(AGENPARL) – ven 17 novembre 2023 Sales of veterinary antimicrobial
agents in 31 European countries
in 2022
Trends from 2010 to 2022
Thirteenth ESVAC report
OPERAT
Years
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Mission statement
The mission of the European Medicines Agency is to foster scientific excellence
in the evaluation and supervision of medicines, for the benefit of public and
animal health.
Legal role
The European Medicines Agency (hereinafter ‘the Agency’
or EMA) is the European Union (EU) body responsible for
coordinating the existing scientific resources put at its
disposal by Member States for the evaluation, supervision
and pharmacovigilance of medicinal products.
The Agency provides the Member States, the institutions
of the EU and the European Economic Area (EEA) countries
with the best possible scientific advice on any questions
relating to the evaluation of the quality, safety and efficacy
of medicinal products for human or veterinary use referred
to it in accordance with the provisions of EU legislation
relating to medicinal products.
The founding legislation of the Agency is Regulation (EC)
No 726/2004 of the European Parliament and the Council
of 31 March 2004 laying down Union procedures for the
authorisation and supervision of medicinal products for
human use and establishing a European Medicines
Agency1, as amended. Veterinary medicinal products are
authorised and supervised by Regulation (EU) 2019/6 of
the European Parliament and of the Council of 11
December 2018 on veterinary medicinal products and
repealing Directive 2001/82/EC2.
Principal activities
Working with the Member States and the European
Commission as partners in a European medicines network,
the Agency:
• provides independent, science-based recommendations
on the quality, safety and efficacy of medicines, and
on more general issues relevant to public and animal
health that involve medicines;
• applies efficient and transparent evaluation procedures
to help bring new medicines to the market by means
of a single, EU-wide marketing authorisation granted
by the European Commission;
• implements measures for continuously supervising the
quality, safety and efficacy of authorised medicines to
ensure that their benefits outweigh their risks;
• provides scientific advice and incentives to stimulate
• recommends safe limits for residues of veterinary
medicines used in food-producing animals to support
the establishment of maximum residue limits by the
European Commission;
• involves representatives of patients, healthcare
professionals and other stakeholders in its work to
facilitate dialogue on issues of common interest;
• publishes impartial and comprehensible information
about medicines and their use;
• develops best practice for medicine evaluation and
supervision in Europe, and contributes alongside the
Member States and the European Commission to the
harmonisation of regulatory standards at the
international level.
Guiding principles
• We are strongly committed to public and animal
health.
• We make independent recommendations based on
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and expertise in our field.
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Agency.
the development and improve the availability of
innovative new medicines;
Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying down Community procedures for
the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency:
https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex%3A32004R0726
Regulation (EU) 2019/6 of the European Parliament and of the Council of 11 December 2018 on veterinary medicinal products and
repealing Directive 2001/82/EC: https://eur-lex.europa.eu/eli/reg/2019/6/oj
Sales of veterinary antimicrobial agents in 31 European
countries in 2022
Trends from 2010 to 2022
Thirteenth ESVAC report
20 November 2023
EMA/299538/2023
Veterinary Medicines Division
Acknowledgements
The members of the ESVAC sales advisory expert group — Kari Grave (chair), Christina Greko, Iva Gruden Zduni?,
Katariina Kivilahti-Mäntylä, Laura Mie Jensen, Lucie Pokludová and Spyridon Farlopoulos — are acknowledged for
providing valuable comments and scientific advice during the production of this report.
Furthermore, Reinhard Fuchs, Klemens Fuchs, Antita Adriaens, Reshat Jashari, Milena Atanasova, Marios Genakritis,
Marju Sammul, Henriette Helin-Soilevaara, Anne Chevance, Katharina Hofmann, Alexandra Klabunde-Negatsch, Paul Siller,
Csilla Rápóti-Fekete, András Lakatos, Jóhann M. Lenharðsson, Jeremiah Gabriel Beechinor, Gavin Ryan, Loredana Candela,
Zanda Auce, Dagnija Arbidane, Jovita Einoryt?, Caroline Coner, Marc Schmit, Bernard Soler, Gineke Hoogeveen,
Inge van Geijlswijk, Kari Olli Helgesen, Dorota ?aboklicka-Bodzioch, Mariusz Kowalik, Inês Martins de Almeida,
João Pedro Duarte da Silva, Camelia Voicu, Daniela Motiu, Katarína Massányiová, Zuzana Duraniová, Anton Svetlin,
Rinaldo Zidar, Cristina Muñoz Madero, Sara Sacristán Álvarez, Alejandro Platt Orzáez, Carmen Pastor Alcaid, Kinfe Girma,
Cedric M?ntener, Fraser Broadfoot, Max Renton and Catrina Prince are all acknowledged for providing data and valuable
comments for the report.
European Medicines Agency staff members, Cristina Ribeiro-Silva, Manuela Mazzuferi, Anastasia Pickford, Zoltan Kunsagi,
Helen Jukes, Barbara Freischem and Filipa Mendes Oliveira are gratefully acknowledged for the preparation of the report.
Citation
Suggested citation: European Medicines Agency, European Surveillance of Veterinary Antimicrobial Consumption, 2022.
‘Sales of veterinary antimicrobial agents in 31 European countries in 2022’ (EMA/299538/2023).
Correspondence
Correspondence relating to this report should be made via the AskEMA form3.
DISCLAIMER
The views and positions expressed in this report do not necessarily represent in legal terms the official position of the European Medicines Agency.
The European Medicines Agency assumes no responsibility or liability for any errors or inaccuracies that may appear in the report.
Use the AskEMA form to send a request for information from EMA or to make a formal request for access to EMA documents that are
not already published on this website: https://www.ema.europa.eu/en/about-us/contacts/send-question-european-medicines-agency
About the European Medicines Agency
The European Medicines Agency (EMA) is a decentralised body of the EU, located in Amsterdam. Its main responsibility
is the protection and promotion of public and animal health through the evaluation and supervision of medicines for
human and veterinary use.
The Agency is responsible for the scientific evaluation of applications for European marketing authorisations for both
human and veterinary medicines (centralised procedure). Under the centralised procedure, companies submit a single
marketing authorisation application to the Agency. Once granted by the European Commission (EC), a centralised
marketing authorisation is valid in all EU Member States and, after implementation at national level, in the European
Economic Area — European Free Trade Association (EEA-EFTA) states (Iceland, Liechtenstein and Norway).
The Agency, with the help of its Committee for Veterinary Medicinal Products (CVMP), and its Antimicrobials Working
Party (AWP), has produced a strong body of scientific advice4 in relation to the use of antimicrobials and the risk of
antimicrobial resistance (AMR), with the intention of promoting the continued availability of effective antimicrobials for
use in animals while, at the same time, acting to minimise risks to animals or humans arising from their use.
