Mulchandani Ranya, Wang Yu, Gilbert Marius, Van Boeckel Thomas P
Health Geography and Policy Group, ETH Zürich, Zurich, Switzerland.
Spatial Epidemiology Lab, Université Libre de Bruxelles, Brussels, Belgium.
PLOS Glob Public Health. 2023 Feb 1;3(2):e0001305. doi: 10.1371/journal.pgph.0001305. eCollection 2023.
Use of antimicrobials in farming has enabled the growth of intensive animal production and helped in meeting the global increase in demand for animal protein. However, the widespread use of veterinary antimicrobials drives antimicrobial resistance, with important consequences for animal health, and potentially human health. Global monitoring of antimicrobial use is essential: first, to track progress in reducing the reliance of farming on antimicrobials. Second, to identify countries where antimicrobial-stewardship efforts should be targeted to curb antimicrobial resistance. Data on usage of antimicrobials in food animals were collected from 42 countries. Multivariate regression models were used in combination with projections of animal counts for cattle, sheep, chicken, and pigs from the Food and Agriculture Organization to estimate global antimicrobial usage of veterinary antimicrobials in 2020 and 2030. Maps of animal densities were used to identify geographic hotspots of antimicrobial use. In each country, estimates of antimicrobial use (tonnes) were calibrated to match continental-level reports of antimicrobial use intensity (milligrams per kilogram of animal) from the World Organization for Animal Health, as well as country-level reports of antimicrobial use from countries that made this information publicly available. Globally, antimicrobial usage was estimated at 99,502 tonnes (95% CI 68,535-198,052) in 2020 and is projected, based on current trends, to increase by 8.0% to 107,472 tonnes (95% CI: 75,927-202,661) by 2030. Hotspots of antimicrobial use were overwhelmingly in Asia (67%), while <1% were in Africa. Findings indicate higher global antimicrobial usage in 2030 compared to prior projections that used data from 2017; this is likely associated with an upward revision of antimicrobial use in Asia/Oceania (6,000 tonnes) and the Americas (4,000 tonnes). National-level reporting of antimicrobial use should be encouraged to better evaluate the impact of national policies on antimicrobial use levels.
在养殖中使用抗菌药物推动了集约化动物生产的发展,并有助于满足全球对动物蛋白不断增长的需求。然而,兽用抗菌药物的广泛使用导致了抗菌药物耐药性,这对动物健康乃至人类健康都产生了重大影响。全球对抗菌药物使用情况进行监测至关重要:其一,以追踪在减少养殖对抗菌药物依赖方面取得的进展。其二,确定应将抗菌药物管理工作的重点放在哪些国家,以遏制抗菌药物耐药性。从42个国家收集了食用动物抗菌药物使用的数据。多元回归模型与联合国粮食及农业组织对牛、羊、鸡和猪存栏量的预测相结合,以估算2020年和2030年全球兽用抗菌药物的使用量。利用动物密度图来确定抗菌药物使用的地理热点地区。在每个国家,抗菌药物使用量(吨)的估算经过校准,以与世界动物卫生组织的大陆级抗菌药物使用强度报告(每千克动物毫克数)以及公开提供此信息的国家的国家级抗菌药物使用报告相匹配。在全球范围内,2020年抗菌药物使用量估计为99,502吨(95%置信区间68,535 - 198,052),基于当前趋势预测,到2030年将增加8.0%,达到107,472吨(95%置信区间:75,927 - 202,661)。抗菌药物使用的热点地区绝大多数在亚洲(67%),而非洲占比不到1%。研究结果表明,与之前使用2017年数据的预测相比,2030年全球抗菌药物使用量更高;这可能与亚洲/大洋洲(约6,000吨)和美洲(约4,000吨)抗菌药物使用量的上调有关。应鼓励各国进行抗菌药物使用情况的国家级报告,以便更好地评估国家政策对抗菌药物使用水平的影响。