The emergence of multi-drug-resistant microbes is a global threat to animals and humans. It puts the effectiveness at risk of a heavily relied-on treatment for infection, antibiotics.
To preserve their critical use in the veterinary profession, Antimicrobial Stewardship Guidelines were developed. The American Veterinary Medical Association (AVMA) identifies 3 key actions for the management of safeguarding antibiotics.
Maintain regular check-ups with pets and communicate the benefits of preventing infection rather than waiting to treat it. Emphasise routine dental health during appointments to minimise the risk of dental disease.
Encourage regular vaccinations according to the AAHA guidelines and parasite prevention. Easy topical treatments only need to be applied monthly and can protect against fleas, ticks, heartworm, and intestinal worms.
Provide advice for suitable pet food since nutrition has a significant impact on the health status of animals. Also, discuss the importance of proper hygiene particularly in multiple pet households to minimise infection.
Use antiseptics, cleansers, and disinfectants to prevent the transmission of infectious diseases. Identify and manage risk factors that increase the likelihood of infection. Some examples are catheters, wounds, immunodeficiency, and endocrine diseases.
The only time to use antibiotics in bacterial infection prevention is when the occurrence is likely or will cause severe complications in surgery. There are more suitable and effective ways to prevent infection as mentioned without contributing to antimicrobial resistance.
Don’t jump to the prescription of antibiotics for the treatment of infection. Consider alternative treatment options first for instance supportive care. You could focus on correcting electrolytes, or acid-base balance by intravenous fluids. In some cases, the removal of abscesses or empyema by surgical intervention is a more effective treatment option.
Select antibiotics based on veterinary medical guidelines with an evidence-based approach.
Confirming bacterial infection starts with a process of elimination.
Confirm bacterial infection by the presence of common symptoms and diagnostic testing before prescribing. You should eliminate other possible causes of infection including viral, fungal, or parasitic. Abnormal cell or tissue growth and imbalances in nutrition may also present similar symptoms to infection.
When infection by bacteria is likely, specimens should be sent to a diagnostic laboratory for further testing. Identification of the causative organism and then susceptibility testing allows the selection of effective antibiotics.
Refer to appropriate guidelines when prescribing antibiotics that are in accordance with local laws. Ensure that the correct dose, frequency, duration and route of administration are used according to the susceptibility results and severity of infection.
The AMR vet collective has useful resources for more information on antimicrobial resistance and prescription guidelines. Check it out here https://www.amrvetcollective.com/home/guidelines/
Studies show that there is a high potential for unnecessary prescription or misuse of antibiotics without proper communication between vets and pet owners (Smith, 2018). Although you may face pressure from pet owners for a prescription make sure to only follow through when necessary.
Establish open communication with clients about antibiotic resistance and the risk of undiagnosed prescriptions. Use easy-to-understand language and reliable information when discussing these topics.
It’s a healthcare professional’s duty to give clear instructions for the prescribed drugs. For antibiotics to work, the duration and frequency of dosage must be followed carefully. Warn pet owners of possible reactions their pets may have to antibiotics, and what steps to take when this happens.
If the misuse of antibiotics continues, this vital tool in medicine will be rendered useless. Enforce the key actions of antibiotic stewardship in the veterinary practice to ensure their effectiveness is maintained.
Take measures to prevent infection that exclude antibiotics and always consider alternative treatments. Only prescribe antibiotics when a bacterial infection is confirmed or in high-risk scenarios.
Refer to relevant guidelines for prescription and ensure that pet owners have all the information necessary to correctly follow these recommendations.
Dale G. Antimicrobial Stewardship. VETRX. https://vetrx.com.au/2022/05/01/antimicrobial-stewardship/
Frey E, Granick J, Weese JS. 2022. AAFP/AAHA Antimicrobial Stewardship Guidelines. AAHA. https://www.aaha.org/globalassets/02-guidelines/2022-antimicrobial/2022-aafp_aaha-antimicrobial-stewardship-guidelines.pdf
Antimicrobial stewardship definition and core principles. AMVA. https://www.avma.org/resources-tools/avma-policies/antimicrobial-stewardship-definition-and-core-principles
AMR. For veterinary practice. 2017. Australian Government. https://www.amr.gov.au/what-you-can-do/veterinary-practice
Smith M. 2018. Pet owner and vet interactions: exploring the drivers of AMR. Antimicrob Resist Infect Control. 46
AMR Vet collective. Guidelines. AMR. https://www.amrvetcollective.com/home/guidelines/