The European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) project was launched by the Agency in
September 2009, following a request from the EC to develop a harmonised approach to the collection and reporting of
data on the use of antimicrobial agents in animals from the Member States.
About the report
The thirteenth ESVAC report presents data on the sales of veterinary antibiotic agents from 31 European countries in
2022. These data are provided at package level in accordance with the data reporting protocol and data collection form
published in March 20215. Information on country-specific trends is published separately on the EMA website in Country
Individual Reports6. This report focuses on the consumption of antibiotic veterinary medicinal products (VMPs) for foodproducing animals at the European level and analyses the trends it has followed since 2010.
The report emphasises certain classes or subclasses of antibiotics included in Category B of the categorisation made
by the EMA’s Antimicrobial Advice ad hoc Expert Group (AMEG) in 2019, available on the EMA website7. The AMEG
categories take account of the World Health Organization (WHO) categorisation of antimicrobials (6th revision)8, the
need for the respective antimicrobials in veterinary medicine and the probability of transfer of antimicrobial resistance
from animals to humans. Category B of the AMEG categorisation includes those veterinary antibiotics from which the
risk to public health is estimated to be higher than from other classes of antibiotics; fluoroquinolones, other quinolones,
3rd- and 4th-generation cephalosporins and polymyxins are included in this category. Macrolides are included in
Category C of the AMEG categorisation.
The data collected for ESVAC are also used in the Joint Interagency Antimicrobial Consumption and Resistance Analysis
(JIACRA) report produced jointly by the European Centre for Disease Prevention and Control (ECDC), the European
Food Safety Authority (EFSA) and EMA. The most recent report, the JIACRA III report published in 2021, has shown,
while recognising the complexity of evaluating the association between sales of antimicrobials and occurrence of AMR
in animals and humans, that reduction of antimicrobial consumption typically following interventions have a positive
impact on the occurrence of AMR.
Available from the European Medicines Agency website (www.ema.europa.eu/en) via Home > Veterinary regulatory > Overview >
Antimicrobial resistance.
Available from the European Medicines Agency website (www.ema.europa.eu/en) via Home > Veterinary regulatory > Overview >
Antimicrobial resistance > European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) > Sales data reporting form and
protocol.
Available from the European Medicines Agency website (www.ema.europa.eu/en) via Home > Veterinary regulatory > Overview >
Antimicrobial resistance > European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) > Trends by country.
EMA/AMEG 2019, ‘Categorisation of antibiotics in the European Union. Answer to the request from the European Commission for
updating the scientific advice on the impact on public health and animal health of the use of antibiotics in animals’ (https://www.ema.
europa.eu/en/documents/report/categorisation-antibiotics-european-union-answer-request-european-commission-updating-scientific_
en.pdf).
ECDC, EFSA and EMA have also jointly established a list of harmonised outcome indicators9 to assist EU Member States in
assessing their progress in reducing the use of antimicrobials and occurrence of AMR in both humans and food-producing
animals. For food-producing animals, the proposed indicators for antimicrobial consumption are: overall sales of veterinary
antimicrobials; sales of 3rd- and 4th-generation cephalosporins; sales of quinolones (specifying the proportion of
fluoroquinolones); and sales of polymyxins, all measured in milligrams per population correction unit (mg/PCU).
The thirteenth ESVAC report follows the same outline as in the twelfth edition, focusing on the primary and secondary
indicators of antimicrobial (more specifically antibiotic) consumption for food-producing animals. All figures and tables
present in previous reports can be found in the ESVAC interactive database10.
The data and information included in this report have been reviewed and approved by the ESVAC National Contact
Points or their alternates.
Advice on how to read this report:
It is generally agreed that it usually takes at least three to four years to establish a valid baseline for the
data on sales of veterinary antibiotic agents. Consequently, for each country, data from the first few years
of collection should be interpreted with due caution.
The data presented in this report should not be used as a sole basis for setting management priorities;
additional data on the production of animals by country and animal demography, available veterinary
medicinal products and other factors such as disease incidence or outbreaks should also be considered.
It should be underlined that data presented in this report should not be used for direct comparison between
countries, as more detailed information and analysis would be needed.
Available on the EMA website (www.ema.europa.eu/en) via Home > Veterinary regulatory > Overview > Antimicrobial resistance >
Analysis of consumption and resistance (JIACRA) > Outcome indicators (https://www.ema.europa.eu/en/documents/report/ecdc-efsaema-joint-scientific-opinion-list-outcome-indicators-regards-surveillance-antimicrobial_en.pdf).
Available on the EMA website (www.ema.europa.eu/en) via: Home > Veterinary regulatory > Antimicrobial resistance > European
Surveillance of Veterinary Antimicrobial Consumption > ESVAC interactive database accessible via: https://esvacbi.ema.europa.eu/
analytics/saw.dll?PortalPages
Table of contents
Summary……………………………………………………………………………………………………. 10
Introduction……………………………………………………………………………………………….. 12
1. Technical notes……………………………………………………………………………………….. 14
1.1. Antibiotic substances included in the sales data sets………………………………………………….. 14
1.2. Product forms reported per antibiotic VMP presentation………………………………………………. 14
1.3. Collection and calculation of sales data…………………………………………………………………… 15
1.4. Denominator: population correction unit (PCU)…………………………………………………………. 15
1.5. Correction of historical data………………………………………………………………………………… 16
1.6. Data quality check and validation of the sales and animal population data………………………… 17
1.7. Analysis and reporting of the data………………………………………………………………………… 17
1.8. Summary of data sources / types included, by country……………………………………………….. 18
2. Results…………………………………………………………………………………………………… 22
2.1. Sales of antibiotic VMPs for food-producing animals in 2022…………………………………………. 22
2.2. Sales trends of antibiotic VMPs for food-producing animals…………………………………………… 36
secondary outcome indicators……………………………………………………………………………………. 36
secondary outcome indicators……………………………………………………………………………………. 39
2.3. Sales of tablet antibiotic VMPs for companion animals in 2022………………………………………. 59
2.4. Farm to Fork Strategy targets: reducing overall EU sales of antimicrobials for farmed
animals and aquaculture by 50%……………………………………………………………………………….. 61
3. Discussion………………………………………………………………………………………………. 63
4. Concluding remarks………………………………………………………………………………….. 67
