title: Assigning defined daily doses animal: a European multi-country experience for antimicrobial products authorized for usage in pigs.
abstract: OBJECTIVE
  To establish a consensus defined daily dose animal (DDDA) for each active substance (AS) and administration route for porcine veterinary antimicrobial products authorized in four European countries, thus allowing cross-country quantification and comparison of antimicrobial usage data.
  
  
  METHODS
  All veterinary antimicrobial products authorized for porcine use in Belgium, France, Germany and Sweden were listed for each administration route. First, separate DDDAs for each product were defined based on the recommended dosing for the main indication. Second, a consensus DDDA was established by taking the mean of the DDDAs for each product within a certain category of AS plus administration route.
  
  
  RESULTS
  One-hundred-and-fifty-nine, 240, 281 and 50 antimicrobial products were licensed in Belgium, France, Germany and Sweden, respectively, in February 2013. Large variations were observed for dosage and treatment duration recommendations between products and between countries for the same ASs. Only 6.8% of feed/water and 29.4% of parenteral AS groups had the same recommended dosage in the four countries.
  
  
  CONCLUSIONS
  This study presents a consensus DDDA list for use in the quantification and comparison of antimicrobial consumption. Four major recommendations have been formulated: (i) urgent need for harmonization of authorization and recommended summary of product characteristics (SPC) dosages; (ii) expand the developed preliminary DDDA list to include all authorized veterinary medicinal products in all EU member states and for all (food-producing) animal species; (iii) improved accessibility of country-specific SPC data would be preferable; and (iv) statement of the 'long-acting' duration of a product in the SPC.
authors.affiliation: Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium merel.postma@ugent.be.
authors.forename: Merel
authors.initials: M
authors.lastname: Postma
authors.affiliation: Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, Uppsala, Sweden Swedish University of Agricultural Sciences, Uppsala, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Sjölund
authors.affiliation: SAFOSO Inc., Bern, Switzerland UMR BIOEPAR, Oniris, INRA, LUNAM, BP40706, F-44307 Nantes Cedex 3, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Collineau
authors.affiliation: Field Station for Epidemiology, University of Veterinary Medicine Hannover, Bakum, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Lösken
authors.affiliation: SAFOSO Inc., Bern, Switzerland.
authors.forename: Katharina D C
authors.initials: KD
authors.lastname: Stärk
authors.affiliation: Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Dewulf
mesh_terms: D000822:Animal Husbandry / Q000379:methods* / Q000592:standards; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D004363:Drug Utilization / Q000592:standards* / Q000706:statistics & numerical data*; D005060:Europe; D013552:Swine / Q000254:growth & development*; D019155:Veterinary Drugs / Q000008:administration & dosage / Q000627:therapeutic use; D014730:Veterinary Medicine / Q000379:methods* / Q000592:standards
chemical_list: D000900:Anti-Bacterial Agents; D019155:Veterinary Drugs
keywords: antimicrobial usage quantification; cross-country comparison; defined course dose animal; defined daily dose animal; porcine antimicrobial products