Today (19 December 2023) has seen the launch of the second Annual Progress Report from the Responsible use of Medicines Alliance – Companion Animal and Equine (RUMA CA&E)[1]. The Alliance was established in 2020 to define the principles of the responsible use of medicines in the companion animal and equine sectors with a view to contributing positively to the One Health agenda.
The Alliance was created from the leadership and vision of the Responsible use of Medicines in Agriculture[2] (RUMA) Alliance, which over the past decade has helped focus activity across the livestock sectors to achieve a 59% reduction in antibiotic sales for food-producing animals since 2014.
The latest RUMA CA&E Annual Progress Report details the work undertaken by the Alliance and its members as well as across the wider CA&E sectors over the past 12 months and also includes usage data for the CA&E sectors from the recently released VARSS[3] report.
Gwyn Jones, RUMA CA&E Chair and the former Chair of RUMA Agriculture, says: “It has been another busy year for RUMA CA&E. We have fed into the Veterinary Medicines Regulations consultation, delivered our second roundtable event bringing industry stakeholders together to drive important data focused discussions, and we continue to be involved in numerous collaborative projects across the CA&E sectors. RUMA CA&E has also taken the lead project managing the Antibiotic Amnesty which ran again this November following a successful pilot last year. Our core focus over the past year as an Alliance has
again been on the responsible use of antibiotics across CA&E sectors and, as reported last year, work has already progressed in defining dog and cat measures, which will soon expand into the equine and exotics sectors.
“However, while antibiotics remains a primary focus, we recognise the importance of widening our remit to cover antiparasitics and anthelmintics and with that in mind, we are working with key industry stakeholders to explore how, as an Alliance, we can
support responsible use discussions in these areas.”
Commenting on usage across the CA&E sectors, RUMA Secretary General, Steve Howard says: “In dogs, the mg/kg measure suggests that there has been an overall reducing trend of antibiotic use over the years since 2016, except for between 2020 and 2021 when it increased. In cats, the overall trend has been a small but steady upward trend, with a decrease between 2021 and 2022. Whilst this metric is consistent with that used in other sectors, there are a number of disadvantages to using it in the companion animal sector. We do intend to keep reporting on this metric, but our focus areas will be led more by the DDDVet[4] results.
“The DDDVet data shows similar trends as described for mg/kg, with dogs showing an overall decrease, while the trend for cats has been more stable when the DDDVet measure is utilised. Both sectors showed an increase as society and the veterinary sector initially emerged from the pandemic in 2021, but then a decrease between 2021 and 2022.”
Whilst both sectors saw a decrease in HP-CIA use between 2021 and 2022, the use of HP-CIAs in cats remains high accounting for 44% of overall use but is on a gradually reducing trend. Use of HP-CIAs in dogs was the lowest since 2014.
Both dog and cat sectors saw a reduction in topical antimicrobial products sold between 2021 and 2022. Dogs saw a reduction of 1.1mg/kg whilst cats saw a smaller decrease of 0.2 mg/kg.
Dogs saw the lowest recorded amount sold for use between 2014 and 2022 (3.8mg/kg) showing a decrease since 2014 of 54% (3.2 mg/kg). There are a number of topical products containing HP-CIAs in use in the Companion Animal sector which provide valuable options to clinicians in the face of some conditions which can be difficult to treat. It is encouraging to see that the rate of use in both dogs and cats is much lower than overall topical use, and that between 2021 and 2022 there has been a decrease in use of topical HP-CIAs in dogs.
Steve adds: “The responsible deployment of these treatment options through good antimicrobial stewardship is important so that they remain efficacious for the future and don’t contribute to the development of wider resistance.”
One of Alliance’s core activities over the past year has included the delivery of a Data Roundtable event to engage with practice management system companies and
understand the capabilities for standardising data and reporting. Steve continues: “RUMA CA&E exited 2022 in a strong place thanks to our first roundtable at which national antibiotic measures for dogs and cats were defined, providing a clear set of foundation metrics to work from. It was the expectation to then move into equine and exotics roundtables in 2023 to carry out a similar exercise but, after consultation with the Alliance’s equine and exotics members, these plans changed direction for very good reason.
“In discussion with the British Equine Veterinary Association (BEVA) and the British Veterinary Zoological Society (BVZS) it became clear that another step was needed before these sector roundtables could take place. Manufacturers sales data is limited and provides no insight into use in equine and exotics sectors because there are so few licensed products, meaning there is more prescribing under the cascade and it is therefore impossible to extract meaningful insights from the sales data. This meant the next roundtable instead needed to be centred on usage data rather than sales data, which can more
reliably inform discussions around measures and targets in those sectors.”
The Data Roundtable delivered a range of feedback and questions around the areas outlined below. RUMA CA&E is now in the process of working with stakeholders to further explore a range of next steps associated with each element:
- Data security, storage and sharing
- Consistency and standardisation in data recording
- Identifying exactly which data are needed to gather the right levels of insight
- Data sources – understanding where data exists and how it can be gathered
- Proof of concept testing – establish a methodology
The RUMA CA&E Annual Report also provides updates and information on initiatives from the Alliance’s member organisations as well as providing details of other sector campaigns and initiatives.
Publication costs for the RUMA CA&E Annual Report have been kindly sponsored by Animalcare.
Dr Colin Capner, Technical Vet at Animalcare, says: “The need for the responsible use of antibiotics is amplified given the lack of new drug class discoveries, and the rise of antimicrobial resistance. Whilst rational reductions in use in the production animal sector have been measured helped by the work of RUMA Agriculture, there is more to do in terms of human use. Measurements of the use of antimicrobials in companion animal and equine medicine have until recently been less systematically examined, but the creation of the RUMA Companion Animal & Equine Alliance is a significant innovation helping to improve this situation. The aims to promote responsible use and stewardship of medicines are important in raising awareness and championing improvements in appropriate use.”
To read and download the report visit: Reports – RUMA CA&E (rumacae.org.uk)
[1] RUMA Companion Animal & Equine. RUMA CA&E (rumacae.org.uk)
[2] RUMA Agriculture: RUMA – Responsible Use of Medicines in Agriculture Alliance
[3] UK VARSS Report. _2669927-v1-UK_VARSS_REPORT_2022__2023_.PDF (publishing.service.gov.uk)
[4] Average number of days treated/ animal (DDDVet – Defined Daily Dose for animals, the assumed average dose per kg animal per species per day). This is calculated (for each active ingredient and route of administration and for both dogs and cats) by using an assumed average dose per animal per day. See appendices for more information on methodology.