Annex 1. Additional tables and figures regarding 2022 data………………………………. 68
Annex 2. List of antibiotic classes or active substances reported in ESVAC…………… 71
Annex 3. Distribution of veterinary medicines: legal framework and data sources
by country…………………………………………………………………………………….. 73
Annex 4. References to national reports………………………………………………………….. 86
Annex 5. Country and affiliation of the ESVAC national contact points/alternates….. 88
Annex 6. ESVAC sales advisory expert group members and observers…………………. 93
List of figures
Figure 1. Organisation of the ESVAC Network and Stakeholders……………………………………………………… 13
Figure 2. Spatial distribution of overall sales, in mg/PCU, of antibiotic VMPs for food-producing animals
in 31 European countries in 2022………………………………………………………………………………. 22
Figure 3. Proportion of aggregated sales, in mg/PCU, of antibiotic VMPs for food-producing animals
by product form in 31 European countries in 2022………………………………………………………….. 24
Figure 4. Proportion of aggregated sales, in mg/PCU, of antibiotic VMPs for food-producing animals
by antibiotic class in 31 European countries in 2022……………………………………………………….. 25
Figure 5. Proportion of penicillin sales for food-producing animals, in mg/PCU, by subclass in 31 European
countries in 2022………………………………………………………………………………………………….. 26
Figure 6. Proportion of sales of 3rd- and 4th-generation cephalosporins, fluoroquinolones, other quinolones
and polymyxins of total sales, in mg/PCU, of antibiotic VMPs for food-producing animals in
31 European countries in 2022…………………………………………………………………………………. 28
Figure 7. Spatial distribution of sales, in mg/PCU, of 3rd- and 4th-generation cephalosporins for
food-producing animals in 31 European countries in 2022………………………………………………… 29
Figure 8. Proportion of sales, in mg/PCU, of 3rd- and 4th-generation cephalosporins for food-producing
animals by product form in 31 European countries in 2022……………………………………………….. 30
Figure 9. Spatial distribution of sales, in mg/PCU, of fluoroquinolones for food-producing animals in
31 European countries in 2022…………………………………………………………………………………. 31
Figure 10. P
roportion of sales, in mg/PCU, of fluoroquinolones for food-producing animals by product form
in 31 European countries in 2022……………………………………………………………………………… 32
Figure 11. S
patial distribution of sales, in mg/PCU, of other quinolones for food-producing animals in
31 European countries in 2022…………………………………………………………………………………. 33
Figure 12. Proportion of sales, in mg/PCU, of other quinolones for food-producing animals by product form
and by country in 2022…………………………………………………………………………………………… 34
Figure 13. Spatial distribution of sales, in mg/PCU, of polymyxins for food-producing animals in
31 European countries in 2022…………………………………………………………………………………. 35
Figure 14. P
roportion of sales, in mg/PCU, of polymyxins for food-producing animals by product form and
by country, in 2022………………………………………………………………………………………………… 36
Figure 15. Trends of aggregated overall sales, sales of 3rd- and 4th-generation cephalosporins, other
quinolones, fluoroquinolones and polymyxins, in mg/PCU, for the 25 European countries
reporting data for ESVAC from 2011 to 2022………………………………………………………………… 37
Figure 16. T
rends of aggregated sales (mg/PCU) by antibiotic class in 25 European countries from 2011
to 2022……………………………………………………………………………………………………………….38
Figure 17. Proportion of sales, in mg/PCU, by product form in 25 European countries from 2011 to 2022…….. 39
Figure 18. Trends of aggregated overall sales, sales of 3rd- and 4th-generation cephalosporins, other
quinolones, fluoroquinolones and polymyxins, in mg/PCU, aggregated by the 31 European countries
reporting data for ESVAC from 2017 to 2022………………………………………………………………… 40
Figure 19. Proportion of tablet sales, in tonnes of active substance, by antibiotic class (reported according
to the ATCvet hierarchical system) in 31 European countries in 2022…………………………………… 60
Figure 20. Proportion of tablet sales (in tonnes of active substance) containing penicillins by subclass in
31 European countries in 2022…………………………………………………………………………………. 61
Figure 21. Current progress of the Farm to Fork Strategy target of reducing total EU sales of antibiotics
for farmed animals and aquaculture by 50% by 2030 in 27 EU Member States……………………….. 62
List of tables
Table 1. Groups and ATCvet codes of antimicrobial substances with antibiotic activity used in veterinary
medicine included in the ESVAC database…………………………………………………………………….. 14
Table 2. Summary of information on number of years of data collection, legal basis for data collection at
national level, national data providers, sources of ESVAC data and characteristics of data,
by country, for 2022………………………………………………………………………………………………. 19
Table 3. Sales in tonnes of active substance of antibiotic VMPs marketed mainly for food-producing
animals, PCU in 1,000 tonnes and sales in mg/PCU in 31 European countries in 2022………………. 23
Table 4. Sales for food-producing animals, in mg/PCU, of the various antibiotic classes in 31 European
countries in 2022………………………………………………………………………………………………….. 27
Table 5. Sales trends for food-producing animals (mg/PCU), including horses and farmed fish, per country
from 2010 to 2022………………………………………………………………………………………………… 42
Table 6. Trends in sales of all antibiotic active substances (tonnes) for food-producing animals and PCU
(in 1,000 tonnes) by country from 2010 to 2022……………………………………………………………. 53
Table 7. Overall sales, in tonnes of active substance, split by tablets (used mainly in companion animals)
and all other product forms (used mainly in food-producing animals), by country, in 2022…………. 59
Table A1. Sales, in tonnes of active substance, of antibiotic VMPs applicable mainly to food-producing animals
by antibiotic class (presented according to the ATCvet hierarchical system), by country, in 2022
(tablets not included)…………………………………………………………………………………………….. 68
Table A2. Estimated PCU (in 1,000 tonnes) of the population of food-producing animals, by country,
in 2022……………………………………………………………………………………………………………… 69
Table A3. Sales, in tonnes of active substance, of VMP presentations sold as premixes, oral powders and
oral solutions containing 1, 2 and 3 active substances, by country, in 2022……………………………. 70
Table A4. List of substances reported sold as VMPs in ESVAC participating countries, 2010–2022……………… 71
Table A5. List of ESVAC national contact points / alternates 2022……………………………………………………. 88
Table A6. List of ESVAC sales advisory expert group observers from the European Commission,
ECDC and EFSA……………………………………………………………………………………………………. 93
Summary
A total of 31 European countries — 29 EU/EEA countries (at the time of the calendar year covered in this report),
Switzerland and the United Kingdom — submitted antibiotic11 veterinary medicinal products (VMPs) sales or prescription
(3 countries) data to the European Medicines Agency for 2022.
The main indicator used to express the sales of antibiotic VMPs in the current report is milligrams (mg) of active
substance sold per population correction unit (PCU) — mg/PCU. The PCU is applied as a proxy for the size of the foodproducing animal population (including all horses and excluding companion animals) and serves to normalise the sales
data by the number of animals that could be potentially treated with antibiotics in each country.
