Abstract
Biases of antimicrobial use (AMU) reporting systems pose a challenge to monitoring of AMU. Our study aimed to cross-compare three data sources of AMU in Swedish dairy herds to provide an account of the validity of AMU reports. We studied AMU differences between two production systems, to investigate how the reporting system affected this comparison. On-farm quantification of AMU via a manual collection of empty drug containers (BIN) took place in organic (n = 30) and conventional (n = 30) dairy herds during two periods between February 2016 and March 2017. A data extract mirroring these periods was obtained from two linked datasets that contain AMU data as reported by the prescribing veterinarians. These included data from the Swedish Board of Agriculture system (SBA) and Växa milk recording system (VXA). Using the European Medicines Agency technical units, the total number of defined daily doses (DDD(vet)), and defined course doses (DCD(vet)) per animal/year were calculated for each herd/period/dataset. Descriptive statistics and Bland-Altman plots were used to evaluate the agreement and systematic bias between the datasets. Mixed models for repeated measures were used to assess AMU differences between production systems. We found consistent numerical differences for the calculated AMU metrics, with BIN presenting higher usage compared to the SBA and VXA. This was driven by a disparity in intramammary tubes (IMt) which appear to be underreported in the national datasets. A statistically significant interaction (BIN dataset) between the production system and drug administration form was found, where AMU for injectable and lactating cow IMt drug forms differed by the production system, but no difference was found for dry-cow IMt. We conclude that calculating AMU using DDD(vet) and DCD(vet) metrics at a herd level based on Swedish national datasets is useful, with the caveat of IMt potentially being misrepresented. The BIN method offers an alternative to monitoring AMU, but scaling up requires considerations. The lower disease caseload in organic herds partly explains the lower AMU in particular drug forms. The fact that organic and conventional herds' had equally low AMU for dry-cow IMt, coupled with mismatches in IMt report across herds indicated an area of further research.