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Volume 13, Number 11—November 2007

Perspective

Danish Integrated Antimicrobial Resistance Monitoring and Research Program

Anette M. Hammerum*Comments to Author , Ole E. Heuer†, Hanne-Dorthe Emborg†, Line Bagger-Skjøt*, Vibeke F. Jensen†, Anne-Marie Rogues*, Robert L. Skov*, Yvonne Agersø†, Christian T. Brandt*, Anne Mette Seyfarth†, Arno Muller*, Karin Hovgaard‡, Justin Ajufo§, Flemming Bager†, Frank M. Aarestrup†, Niels Frimodt-Møller*, Henrik C. Wegener†, and Dominique L. Monnet*
Author affiliations: *Statens Serum Institut, Copenhagen, Denmark; †Technical University of Denmark, Copenhagen, Denmark; ‡Danish Medicine Agency, Copenhagen, Denmark; §Danish Veterinary and Food Administration, Søborg, Denmark;

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Table

DANMAP’s contributions to decreasing antimicrobial agent resistance in Denmark, 11 years*

Sector Problem Intervention (reference) Type of
intervention Intervention had effect
Food animal High occurrence of vancomycin-resistant Enterococcus faecium isolates in food and production animals Banned avoparcin: Denmark May 1995 and 
EU Dec 1997. Provided data for national and EU ban. Monitored effect of ban in animals, food, and healthy humans. Regulatory Yes
High occurrence of streptogramin-resistant E. faecium isolates in food and production animals Banned virginiamycin: Denmark Jan 1998 
and EU Jul 1999. Provided data for national and EU ban. Monitored effect of ban in animals, food, and healthy humans. Regulatory Yes
High use of fluoroquinolones in animal production Restricted use of fluoroquinolones in animal husbandry, by Danish law in 2002. Regulatory Yes
High use of antimicrobial agents in swine production Implemented new guidelines for veterinary practitioner prescription of antibacterial 
agents for swine production in 2005. Guideline Not yet known
Food Higher levels of resistance in Salmonella and Campylobacter isolates from imported food than from Danish food Implemented evaluation of safety of food products, by November 2006. Regulatory Not yet known
Human Increasing macrolide resistance in Streptococcus pneumoniae Published report to prescribers in 
EPI-NEWS (13). Awareness campaign Yes
Increasing use of newer, broad-spectrum antibiotics, especially in hospitals Published report to prescribers in 
EPI-NEWS (14). Awareness campaign No, use of newer, broad-spectrum antibiotics still increasing
Higher levels of resistance in travel-associated Salmonella and Campylobacter infections Published report to prescribers in 
EPI-NEWS (14). Awareness campaign Not yet known
Increasing no. of methicillin-resistant Staphylococcus aureus (MRSA) cases Published report to prescribers in
 EPI-NEWS (15). Informed national 
reference center, which reported to 
physicians and other prescribers (15). Made notification mandatory Nov 2006 (16). Mandatory notification Not yet known
Increasing use of antimicrobial agents, outside and inside hospitals Published report to prescribers in 
EPI-NEWS (14). Awareness campaign No, antibiotic use still increasing
Increasing ciprofloxacin resistance related to increasing ciprofloxacin use Published report to prescribers in 
EPI-NEWS (14). Awareness campaign No, ciprofloxacin use and resistance still increasing, but low compared with that of other countries

*DANMAP, Danish Integrated Antimicrobial Resistance Monitoring and Research Program; EU, European Union.

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