Overall sales of antibiotic VMPs in 2022 for 31 countries
Overall aggregated sales of antibiotic VMPs for all 31 countries reporting data in 2022 were 73.9 mg/PCU. This
represents a 12.7% decrease compared to 2021 (84.7 mg/PCU). A large difference continues to be observed between
countries with the highest and lowest sales, ranging from 2.1 mg/PCU to 254.7 mg/PCU, while the median for all
31 countries was 45.8 mg/PCU.
The highest selling antibiotic class consisted of penicillins, accounting for 32.7% of overall sales (24.2 mg/PCU).
Together with tetracyclines (17.4 mg/PCU, 23.5%) and sulfonamides (6.9 mg/PCU, 9.4%), these 3 classes accounted
for 65.5% of total sales in 2022. In general, the sales patterns of the various antibiotic classes varied substantially
among the 31 countries. This was also true for the antibiotic classes of EMA AMEG Category B, for which it is
recommended to restrict the use — i.e. 3rd- and 4th-generation cephalosporins, fluoroquinolones, other quinolones and
polymyxins — the sales of which ranged from Antimicrobial resistance > European
Surveillance of Veterinary Antimicrobial Consumption > Units of measurement.
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
The ESVAC sales data activity is supported by an Expert Advisory Group (EAG), which is comprised of representatives
of the ESVAC main National Contact Points and alternates network. There are also observers from EC, ECDC and EFSA.
The task of the ESVAC sales EAG is to provide technical advice on the surveillance of overall sales data of antibiotic
VMPs, including the collection, data analysis and reporting, and preparation of the annual reports. A list of the ESVAC
EAG members and observers can be found in Annex 6 of this report.
The organisation of the ESVAC project is illustrated in Figure 1.
Figure 1. Organisation of the ESVAC Network and Stakeholders
National Networks
Observers
• EU Reference LaboratoryAntimicrobial Resistance
(EURL-AR)
• Food and Agriculture
Organization of the
United Nations (FAO)
• Public Health Agency of
Canada (PHAC)
• U.S. Food and Drug
Administration (FDA)
• World Health
Organization (WHO)
• World Organisation for
Animal Health (WOAH)
Collaborating
Centre for Drug
Statistics
Methodology
ESVAC Main National
Contact Points
(NCs)/Altemates
European Commission
ESVAC Species NCs
Data Managers
European
Surveillance
of Veterinary
Antimicrobial
Consumption
(ESVAC)
European Medicines
Agency (EMA)
Committee for Veterinary
Medicinal Products (CVMP)
• European Centre for
Disease Prevention
and Control (ECDC)
• European Food Safety
Authority (EFSA)
• ESVAC sales Expert
Advisory Group
• ESVAC species Expert
Advisory Group
• ESVAC
DDDvet/DCDvet Expert
Advisory Group
Other stakeholders
• AnimalhealthEurope
• European Group for Generic Veterinary Products (Access VetMed)
• Federation of Veterinarians of Europe (FVE)
• Association of Veterinary Consultants (AVC)
• European Healthcare Distribution Association (GIRP)
• COPA-COGECA (European agricultural union and European
agricultural cooperative organisations)
• European Consumer Organisation (BEUC)
ESVAC deliverables also include publication of the core graphs and tables of the ESVAC reports available on the
EMA website through the ESVAC BI interactive database (web-based Oracle Business Intelligence Enterprise Edition
application)14.
The thirteenth ESVAC report containing 2022 data submitted voluntarily by participating countries is the last ESVAC
report. Under Regulation (EU) 2019/6 on VMPs, the collection of data on sales of veterinary antimicrobials and on use
of antimicrobials in animals and the reporting of these data to the Agency becomes a mandatory activity of Member
States. In turn, the Agency will publish a new series of annual reports with these data, starting in 2025 with data from
2023 and 2024.
Available on the EMA website (www.ema.europa.eu/en) via: Home > Veterinary regulatory > Antimicrobial resistance > European
Surveillance of Veterinary Antimicrobial Consumption > ESVAC interactive database accessible via: https://www.ema.europa.eu/en/
veterinary-regulatory/overview/antimicrobial-resistance/european-surveillance-veterinary-antimicrobial-consumption-esvac#
interactiveesvac-database-section
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
1.? Technical notes
1.1.? Antibiotic substances included in the sales data sets
To obtain harmonised data on sales of antimicrobial VMPs from the ESVAC-participating countries, the antimicrobial
substances to be included in the sales datasets are defined in the ESVAC protocol15 using ATCvet16 codes (Table 1).
Although some substances may additionally be classified as antiprotozoals, e.g. metronidazole and sulfonamides, all
the antimicrobials reported to ESVAC have antibiotic activity as defined in Article 4 of the Regulation (EU) 2019/617.
Furthermore, data collected for ESVAC are also used for the JIACRA report, where possible relationships between
antimicrobial consumption and resistance are analysed between specific antibiotics and indicator bacteria. Therefore,
throughout this report the term ‘antibiotic’ has been used instead of ‘antimicrobial’.
The ESVAC scope covers all pharmaceutical forms, including premixes used to produce medicated feed, except
for dermatological (ATCvet group QD) and sensory organ (ATCvet group QS) VMPs. The contribution of these
pharmaceutical forms to the total quantity of veterinary antibiotics sold, in tonnes of active substance, is considered to
be negligible for food-producing animals. The use of antimicrobial growth promoters is prohibited in ESVAC-participating
countries, and therefore they are not part of the data collection. Ionophore coccidiostat feed additives and veterinary
medicines containing zinc oxide18 are also not included. Other active substances that are not classified as antibiotics,
e.g. antiprotozoals (without antibiotic effect), antivirals, antifungals and anti-inflammatory substances fall outside the
scope of the ESVAC protocol.
To harmonise the reporting of VMP sales with the data on sales of antibiotic agents used in human medicine, the
substances are presented according to the classes / subclasses defined by the ATCvet hierarchical system, using WHO
international non-proprietary names (INN) where available. If INNs have not been assigned, the ATCvet system applies
either USAN (United States Adopted Names) or BAN (British Approved Names).
Table 1. Groups and ATCvet codes of antimicrobial substances with antibiotic activity used in veterinary medicine
included in the ESVAC database
Groups of antimicrobial substances
ATCvet codes
Antimicrobial substances for intestinal use
QA07AA, QA07AB
Antimicrobial substances for intrauterine use
QG01AA, QG01AE, QG01BA, QG01BE, QG51AA, QG51AG
Antimicrobial substances for systemic use
Antimicrobial substances for intramammary use
Antimicrobial substances used as antiprotozoals
QP51AG
1.2.? Product forms reported per antibiotic VMP presentation
To standardise information and facilitate data management, the ESVAC analysis applies ‘product forms’, which are
a combination of a pharmaceutical form and the route of administration. These product forms are selected from a
standardised list and include: boluses, injectable products, intramammary products for lactating cow treatment,
intramammary products for dry cow treatment, intrauterine products, oral solutions (including powders and concentrates
for administration in drinking water), oral pastes, oral powders (powder to be administered with feed), premixes (for
Available on the EMA website (www.ema.europa.eu/en) via: Home > Veterinary regulatory > Antimicrobial resistance > European
Surveillance of Veterinary Antimicrobial Consumption > Sales data reporting form and protocol: https://www.ema.europa.eu/en/
documents/other/european-surveillance-veterinary-antimicrobial-consumption-esvac-web-based-sales-animal-population_en.pdf
Available on the WHO Collaborating Centre for Drug Statistics methodology ATCvet web page: http://www.whocc.no/atcvet/
As per Article 4(12) of the Regulation (EU) 2019/6, ‘antibiotic means any substance with a direct action on bacteria that is used for
treatment or prevention of infections or infectious diseases’.
