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Alternatives to Veterinary ANTimicrobials

Periodic Reporting for period 3 - AVANT (Alternatives to Veterinary ANTimicrobials)

Período documentado: 2023-01-01 hasta 2024-06-30

Antimicrobial resistance (AMR) is a recognized societal problem with serious consequences on public health and economy. Since resistant bacteria can be selected by any use of antibiotics, their use in livestock production poses a threat to human health due to the possible transfer of resistant bacteria to people via direct contact with animals or by consumption of contaminated food of animal origin. AVANT is a multi-actor project bringing together scientists, stakeholders and end-users involved in the fight against AMR in the veterinary sector, including academic and research institutions, animal health enterprises, and veterinary associations. The goal is to develop and test the efficacy and sustainability of a comprehensive set of alternatives to antibiotics for the management of bacterial infections in pigs with particular emphasis on post-weaning diarrhoea (PWD), which is the main reason for antibiotic use in pig production. The AVANT portfolio of alternatives to antibiotics comprises i) gut microbiome modulators such as synbiotics and faecal transplants from healthy donors, ii) innovative medicines targeting the causative pathogen of PWD, enterotoxigenic Escherichia coli (ETEC), iii) immunostimulators that strengthen the host immune response against infection, and iv) feeding strategies for PWD prevention.
During the first 4.5 years of the project (January 2020 to June 2024), various alternatives to were developed and optimized regarding formulation, administration route and dosage. First their efficacy for control and prevention of PWD was studied under controlled experimental conditions using pig infection models. Then two interventions were selected for the farm trials based on the clinical efficacy and safety data generated in these pre-clinical studies, as well as legal and economic considerations and acceptance by pig farmers, veterinarians and consumers. The first selected intervention is a faecal filtrate transplantation (FFT) protocol developed at the University of Copenhagen (DK), which utilizes faeces from healthy sows from the same farm to avoid the risk of spreading pathogens across farms. The second intervention is a diet developed by Schothorst Feed Research (NL). The FFT protocol, which is based on the administration of fermentable fibre to sows in the transition diet and inert fibre to suckling piglets. A multicentre clinical study was conducted in Denmark, The Netherlands, and France to assess the efficacy of interventions for controlling PWD and reducing antibiotic use under farm conditions. All trials have now been completed, with preliminary results indicating a slight improvement in faecal consistency and a reduction in the prevalence of PWD. Data on antibiotic use at the trial farms are currently being analysed through mathematical modelling to predict the potential impact on reducing antibiotic consumption in the EU. Notably, FFT has shown a significant effect on modulating piglet gut microbiota by increasing the relative abundance of beneficial bacteria, and its mechanisms of action are under investigation. A third intervention based on polymers has demonstrated general positive effects on health and growth, with the production of the active ingredient being upscaled to make it more affordable for farmers and allow for further on-farm testing.
An extensive survey was conducted to understand how alternatives to antibiotics are perceived by consumers, pig veterinarians and farmers in 5 countries (Germany, Poland, France, Spain and Denmark). The survey shows that traditional solutions to prevent antibiotic use, such as vaccines and biosecurity measures, are more favourably accepted than innovative solutions such as FFT and phage therapy. Interestingly, approximately 70% consumers state that they would pay 10% or more to buy food products from animals that are not treated with antibiotics. The outcomes of the survey were submitted as a public deliverable and disseminated through the project website (https://avant-project.eu(se abrirá en una nueva ventana)) the AVANT social media as well as lectures, animation videos and infographics presented in international conferences and events involving key stakeholders.
The interventions generated by the project offer effective preventive strategies for managing PWD, thereby reducing antibiotic use and minimizing the risk of AMR transmission from pigs to humans. However, neither FFT nor the diet fully matches the effectiveness of antibiotics, indicating that while they could help reduce antibiotic use, they cannot eliminate reliance on antibiotics. Given that PWD is an endemic disease often triggered by stress and poor farm management, the AVANT consortium stresses the need to complement alternatives to antibiotics with strategies that reduce stress and promote best management practices in pig production. Measures such as reducing litter size, limiting cross-fostering, and increasing weaning time and weight could significantly decrease antibiotic reliance by reducing stress and preventing disease. Accordingly, the consortium has initiated discussions with key stakeholders to develop a position paper establishing best practices for pig production across Europe. This initiative aligns with the EU Farm-to-Fork Strategy, aiming to achieve a 50% reduction in EU antimicrobial sales for livestock by 2030 while meeting societal expectations for environmental sustainability and animal welfare. In the project's final year, these outcomes will be disseminated through scientific publications, conference presentations, and outreach via social media, press releases, and stakeholder engagement.
AVANT project overview and WP interactions
AVANT impact
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