Murphy David, Ricci Antonia, Auce Zanda, Beechinor J Gabriel, Bergendahl Hanne, Breathnach Rory, Bureš Jiří, Duarte Da Silva João Pedro, Hederová Judita, Hekman Peter, Ibrahim Cornelia, Kozhuharov Emil, Kulcsár Gábor, Lander Persson Eva, Lenhardsson Johann M, Mačiulskis Petras, Malemis Ioannis, Markus-Cizelj Ljiljana, Michaelidou-Patsia Alia, Nevalainen Martti, Pasquali Paolo, Rouby Jean-Claude, Schefferlie Johan, Schlumbohm Wilhelm, Schmit Marc, Spiteri Stephen, Srčič Stanko, Taban Lollita, Tiirats Toomas, Urbain Bruno, Vestergaard Ellen-Margrethe, Wachnik-Święcicka Anna, Weeks Jason, Zemann Barbara, Allende Ana, Bolton Declan, Chemaly Marianne, Fernandez Escamez Pablo Salvador, Girones Rosina, Herman Lieve, Koutsoumanis Kostas, Lindqvist Roland, Nørrung Birgit, Robertson Lucy, Ru Giuseppe, Sanaa Moez, Simmons Marion, Skandamis Panagiotis, Snary Emma, Speybroeck Niko, Ter Kuile Benno, Wahlström Helene, Baptiste Keith, Catry Boudewijn, Cocconcelli Pier Sandro, Davies Robert, Ducrot Christian, Friis Christian, Jungersen Gregers, More Simon, Muñoz Madero Cristina, Sanders Pascal, Bos Marian, Kunsagi Zoltan, Torren Edo Jordi, Brozzi Rosella, Candiani Denise, Guerra Beatriz, Liebana Ernesto, Stella Pietro, Threlfall John, Jukes Helen
EFSA J. 2017 Jan 24;15(1):e04666. doi: 10.2903/j.efsa.2017.4666. eCollection 2017 Jan.
EFSA and EMA have jointly reviewed measures taken in the EU to reduce the need for and use of antimicrobials in food-producing animals, and the resultant impacts on antimicrobial resistance (AMR). Reduction strategies have been implemented successfully in some Member States. Such strategies include national reduction targets, benchmarking of antimicrobial use, controls on prescribing and restrictions on use of specific critically important antimicrobials, together with improvements to animal husbandry and disease prevention and control measures. Due to the multiplicity of factors contributing to AMR, the impact of any single measure is difficult to quantify, although there is evidence of an association between reduction in antimicrobial use and reduced AMR. To minimise antimicrobial use, a multifaceted integrated approach should be implemented, adapted to local circumstances. Recommended options (non-prioritised) include: development of national strategies; harmonised systems for monitoring antimicrobial use and AMR development; establishing national targets for antimicrobial use reduction; use of on-farm health plans; increasing the responsibility of veterinarians for antimicrobial prescribing; training, education and raising public awareness; increasing the availability of rapid and reliable diagnostics; improving husbandry and management procedures for disease prevention and control; rethinking livestock production systems to reduce inherent disease risk. A limited number of studies provide robust evidence of alternatives to antimicrobials that positively influence health parameters. Possible alternatives include probiotics and prebiotics, competitive exclusion, bacteriophages, immunomodulators, organic acids and teat sealants. Development of a legislative framework that permits the use of specific products as alternatives should be considered. Further research to evaluate the potential of alternative farming systems on reducing AMR is also recommended. Animals suffering from bacterial infections should only be treated with antimicrobials based on veterinary diagnosis and prescription. Options should be reviewed to phase out most preventive use of antimicrobials and to reduce and refine metaphylaxis by applying recognised alternative measures.
欧洲食品安全局（EFSA）和欧洲药品管理局（EMA）联合审查了欧盟为减少食用动物中抗菌药物的使用需求和使用量所采取的措施，以及由此对抗菌素耐药性（AMR）产生的影响。一些成员国已成功实施了减少策略。这些策略包括国家减少目标、抗菌药物使用的基准化、处方控制以及对特定关键重要抗菌药物使用的限制，同时还包括改善畜牧养殖以及疾病预防和控制措施。由于导致抗菌素耐药性的因素众多，尽管有证据表明抗菌药物使用的减少与抗菌素耐药性的降低之间存在关联，但任何单一措施的影响都难以量化。为尽量减少抗菌药物的使用，应实施因地制宜的多方面综合方法。推荐的选项（未排序）包括：制定国家战略；统一的抗菌药物使用和抗菌素耐药性发展监测系统；设定国家抗菌药物使用减少目标；使用农场健康计划；增加兽医在抗菌药物处方方面的责任；培训、教育并提高公众意识；增加快速可靠诊断方法的可及性；改善疾病预防和控制的畜牧养殖及管理程序；重新思考畜牧生产系统以降低内在疾病风险。仅有少数研究提供了有力证据证明可替代抗菌药物的物质能对健康参数产生积极影响。可能的替代物包括益生菌和益生元、竞争性排斥、噬菌体、免疫调节剂、有机酸和乳头封闭剂。应考虑制定允许使用特定产品作为替代物的立法框架。还建议进一步开展研究，以评估替代养殖系统在降低抗菌素耐药性方面的潜力。患有细菌感染的动物仅应根据兽医诊断和处方使用抗菌药物。应审查相关选项，逐步淘汰抗菌药物的大多数预防性使用，并通过采用公认的替代措施减少和优化群体预防用药。