On 26 June 2017, the European Commission issued a decision to request the Member States to withdraw, within five years of the
above date, existing marketing authorisations of veterinary medicinal products containing zinc oxide for oral administration to
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
medicated feed normally produced by feed mills) and tablets. Data on intramammary products for lactating cows and dry
cow treatments are collected separately but reported together throughout the report. Detailed information on the product
forms to be reported to EMA for each antibiotic VMP presentation can be found in the ESVAC protocol19.
1.3.? Collection and calculation of sales data
For each calendar year, the ESVAC-participating countries provide the number of packages sold within their territory
for each antibiotic VMP presentation in addition to information on the name of the VMP, the pharmaceutical form, the
strength of the antibiotic active substance(s) and the pack size, among others. Countries upload their data directly to
the ESVAC database using the ESVAC web-based application. The quantity of antibiotic active substance, in tonnes sold,
for each VMP presentation is calculated by multiplying the number of packages sold by the amount of the antibiotic
active substance per package unit, the latter calculated by multiplying the strength given in the corresponding product
information with the pack size. These calculations are performed automatically in a standardised and harmonised
manner by the ESVAC web-based application tool, including the use of conversion factors to convert international
units (IU) into mg when the strength is reported in IU or to calculate the mass of antibiotic active moiety in mg when
the strength is reported as the derivative / compound strength. These conversion factors were updated in 2021 and
are included in the ESVAC sales data reporting form and protocol. For fixed combination VMPs, the quantity of each
antibiotic active substance is calculated separately.
1.4.? Denominator: population correction unit (PCU)
The population correction unit, referred to as PCU, has been established as a denominator for reporting the sales data
and serves to normalise the total quantities of antibiotic active substance sold in each country by the animal population
that could be potentially treated with these in each country. The PCU only includes food-producing animals, including
horses and farmed fish, as population data of companion animals such as dogs and cats are not available for all
participating countries. Therefore, tablets are excluded from the data sets prior to the normalisation of sales by PCU
since they are typically approved for companion animals only.
The Eurostat database20 is the selected source for animal population data (both livestock and slaughtered animals),
which is then corrected with data from TRACES (the Trade Control and Expert System run by EC DG SANTE) on the
number of animals moved across borders within the single market for fattening or slaughter. The PCU for each terrestrial
food-producing animal category (cattle, pigs, poultry, horses, sheep, goats and rabbits) is calculated by multiplying the
number of livestock or slaughtered animals by their theoretical weight at the likely time of treatment. For farmed fish,
the live-weight slaughtered biomass is used directly.
A summary of the PCU calculations can be found in the box below, while further details on the data sources and the
methodology used for the calculation of the PCU are comprehensively described in Appendix 2 of the Agency’s report
‘Trends in the sales of veterinary antimicrobial agents in nine European countries: 2005-2009’ (EMA/238630/2011)21,
as well as in the ESVAC protocol. It must be emphasised that the PCU is purely a surrogate for the animal population
that could potentially be treated.
Available on the EMA website (www.ema.europa.eu/en) via: Home > Veterinary regulatory > Antimicrobial resistance > European
Surveillance of Veterinary Antimicrobial Consumption > Sales data reporting form and protocol: https://www.ema.europa.eu/en/
documents/other/european-surveillance-veterinary-antimicrobial-consumption-esvac-web-based-sales-animal-population_en.pdf
Available on the Eurostat website (https://ec.europa.eu/eurostat/web/main/home) via: Home > Data > Database: https://ec.europa.
eu/eurostat/data/database
Available on the EMA website (www.ema.europa.eu/en) via: Home > Veterinary regulatory > Overview > Antimicrobial resistance >
European Surveillance of Veterinary Antimicrobial Consumption > https://www.ema.europa.eu/en/documents/report/trends-salesveterinary-antimicrobial-agents-nine-european-countries_en.pdf
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
The PCU is calculated for each species, weight class or production type,
as follows:
PCU domestic
• Number of animals slaughtered × estimated weight at treatment
• Number of livestock animals × estimated weight at treatment
PCU export
• Number of animals transported to another country for fattening or slaughter × estimated
weight at treatment
PCU import
• Number of animals transported from another country for fattening or slaughter × estimated
weight at treatment
Total PCU per country
• PCU = total PCUDomestic + total PCUExport – total PCUImport
1 PCU = 1 kg of animal biomass
1.5.? Correction of historical data
Occasionally, errors or inconsistencies in previously submitted datasets are identified during the data validation process
— e.g. due to availability of new official statistics regarding animal population data or identification of inaccuracies in
the data provided for one or more VMP presentations. In such cases, data are corrected and the updated values are
published in the ESVAC interactive database as soon as they have been validated and approved by the participating
country.
Published reports are not updated when changes to data are implemented in the interactive database, therefore minor
discrepancies between values in the ESVAC reports and the interactive database may occur.
Following the publication of the twelfth ESVAC report and during the validation process of 2022 data, the following
historical sales updates were implemented and are included in the results of this report:
• Ireland corrected the ATCvet code for two products for all years since 2010 — one ATCvet code change from
QJ01CR01 (ampicillin and beta-lactamase inhibitor) to QJ01CR02 (amoxicillin and beta-lactamase inhibitor) and one
ATCvet code from QJ01CR02 to QJ01CA04 (amoxicillin). These corrections led to minor changes in the proportion of
penicillin sales as tablets for all years. For food-producing animals, the proportion of sales as penicillins changed,
with the proportion of penicillins with beta-lactamase inhibitors decreasing and penicillins with extended spectrum
increasing.
