Rationale: Treatment of diarrhea in pigs post weaning is the number one reason for antibiotic use in the pig industry and therefore a major cause of antibiotic consumption in animals globally. The ban of antibiotic growth-promotors and use of medical zinc will probably increase the need for treatment additionally in years to come. Post weaning diarrhea has a multifactorial etiology including different bacterial and virus infections. In addition, non-infections causes of diarrhea exist. This make prober diagnostics, selection of antibiotic substance, route of administration, dose and length of treatment very important to secure a prudent use of antibiotics for treatment of diarrhea. These elements need to be addressed in a guideline on Antimicrobial Use in Post Weaning Diarrhea in Pigs.

Target audience: European veterinary practitioners

For the drafting group we are looking for veterinary epidemiologists

The European Veterinary practice guidelines on antimicrobial use for post weaning diarrhea in pigs will be a joint ENOVAT/ESGVM set of guidelines and the drafting group is chaired by Ken Steen Pedersen (chair) and Ana Vale (co-chair).

If you are interested in joining please contact Ken (ken@sund.ku.dk) and Ana (ana.vale@ucd.ie).

Members

Name	Country	Area of Expertise
Ken Steen Pedersen	Denmark	Porcine Health Management
Ana Vale	Ireland	Veterinary Microbiology
John Elmerdahl Olsen	Denmark	Veterinary Microbiology
Ronette Gehring	Netherlands	Pharmacology
Jeroen Dewulf	Belgium	Epidemiology
Enric Marco	Spain	Swine Practice
John van der Wielen	Netherlands	Swine Practice
Dolf Kümmerlen	Switzerland	Porcine Health Management
Magdalena Jacobson	Sweden	Porcine Health Management
Carl Ekstrand	Sweden	Pharmacology
Josef Kamphues	Germany	Nutrition
Laura Boyle	Ireland	Animal Welfare
Lazarin Lazarov	Bulgaria	Animal Diseases
Elina Aimo-Koivisto	Finland	Clinical Microbiology
Helena Ferreira	Belgium	Methodology Task Force Leader

 

 

The Veterinary Practice Guidelines for Antimicrobial Use in Pigs with Post-Weaning Diarrhoea (PWD) drafting group presented some recommendations based on the work conducted during the ENOVAT COST Action at the final ENOVAT meeting in Copenhagen on the 7^th of March 2024.

Please see below the recommendations. 

PICO 1

Is the use of antibiotics in pigs presenting symptoms of post-weaning diarrhoea effective in reducing mortality, morbidity and improving growth rates as compared with placebo use?

 

Recommendations

• In pigs with moderate to severe PWD symptoms with no recent farm diagnostic data available, first line antibiotics EMA cat D (preferable) and C should be used, and individual antibiotic treatment should be prioritized.

Comment: If no recent farm diagnostic data are available, regional/national antimicrobial resistance data and farm history data should be used to further inform antibiotic treatment. Conditional recommendation, very low certainty evidence, 100% consensus

 

• In pigs with moderate/severe PWD symptoms, we suggest that diagnostic samples should be submitted for microorganism identification and antimicrobial susceptibility testing. These should be performed by laboratories that use standardized methods (EUCAST/CLSI) and go through periodic internal and external quality assurance schemes (e.g. proficiency testing). Samples should be collected from animals that have not been treated with antibiotics and show acute symptoms. Expert opinion, 100% consensus

 

• In pigs with moderate/severe PWD symptoms we suggest antibiotic treatment should be based on pharmacokinetics and pharmacodynamics of the drug, MIC values and clinical signs of the animals. Expert opinion, 100% consensus

• In pigs with mild PWD symptoms with no farm diagnostic data available, we suggest animals may be symptomatically treated and antibiotics should be avoided. Expert opinion, 100% consensus

Recommendations for further research and action

• Perform more field studies on commercial farms:

1. a) Randomized control clinical trials in herds with PWD, comparing different decisions for treatment, thresholds and strategies (duration and dosage of antibiotics, batch medication/individual medication).
2. b) Studies on infection dynamics that can be used to model the effects of interventions.

• Development and validation of pen-side diagnostic tests.

• Using the COM-B model of behaviour (or a comparable framework) at the regional/national level to identify the needs and barriers for the implementation of behaviour changes in stakeholders towards prudent antibiotic use. This assessment can inform policies, actions and interventions.

• Design a clinical decision tree based on current knowledge and identify knowledge gaps.

Acknowledgments

Ana Vale, Dolf Kümmerlen, Jobke van Hout, Steffanie Senf, Friederike Zeeh, Daniela Araujo, Joana Castro, Elsa Leclerc, Ken Pedersen, Helena Ferreira, Lisbeth Rem Jessen, Karolina Scahill and other PWD drafting group members and stakeholders.

Methodology taskforce members, ENOVAT, COST and ESGVM.