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The benefits of symptomatic treatment in the responsible use of antibiotics

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01 March 2016, at 12:00am

ARNAUD ANTY believes that the use of paracetamol as a symptomatic treatment before going straight for antibiotics should become more common on forward-thinking farms

THE use of antibiotics in general and in intensive production systems in particular is becoming increasingly controversial in Europe, with many countries now demanding reduced usage. We therefore need to review our production systems with this in mind.

The use of paracetamol as a symptomatic treatment to help reduce the need for antibiotics would appear to be a useful tool. The value of paracetamol in this role has led to an increasing use throughout Europe.

Following the lead of Denmark, positive antibiotic usage reduction policies have been implemented in various European countries. The Danes have established a stockbreeder “yellow card” system.

If farms use more than a certain amount of antibiotic (as defined by the authorities), they are issued with a “yellow card”. This obliges them to reduce their antibiotic usage, and may lead to a fine and regular inspections at their expense by the veterinary authorities.

In the Netherlands in 2009, an antibiotic usage reduction plan was voted in, aimed at achieving a 20% reduction by 2011 and 50% by 2013. In July 2011, the 20% goal had been exceeded, the reduction having reached 37%. Some are now recommending a 90% reduction target! In France, a national antibiotic resistance control plan has been implemented, the flagship measure of which is a 25% reduction of animal exposure to antibiotics.

While these countries are in the forefront, it should also be noted that Germany, Belgium and many other European countries have implemented antibiotic consumption reduction plans.

Contrary to most European countries, in the UK, an antibiotic consumption report published in 2012 showed that antibiotic consumption increased by 10% between 2009 and 2010 (source: VMD, 2011), i.e. 41 extra tons of antibiotics used in livestock production.

The search for alternatives to the use of antibiotics fits into a European framework.

Reducing antibiotic use

  • Antibiotic consumption reduction can be based on multiple approaches: biosecurity to control the entry of diseases;
  • housing and management methods aimed at reducing disease spread (e.g. batch pig flow);
  • consideration of alternatives to regular or routine use of antibiotics;
  • the use of alternative medicinal products, including symptomatic treatments, represents an essential and growing arsenal.

Symptomatic antipyretic, analgesic and/or anti-inflammatory treatments offer new treatment perspectives for common ailments. They cannot replace antibiotic treatment in the event of a demonstrated serious infectious event, but they can replace or delay the use of antibiotics if the disease is mild, or accelerate the recovery process when used in combination with antibiotics.

Indeed, it has been demonstrated, in the context of respiratory disease for example, that fever is correlated with the severity of clinical signs on the farm. The higher the fever, the more serious the disease and treating the 

fever itself helps reduce the extent of clinical signs: the animals regain their appetite more rapidly, clinical signs are reduced and the administration of antibiotics may even be avoided altogether.

In this context, the main characteristics sought for an “alternative” treatment are: n a registered drug that has thus demonstrated its efficacy against fever and associated symptoms;

  • a drug that is as safe as possible, that can be used on animals whatever their age, with no risk of toxicity;
  • a drug with a minimal or zero meat withdrawal period, allowing use in animals near slaughter.

NSAIDs and paracetamol both present these characteristics. Additionally, paracetamol possesses the added advantage of not presenting any risk of toxicity for piglets and sows. And, in sows as it is in humans, paracetamol is the only drug of this kind to be authorised for use during pregnancy.

Paracetamol: its field uses

Paracetamol has been used for several years in major pork-producing countries: Germany, the Netherlands, France, Italy, Poland, Spain and Denmark.

Various studies have shown that paracetamol accelerates fever drop and regained appetite during episodes of respiratory disease.

A recent study demonstrated that paracetamol could be used as an alternative to antibiotics during ‘flu epidemics.

It should be noted that in Europe, paracetamol along with other NSAIDs is used as first-time treatment in cases of respiratory ‘flu, before a decision is made concerning the use of antibiotics, thus avoiding the need to use antibiotics in many cases.

Finally, the particularly safe nature of paracetamol has led to the development of numerous parallel uses, such as: n during farrowing, to improve sow food consumption and thus the condition of the piglets; n reduction of vaccination reactions when administering highly “reactive” vaccines or in the event of multi- vaccination in sows and piglets (vaccines that can trigger significant temperature peaks that can potentially stop food intake by some animals); n use during non-specific stress; n pain management (a recent castration study demonstrated the ability of paracetamol to reduce post-surgical pain). 

Paracetamol is an efficient symptomatic treatment. Its safety is well proven and it is the only drug of its kind to be authorised for mass medication in fattening pigs as well as in pregnant, farrowing and lactating sows. Its zero withdrawal period is a big advantage when facing problems in finishing pigs.

In the context of reduction of antibiotic usage, paracetamol also appears to be a great opportunity to think outside the box. Paracetamol will not replace antibiotics when they are needed, but it may encourage questioning our treatment habits. Symptomatic treatment before going straight for antibiotics should become more the norm on forward-thinking farms.