• Lithuania resubmitted sales data for 2019–2021 to ESVAC. The State Food and Veterinary Service (SFVS) of
Lithuania recalculated the sales data for 2019–2021, which were submitted to ESVAC. This was due to several
wholesalers failing to submit their reports for this period, resulting in a discrepancy in the data. To investigate the
matter, the Director of the SFVS set up a working group to review the reports for the missing years. As a result of
the recalculation, the correct data were resubmitted to ESVAC and are now reflected in the ESVAC database. It is
important to note that the updated datasets for 2019–2022 do not include tablet sales, unlike previous years. The
updated sales data for 2019–2021 showed a significant 2.9–3.5-fold increase in sales for food-producing animals,
ranging from 20.8 to 65.6 mg/PCU, 20.5 to 60.2 mg/PCU, and 20.3 to 71.2 mg/PCU in 2019, 2020 and 2021,
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
respectively. It is advisable to exercise caution when interpreting trends and drawing conclusions from data prior to
2019, as it is not feasible to verify their accuracy.
• Norway corrected the number of packs sold for farmed fish in 2021 (1 product), resulting in a decrease of 6.5%
(from 2.5 to 2.3 mg/PCU) in the total sales for food-producing animals.
• Sweden corrected the number of packs sold for a large number of VMPs upon identifying a lack of data completeness
affecting the years 2017–2021. These corrections resulted in minor increases in sales in mg/PCU for 2017, 2018
and 2019 (2.3%, 0.1% and 3.5%, respectively). Moreover, the updated 2017 sales include products for fish
containing florfenicol and oxytetracycline, thus the reporting for fish is complete. The updates to 2020 and 2021
data resulted in an increase of sales for food-producing animals of 10.3% (from 11.1 to 12.2 mg/PCU) and 10.6%
(from 10.9 to 12.1 mg/PCU), respectively.
There were no historical updates made to animal population data during this reporting.
1.6.? Data quality check and validation of the sales and animal population data
ESVAC-participating countries submit their data directly to the ESVAC web-based application. Various reports can be
created using the ESVAC BI web-based application and used for validation purposes. Each country is responsible for the
quality of the sales data it delivers to EMA and is assisted by the ESVAC secretariat with data validation. This includes
the identification of outliers, mainly by comparison with available data from previous years and with official product
information found in the registers of nationally authorised medicinal products.
Suitable quality control measures, including assessment of data coverage and accuracy, are defined and set up by each
country individually, taking into account the distinctive aspects of each country’s data collection.
1.7.? Analysis and reporting of the data
The results presented in the current report focus on the primary and secondary outcome indicators of antibiotic
consumption (established by ECDC, EFSA and EMA) for 2022 and their trends between 2011 and 2022. For foodproducing animals, the proposed indicators for antimicrobial consumption are: overall sales of veterinary antimicrobials;
sales of 3rd- and 4th-generation cephalosporins; sales of quinolones (specifying the proportion of fluoroquinolones);
and sales of polymyxins, measured in mg/PCU. Further analyses are performed based on sales by antibiotic class and
product form.
With regard to food-producing animals, ESVAC product forms are grouped by their predominant use for group or
individual treatment. In this manner, the term ‘group treatment’ is used for VMPs administered orally via feed or
water, i.e. the product forms’ premixes, oral solutions and oral powders; while ‘individual treatment’ refers to boluses,
injectable products, intramammary products, intrauterine products and oral pastes.
The main measurement unit (primary indicator) applied in this report to expresses the consumption of veterinary
antibiotics is mg of active substance normalised by the population correction unit (mg/PCU):
Quantity sold in tonnes x 109
PCU in kg
When presenting total sales in mg/PCU for all the ESVAC reporting countries, these represent aggregated sales, i.e.
total quantity of all antibiotic active substances sold (mg) in all countries divided by the total PCU (kg) of all countries.
The data are presented according to the antibiotic classes or subclasses defined in the ATCvet hierarchical system
for the active substance(s) of each VMP, irrespective of whether it is a single or fixed-combination product. The class
‘Others’ can include the following subclasses: imidazole derivatives (metronidazole), nitrofuran derivatives (nifurpirinol,
furazolidone) and other antibacterials (bacitracin, fosfomycin, furaltadone, nitroxoline, novobiocin, rifaximin,
spectinomycin). Of note, metronidazole, nifurpirinol, furazolidone and furaltadone are included in Table 2 (prohibited
substances) of the Annex to Commission Regulation (EU) No 37/2010 and are prohibited for use in food-producing
animals. However, they are included in Table A4 of this report because they can be used in companion animals for
which no maximum residue limits (MRLs) are required. In 2022, sales of VMPs with these four substances accounted for
0.22% of the total tonnes sold for the 31 ESVAC-participating countries.
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
The data presented in this report correspond to the exact sales figures (in tonnes) calculated for each product, while
in the tables and graphs the numbers are aggregated and rounded. Therefore, the total sales figures in tables, for
example, may differ slightly from the more detailed data presented in this report.
All data presented in this report reflect the datasets available in the ESVAC database on 12 September 2023. Any
updates made to the data at a later stage are not included in the present data analyses.
Data on sales, including tablets used for the treatment of companion animals, are available in the ESVAC interactive
database.
1.8.? Summary of data sources / types included, by country
Information concerning the number of years of data collection, the legal basis for the data collection at national level,
systems for distribution of antibiotic VMPs, sources from which sales data were obtained, type of data and the data
included are shown, by country, in Table 2.
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czechia
Denmark
Estonia
Finland
France
Germany
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Legal
basis
Federal Office of
Consumer Protection
and Food Safety
National Agency for
Veterinary Medicinal
Products (Anses-ANMV)
Finnish Medicines
Agency
State Agency of
Medicines
Danish Veterinary and
Food Administration
Institute for State
Control of Veterinary
Biologicals and
Medicines
Ministry of Agriculture,
Rural Development
and Environment –
Veterinary Services
Ministry of Agriculture,
Veterinary Directorate
Bulgarian Food Safety
Agency
Federal Agency for
Medicines and Health
Products
Austrian Agency for
Health and Food Safety
National data
provider to ESVAC
MAHs (n=25)
Wholesalers (n=11)
MAHs (n=62)
Wholesalers (n=3)
Importers of medicated
feed (n=1)
Wholesalers (n=7)
VetStat (n=1) obtaining
data from pharmacies
(n=580)
Feed mills (n=1)
Wholesalers (n=97)
Feed mills (n=41)
Wholesalers (n=27)
Feed mills (n=19)
Wholesalers (n=13)
Wholesalers (n=38)
Wholesalers (n=19)
Feed mills (n=33)
MAHs (n=7)
Wholesalers (n=8)
Sources for ESVAC data
(approx. number)
Sales to veterinarians
Sales to wholesalers
Sales to pharmacies and
veterinarians
Sales to veterinarians and
pharmacies
Prescriptions data from
pharmacies and feed mills
Sales by wholesalers
to veterinarians and
pharmacies; sales by feed
mills to farmers
Sales by wholesalers
to veterinarians and
pharmacies; sales by feed
mills to farmers
Sales to pharmacies and
veterinarians
Sales to veterinarians,
farmers and pharmacies
Sales to veterinarians and
pharmacies; sales by feed
mills to farmers
Sales to pharmacies
Sales data, prescription
data or purchase data1
Sales between
wholesalers
and/or MAHs2
excluded
(Yes/No)
Yes (8%)
Yes (3%)
Yes (2.9%)
Yes (0.17%)
Yes (1.6%)
Products sold
on special
licence
included3
(Yes/No)
Purchase / import data from e.g. pharmaceutical industry and/or from wholesalers in other countries.
