Antibiotic use in human medicine, veterinary medicine, and agriculture has been linked to the rise of antibiotic resistance globally. We did a systematic review and meta-analysis to summarise the effect that interventions to reduce antibiotic use in food-producing animals have on the presence of antibiotic-resistant bacteria in animals and in humans. On July 14, 2016, we searched electronic databases (Agricola, AGRIS, BIOSIS Previews, CAB Abstracts, MEDLINE, Embase, Global Index Medicus, ProQuest Dissertations, Science Citation Index) and the grey literature. The search was updated on Jan 27, 2017. Inclusion criteria were original studies that reported on interventions to reduce antibiotic use in food-producing animals and compared presence of antibiotic-resistant bacteria between intervention and comparator groups in animals or in human beings. We extracted data from included studies and did meta-analyses using random effects models. The main outcome assessed was the risk difference in the proportion of antibiotic-resistant bacteria. A total of 181 studies met inclusion criteria. Of these, 179 (99%) described antibiotic resistance outcomes in animals, and 81 (45%) of these studies were included in the meta-analysis. 21 studies described antibiotic resistance outcomes in humans, and 13 (62%) of these studies were included in the meta-analysis. The pooled absolute risk reduction of the prevalence of antibiotic resistance in animals with interventions that restricted antibiotic use commonly ranged between 10 and 15% (total range 0–39), depending on the antibiotic class, sample type, and bacteria under assessment. Similarly, in the human studies, the pooled prevalence of antibiotic resistance reported was 24% lower in the intervention groups compared with control groups, with a stronger association seen for humans with direct contact with food-producing animals. Interventions that restrict antibiotic use in food-producing animals are associated with a reduction in the presence of antibiotic-resistant bacteria in these animals. A smaller body of evidence suggests a similar association in the studied human populations, particularly those with direct exposure to food-producing animals. The implications for the general human population are less clear, given the low number of studies. The overall findings have directly informed the development of WHO guidelines on the use of antibiotics in food-producing animals. World Health Organization.

Staphylococcus aureus is an important cause of udder infections in dairy herds. Both lactational and dry cow therapy are part of Staph. aureus control programs. Reported cure rates for Staph. aureus mastitis vary considerably. The probability of cure depends on cow, pathogen, and treatment factors. Cure rates decrease with increasing age of the cow, increasing somatic cell count, increasing duration of infection, increasing bacterial colony counts in milk before treatment, and increasing number of quarters infected. Staphylococcus aureus mastitis in hind quarters has a low cure rate compared with front quarters. Antimicrobial treatment of intramammary infections with penicillin-resistant Staph. aureus strains results in a lower cure rate for treatment with either beta-lactam or non-beta-lactam antibiotics. Other strain-specific factors may affect the probability of cure but routine diagnostic methods for use in bacteriology laboratories or veterinary practices are not yet available. The most important treatment factor affecting cure is treatment duration. Increased duration of treatment is associated with increased chance of cure. Economically, extended treatment is not always justified, even when indirect effects of treatment such as prevention of contagious transmission are taken into consideration. Usefulness of treatment trials could be improved by standardization of case definitions, consideration of host and strain factors, and sufficient statistical power. Treatment of young animals with penicillin-sensitive Staph. aureus infections is often justified based on bacteriological cure and economic outcome, whereas treatment of older animals, chronic infections, or penicillin-resistant isolates should be discouraged.

