Prudent use of antibiotics

This is a complex subject matter that has been thoroughly covered by key authorities in the GRAM book developed by CEVA animal health Click here to watch a video.

Click on this link for further information: disease fact sheets, synopsis chapters and recommendations.

It is essential that an infection is correctly diagnosed using clinical signs, cytology and, where appropriate, culture and sensitivity testing. 

Antibiotics should not be used speculatively to treat non-specific clinical signs. It is 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  in confirming the need for antimicrobial therapy and identifying the most appropriate drug. Clinicians should strive to use the most specific appropriate drug . The drug should be given at the correct dose and dosing interval until there is a complete clinical cure. It is  of the greatest  importance 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 in more detail the issues involved in the development and spread of antimicrobial resistance 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 already have significant issues. In some referral centres in Japan and the US, for example, colonisation and/or infection rates with MRSA and MRSP are reported to stand at 30-40%. We therefore have 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 so will lead to an increasing problem with antimicrobial resistance and failing  to have adequate measures in place may mean that individual practices could 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 may carry MRSA, with these personnel carrying the same type of isolates as the animals with which they work.

Problems with other antimicrobial-resistant bacteria, including Pseudomonas and E. coli, are also being more frequently recognised. All  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.