MAHs = marketing authorisation holders.
Antimicrobial VMPs available through special licence / marketing authorisation or through parallel trade. The type of authorisation procedure used might differ among Member States. The
% refers to such sales as a proportion of the total sales reported for that year.
Number of
years of data
collection
Country
Table 2. Summary of information on number of years of data collection, legal basis for data collection at national level, national data providers, sources of ESVAC
data and characteristics of data, by country, for 2022
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
>5 years
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Lithuania
Luxembourg
Malta
Netherlands
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Legal
basis
Federation of the
Dutch Veterinary
Pharmaceutical Industry
(FIDIN)
Ministry for Agriculture,
Fisheries and Animal
Rights
Ministry of Health
State Food and
Veterinary Service
Food and Veterinary
Service
Italian Ministry of Health
Health Products
Regulatory Authority
Icelandic Medicines
Agency
National Food Chain
Safety Office
Directorate of Veterinary
Medicinal Products
Greek National
Organisation for
Medicines
National data
provider to ESVAC
MAHs (n=17)
Wholesalers (n=14)
Medicated feed mill (n=1)
Medicated feed traders
(n=3)
Wholesalers (n=2)
Wholesalers (n=31)
Wholesalers (n=17)
Italian Drug Traceability
System (n=1) obtaining
data from pharmacies
(n=19,773) and
wholesalers (n=237)
MAHs (n=19)
MAHs (n=60)
Wholesalers (n=2)
Wholesalers (n=31)
MAHs (n=67)4
Sources for ESVAC data
(approx. number)
Sales to wholesalers and
veterinarians
Sales to pharmacies,
veterinarians and farmers
Sales to pharmacies and
veterinarians
Sales to pharmacies,
veterinarians and farmers
Sales to pharmacies,
veterinarians and farmers
Dispensed e-prescription
from wholesalers
and pharmacies to
veterinarians, farmers and
companion animal owners;
sales of premixes from
MAHs to wholesalers
Sales to wholesalers,
pharmacies, veterinarians
and licensed merchants
Sales to veterinarians and
pharmacies
Sales to pharmacies,
veterinarians, feed mills,
farmers, retailers and
animal clinics
Sales to pharmacies and
veterinarians
Sales data, prescription
data or purchase data1
Sales between
wholesalers
and/or MAHs2
excluded
(Yes/No)
Yes (0.3%)
Yes (6.75%)
Yes (30%)
Yes (5 years
>5 years
Switzerland
United
Kingdom
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Mandatory
to report
Legal
basis
Veterinary Medicines
Directorate
Federal Food Safety and
Veterinary Office
National Veterinary
Institute and Swedish
Board of Agriculture
Spanish Agency for
Medicines and Health
Products
Administration of the
Republic of Slovenia for
Food Safety, Veterinary
Sector and Plant
Protection (AFSVSPP)
Institute for State
Control of Veterinary
Biologicals and
Medicaments
Institute for Control of
Biological Products and
Veterinary Medicines
Directorate-General for
Food and Veterinary
Ministry of Agriculture
and Rural Development
Norwegian Veterinary
Institute
National data
provider to ESVAC
MAHs (n=71)
MAHs (n=14)
The Swedish eHealth
Agency (n=1) obtaining
data from pharmacies
(n=1446)
Retailers (n=744)
Feed mills (n=11)
Pharmacies (n=4,358)7
Wholesalers (n=11)
Wholesalers (n=24)
MAHs (n=84)6
Wholesalers (n=86)
Wholesalers (n=121)
Wholesalers (n=5)
Feed mills (n=1)
Sources for ESVAC data
(approx. number)
Sales to wholesalers,
veterinarians, feed mills
and veterinary pharmacies
Sales to veterinarians,
pharmacies and feed mills
Dispensed veterinary
prescriptions and
requisitions8
Sales to veterinarians,
farmers and pet owners
Sales to veterinarians
Sales to pharmacies,
military forces, State
Veterinary and Food
Administration,
veterinarians, farmers
and feed mills
Sales to wholesalers
Sales to pharmacies and
veterinarians
Sales to veterinarians
Sales by wholesalers
to pharmacies and
veterinarians; sales by
feed mills to fish farmers
(only as medicated feed)
Sales data, prescription
data or purchase data1
Sales between
wholesalers
and/or MAHs2
excluded
(Yes/No)
Yes (13.6%)
Yes (4.5%)
Yes (11.2%)
Products sold
on special
licence
included3
(Yes/No)
For 2015–2022, data were collected from MAHs, while for 2014 the data were obtained from MAHs and wholesalers and include MAHs’ sales to wholesalers and wholesalers’ sales to
pharmacies and veterinarians.
Since 2017, data have been collected from retailers and pharmacies, but data from feed mills were used to verify the sales of medicated feed.
Data represent veterinary prescriptions and requisitions dispensed by pharmacies for use in their own practice.
No data provided by wholesalers or feed mills.
>5 years
>5 years
Slovakia
Sweden
>5 years
Romania
>5 years
>5 years
Portugal
Spain
>5 years
Poland
>5 years
>5 years
Norway
Slovenia
Number of
years of data
collection
Country
2.? Results
2.1.? Sales of antibiotic VMPs for food-producing animals in 2022
This section presents the 2022 primary indicator of antibiotic consumption that corresponds to the overall sales (mg/PCU)
of antibiotic VMPs in food-producing animals, which include cattle, pigs, chickens, turkeys, sheep, goats, rabbits, farmed
fish and horses22. It is important to note that the overall sales in mg/PCU include the sales of all ESVAC product forms
except tablets, based on the assumption that these are almost exclusively used in companion animals. Although some
product forms, e.g. injectable products, are frequently marketed for both food-producing and companion animals, their
sales are included in the statistics of food-producing animals given that their overall use in companion animals is minor.
Moreover, some of the sales allocated to food-producing animals could be for non-food-producing animals such as
companion animals, fur animals, exotic birds and racing pigeons.
In addition to the primary outcome indicator, this section also presents aggregated sales data of antibiotic VMPs for
food-producing animals by product form and by antibiotic class, as well as the aggregated proportion of penicillin sales
for food-producing animals by subclass in 31 European countries in 2022.
