title: Describing antimicrobial use and reported treatment efficacy in Ontario swine using the Ontario Swine Veterinary-based Surveillance program.
abstract: BACKGROUND
  The objective of this work was to retrospectively assess records received through the Ontario Swine Veterinary-based Surveillance program July 2007 - July 2009 to describe and assess relationships between reported treatment failure, antimicrobial use, diagnosis and body system affected.
  
  
  RESULTS
  Antimicrobial use occurred in 676 records, 80.4% of all records recording treatment (840). The most commonly used antimicrobials were penicillin (34.9%), tetracyclines (10.7%) and ceftiofur (7.8%), and the use of multiple antimicrobials occurred in 141/676 records (20.9%). A multi-level logistic regression model was built to describe the probability of reported treatment failure. The odds of reported treatment failure were significantly reduced if the record indicated that the gastro-intestinal (GI) system was affected, as compared to all other body systems (p < 0.05). In contrast, the odds of reported treatment failure increased by 1.98 times if two antimicrobials were used as compared to one antimicrobial (p = 0.009) and by 6.52 times if three or more antimicrobials were used as compared to one antimicrobial (p = 0.005). No significant increase in reported treatment failure was seen between the use of two antimicrobials and three or more antimicrobials. No other antimicrobials were significantly associated with reported treatment failure after controlling for body system and the number of antimicrobials used.
  
  
  CONCLUSIONS
  Failure of antimicrobial treatment is more likely to occur in non-GI conditions, as compared to GI conditions and the use of multiple antimicrobial products is also associated with an increased probability of antimicrobial treatment failure. The authors suggest that a more preventative approach to herd health should be taken in order to reduce antimicrobial inputs on-farm, including improved immunity via vaccination, management and biosecurity strategies. Furthermore, improved immunity may be viewed as a form of antimicrobial stewardship to the industry by reducing required antimicrobial inputs and consequently, reduced selection pressure for AMR.
authors.affiliation: Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G2W1, Canada. sglass@uoguelph.ca.
authors.forename: Shiona K
authors.initials: SK
authors.lastname: Glass-Kaastra
authors.forename: David L
authors.initials: DL
authors.lastname: Pearl
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Reid-Smith
authors.forename: Beverly
authors.initials: B
authors.lastname: McEwen
authors.forename: Scott A
authors.initials: SA
authors.lastname: McEwen
authors.forename: Rocio
authors.initials: R
authors.lastname: Amezcua
authors.forename: Robert M
authors.initials: RM
authors.lastname: Friendship
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use; D009864:Ontario; D010406:Penicillins / Q000627:therapeutic use; D011159:Population Surveillance; D012189:Retrospective Studies; D013552:Swine; D013553:Swine Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D013752:Tetracycline / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome; D014730:Veterinary Medicine / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D000890:Anti-Infective Agents; D002511:Cephalosporins; D010406:Penicillins; C053503:ceftiofur; D013752:Tetracycline