UK Registered Charity 1122246 This website would not be possible without the kind help of Tony Martin of the “AV Martin Charitable Foundation”

Antimicrobial stewardship begins by recognizing the problems and issues leading to antimicrobial resistance, and successfully implementing procedures that reasonably minimise the impact of antimicrobial use in the patient while not forfeiting the likelihood of therapeutic success. The goal of antimicrobial therapy is to achieve sufficient concentrations of an appropriate drug at the site of infection such that the infecting organism is killed, while simultaneously avoiding selecting for resistance in pathogenic or commensal organisms at the target or remote sites.

It is critical that the infection is correctly diagnosed using clinical signs, cytology and, where appropriate, culture.

Antibiotics should not be used speculatively to treat non-specific clinical signs. It’s also important to realise that systemic antibiotic therapy may not be necessary in all cases – some mild and focal infections will respond to topical antimicrobials or antibiotics, especially if the underlying cause is managed. Bacterial culture and antibiotic sensitivity testing helps confirm the need for antimicrobial therapy and identifies the most appropriate drug. Clinicians should strive to use the lowest tier drug that is appropriate. The drug should be given at the correct dose and dosing interval until there is a complete clinical cure. It is critically important that owners understand this to avoid errors in dosing.

Antimicrobial stewardship will be vital in preserving the efficacy of antibiotics for the future. This website will discuss the issues involved in the development and spread of antimicrobial resistance in more detail, and explain how vets and owners can avoid these problems.

There is not yet an overwhelming crisis with antimicrobial resistance in veterinary practice, but some countries are already there. In some referral centres in Japan and the US, for example, colonisation and/or infection rates with MRSA and MRSP are reported to be 30-40%. We therefore has a window of opportunity to adopt best practice in responsible antimicrobial use and infection control to minimise the development of resistance and preserve the efficacy of these drugs for the future. Failure to do this will lead to an increasing problem with antimicrobial resistance. Failure to have adequate measures in place may mean that individual practices will face litigation, with subsequent loss of revenue and reputation.

MRSA colonisation and infection in animals is clearly associated with veterinary practice. Carriage rates in healthy dogs and humans in the community are <1%, but 3-10% of vet-visiting animals become colonised with MRSA, and 7-13% of veterinary staff can carry MRSA, with staff carrying the same type of isolates as the animals that they work with.

Problems with other antimicrobial-resistant bacteria including Pseudomonas and E. coli are also being more frequently recognised. All of these organisms can be associated with skin, ear and surgical site infections, which are expensive and difficult to treat. These bacteria pose a clear and significant risk to animals and their owners. Veterinary practices must pay careful attention to patient care, antimicrobial use, infection control and disease surveillance to minimise the risks from antimicrobial resistant organisms.

For more on infection control, view our sister website www.veterinarynursetrainingonline.org

Good communication is essential in helping clients understand and follow the treatment correctly. Thorough antimicrobial use guidelines are available from the BVA, BSAVA/SAMSOC, RUMA, ISCAID

When and how should antibiotics be used to kill bacterial infections?

How long should treatment be continued?

Should narrow spectrum antibiotics always be chosen in hospital?

How do you use evidence based medicine as a basis for the choice of antimicrobial product?

Best Way to use antimicrobials

What role does topical therapy have to play in treating infections with multi-resistant bacteria?

 

 

 

 

 

Participate in our survey on prudent use of antimicrobials in practice.

This survey has been developed by the Bella Moss Foundation and in conjunction with the Royal Veterinary College in response to the need for further information on how antimicrobial drugs are being used in small animal practice and on awareness of guidelines for prudent antimicrobial use and clinical hygiene. The findings will be used to aid in the development of improved methods promoting the implementation and effectiveness of such guidelines.

Participate Now

Authors: Dr Ana L P Mateus, Lecturer in Veterinary Public Health, David H Lloyd Professor of Veterinary Dermatology, Royal Veterinary College (University of London), Hawkshead Campus, Hatfield, UK.

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Veterinary Practitioners as Antibiotic Guardians

BMF collaborates with Public Health England, European antibiotic awareness day, Antibiotic Guardian, Veterinary Medicines Directorate, and British Veterinary Association

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