Figure 2. Spatial distribution of overall sales, in mg/PCU, of antibiotic VMPs for food-producing animals in 31 European
countries in 20221
m g/P C U
?254.7
170.5
No data
available
ESVAC-participating countries’ codes according to ISO 3166 — Codes for the representation of names of countries and their subdivisions.
Regulation (EC) No 854/2004 establishes that horses are considered to be food-producing animals. Typically, statistics on living horses
cover both food-producing and non-food-producing horses. This implies that the use of medicines authorised for horses not intended
for slaughter is also included in the surveillance.
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
In 2022, sales of antibiotic VMPs for use in food-producing animals represented 98.4% of total sales in tonnes (sales of
tablets are described in Section 2.3) and ranged from 2.1 mg/PCU to 254.7 mg/PCU in the 31 participating countries
(Figure 2). The total aggregated sales across all reporting countries were 73.9 mg/PCU (Table 3). It is important
to highlight that the sales data for the different countries should not be directly compared given that they may be
influenced by other factors, such as animal demographics, types of animal production systems, selection of antibiotic
agents and treatment protocols, data sources used or collection of data, among others.
Table 3. Sales in tonnes of active substance of antibiotic VMPs marketed mainly for food-producing animals1, PCU in
1,000 tonnes and sales in mg/PCU in 31 European countries in 2022
Sales (tonnes) for
food-producing animals
PCU (1,000 tonnes)
mg/PCU
946.4
Belgium
120.2
1,634.6
Bulgaria
358.0
103.2
Croatia
304.1
Cyprus
139.7
254.7
Czechia
696.7
Denmark
2,355.9
Estonia
114.5
Finland
484.8
France
255.2
6,561.4
Germany
531.1
7,600.9
Greece
101.7
1,141.9
Country
Austria
Hungary
832.9
111.2
Iceland
140.2
Ireland
2,246.0
585.4
3,716.3
157.5
163.7
300.1
Luxembourg
Malta
112.0
3,025.4
Italy
Latvia
Lithuania
Netherlands
Norway
2,198.1
838.3
4,277.7
196.0
Portugal
1,062.4
Romania
136.4
2,794.4
Slovakia
223.9
Slovenia
182.4
1,027.2
8,063.3
127.4
788.1
829.0
Poland
Spain
Sweden
Switzerland
United Kingdom
Total 31 countries
181.1
7,037.5
4,458.1
60,286.7
73.9*
Tablets are excluded as they are used almost exclusively in companion animals. On the contrary, sales of some injectable antibiotic VMPs
and a few other products that are solely or also used in companion animals are included in the sales for food-producing animals given that
their proportional use in companion animals is minor.
* Total mg/PCU for 31 countries represents aggregated sales (tonnes) for food-producing animals, including horses and farmed fish,
normalised by the aggregated PCU (1,000 tonnes).
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
The aggregated sales of antibiotic VMPs for food-producing animals stratified by product form are shown in Figure 3.
Oral solutions were the highest selling product form, accounting for 63.4% of the total sales (mg/PCU) of antibiotic
VMPs in the 31 countries, followed by premixes (14.9%), injectable products (13.6%), oral powders (6.8%),
intramammary products (0.74%); the remaining sales (0.58%) corresponded to oral pastes, boluses and intrauterine
products.
Oral powders that can be administered both via feed and as oral solution are reported in ESVAC as oral powders.
Although a small proportion of oral powders and oral solutions are suitable for the treatment of single animals or a
very limited number of animals, the overall sales figures for these product forms, in addition to the sales of premixes,
provide a reasonable estimate of sales for group treatment, including groups in one pen / farm23. In 2022, 85.1% of
total sales of antibiotic VMPs for use in food-producing animals were of VMPs predominantly used for group treatment.
Detailed information on sales per product form at country level can be found in the ESVAC interactive database and in
the 2022 individual country reports.
Figure 3. Proportion of aggregated sales, in mg/PCU, of antibiotic VMPs for food-producing animals by product form in
31 European countries in 2022
13.6%
Oral solution
Premix
Injectable products
63.4%
14.9%
Oral powder
Intramammary products
Other forms*
* ‘Other forms’ includes oral pastes, boluses and intrauterine products.
As shown in Figure 4, in 2022 the overall highest selling antibiotic classes were penicillins (32.7%), tetracyclines
(23.5%) and sulfonamides (9.4%), accounting for 65.5% of total sales of antibiotic VMPs for food-producing animals,
in mg/PCU. Among the antibiotic classes shown as ‘Other classes’, 1st- and 2nd-generation cephalosporins, 3rd- and
4th-generation cephalosporins, amphenicols and other quinolones accounted for 0.15%, 0.17%, 2.7% and 0.16% of the
overall sales in the 31 countries, respectively.
In 2020, a thorough analysis was carried out of the provisions concerning oral administration of VMPs, as detailed in Regulation (EU)
2019/6, and of the preparation and administration of medicated feed, as detailed in Regulation (EU) 2019/4 (https://www.ema.europa.
eu/en/documents/regulatory-procedural-guideline/advice-implementing-measures-under-article-106-6-regulation-eu-2019/6veterinary-medicinal-products-scientific-problem-analysis-recommendations-ensure-safe-efficient_en.pdf). One of the
recommendations resulting from this analysis was that oral powders, granules or similar pharmaceutical forms administered to
terrestrial animals via solid feed, including VMPs administered via top-dressing, should be restricted to use in individual animals only.
Therefore, the classification of group treatment included in the ESVAC analysis could be adjusted in the future once these
recommendations are fully implemented by the Member States.
Sales of veterinary antimicrobial agents in 31 European countries in 2022
Thirteenth ESVAC report
Figure 4. Proportion of aggregated sales, in mg/PCU, of antibiotic VMPs for food-producing animals by antibiotic class in
31 European countries in 2022
32.7%
Penicillins
Tetracyclines
Sulfonamides
Macrolides
Aminoglycosides
Lincosamides
Other classes*
Fluoroquinolones
Polymyxins
Pleuromutilins
23.5%
Trimethoprim
* ‘Other classes’ includes amphenicols, cephalosporins, other quinolones and ‘Others’. The class ‘Others’ includes the following
subclasses: imidazole derivatives (metronidazole), nitrofuran derivatives (furazolidone) and other antibacterials (bacitracin, furaltadone,
novobiocin, rifaximin and spectinomycin). Of note, some sales could be for non-food-producing animals such as companion animals, fur
animals, exotic birds and racing pigeons.
The sales patterns of penicillins differed substantially between countries with regards to the various subclasses
(Figure 5). In the Nordic countries and Switzerland, where the sales of penicillins are typically high, beta-lactamasesensitive penicillins24 were the highest selling penicillin subclass, representing between 54% and 96% of total penicillin
sales. For the remaining countries, penicillins with extended spectrum (98.1% amoxicillin, 1.9% ampicillin and