The dairy industry in the developed world has undergone profound changes over recent decades. In this paper, we present an overview of some of the most important recent changes in the dairy industry that affect health and welfare of dairy cows, as well as the science associated with these changes. Additionally, knowledge gaps are identified where research is needed to guide the dairy industry through changes that are occurring now or that we expect will occur in the future. The number of farms has decreased considerably, whereas herd size has increased. As a result, an increasing number of dairy farms depend on hired (nonfamily) labor. Regular professional communication and establishment of farm-specific protocols are essential to minimize human errors and ensure consistency of practices. Average milk production per cow has increased, partly because of improvements in nutrition and management but also because of genetic selection for milk production. Adoption of new technologies (e.g., automated calf feeders, cow activity monitors, and automated milking systems) is accelerating. However, utilization of the data and action lists that these systems generate for health and welfare of livestock is still largely unrealized, and more training of dairy farmers, their employees, and their advisors is necessary. Concurrently, to remain competitive and to preserve their social license to operate, farmers are increasingly required to adopt increased standards for food safety and biosecurity, become less reliant on the use of antimicrobials and hormones, and provide assurances regarding animal welfare. Partly because of increasing herd size but also in response to animal welfare regulations in some countries, the proportion of dairy herds housed in tiestalls has decreased considerably. Although in some countries access to pasture is regulated, in countries that traditionally practiced seasonal grazing, fewer farmers let their dairy cows graze in the summer. The proportion of organic dairy farms has increased globally and, given the pressure to decrease the use of antimicrobials and hormones, conventional farms may be able to learn from well-managed organic farms. The possibilities of using milk for disease diagnostics and monitoring are considerable, and dairy herd improvement associations will continue to expand the number of tests offered to diagnose diseases and pregnancy. Genetic and genomic selection for increased resistance to disease offers substantial potential but requires collection of additional phenotypic data. There is every expectation that changes in the dairy industry will be further accentuated and additional novel technologies and different management practices will be adopted in the future.

Heifer mastitis is a disease that potentially threatens production and udder health in the first and subsequent lactations. In general, coagulase-negative staphylococci (CNS) are the predominant cause of intramammary infection and subclinical mastitis in heifers around parturition, whereas Staphylococcus aureus and environmental pathogens cause a minority of the cases. Clinical heifer mastitis is typically caused by the major pathogens. The variation in proportions of causative pathogens between studies, herds, and countries is considerable. The magnitude of the effect of heifer mastitis on an individual animal is influenced by the form of mastitis (clinical versus subclinical), the virulence of the causative pathogen(s) (major versus minor pathogens), the time of onset of infection relative to calving, cure or persistence of the infection when milk production has started, and the host's immunity. Intramammary infection in early lactation caused by CNS does not generally have a negative effect on subsequent productivity. At the herd level, the impact will depend on the prevalence and incidence of the disease, the nature of the problem (clinical, subclinical, nonfunctional quarters), the causative pathogens involved (major versus minor pathogens), the ability of the animals to cope with the disease, and the response of the dairy manager to control the disease through management changes. Specific recommendations to prevent and control mastitis in late gestation in periparturient heifers are not part of the current National Mastitis Council mastitis and prevention program. Control and prevention is currently based on avoidance of inter-sucking among young stock, fly control, optimal nutrition, and implementation of hygiene control and comfort measures, especially around calving. More risk factors for subclinical and clinical heifer mastitis have been identified (e.g., season, location of herd, stage of pregnancy) although they do not lend themselves to the development of specific intervention strategies designed to prevent the disease. Pathogen-specific risk factors and associated control measures need to be identified due to the pathogen-related variation in epidemiology and effect on future performance. Prepartum intramammary treatment with antibiotics has been proposed as a simple and effective way of controlling heifer mastitis but positive long-lasting effects on somatic cell count and milk yield do not always occur, ruling out universal recommendation of this practice. Moreover, use of antibiotics in this manner is off-label and results in an increased risk of antibiotic residues in milk. Prepartum treatment can be implemented only as a short-term measure to assist in the control of a significant heifer mastitis problem under supervision of the herd veterinarian. When CNS are the major cause of intramammary infection in heifers, productivity is not affected, making prepartum treatment redundant and even unwanted. In conclusion, heifer mastitis can affect the profitability of dairy farming because of a potential long-term negative effect on udder health and milk production and an associated culling risk, specifically when major pathogens are involved. Prevention and control is not easy but is possible through changes in young stock and heifer management. However, the pathogenesis and epidemiology of the disease remain largely unknown and more pathogen-specific risk factors should be identified to optimize current prevention programs.