among farmers.