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Antibiotic Awareness

Antimicrobial resistance is an emerging clinical problem, recognised internationally as one of the largest threats to human and animal health. All major health and veterinary organisations, including Paton and Lee Ltd, are working to try and limit the development of resistance so that effective antimicrobials can be retained for use in clinical practice.

Following the launch of the British Equine Veterinary Association’s (BEVA) PROTECT ME campaign in 2012, Paton and Lee Ltd now adheres to a self-imposed policy governing the responsible use of antimicrobials. On this page we have attached a number of resources from BEVA and the British Veterinary Associated (BVA) for horse owners. We hope that they will help owners to understand the risks of antibiotic resistance, and explain why veterinary surgeons choose the antibiotics they choose, and why sometimes they will not give antibiotics to your horse at all.

Paton and Lee are proud to adhere to the BEVA 'PROTECT ME' policy.

Practice Policy

Develop protocols for antimicrobial usage based on common clinical scenarioas

Classify key antibiotics as PROTECTED or AVOIDED

Reduce Prophylaxis

Develop rational protocols for prophylaxis

Define prophylaxis for surgical procedures whether CLEAN, CONTAMINATED or HIGH RISK

Rationalise disease control

For common conditions eg the neonate and Streptococcus equi var equi Utilise HBLB codes for management of infectious diseases

Other options

Reduce or replace antimicrobials with other methods for bacterial reduction

• Utilise wound debridement / lavage

• Consider topical preparations or local intravenous administration

Types of drug and bacteria

Select appropriate drugs based on empirical use guidelines

Use cytology where possible

Consider the dose and pharmacokinetics of the drugs selected

Avoid empical use of the highest priority critically important antimicrobials

The macrolides (eg azithromycin) The fluoroquinolones (eg enrofloxacin)

The 3rd and 4th generation cephalosporins (ceftiofur and cefquinome)

Employ narrow spectrum drugs wherever possible

e.g. penicillin, rather than drug combinations

Culture and sensitivity

Use bacterial culture promptly

Especially when clinical response is less than expected

when long term therapy is suspected

Treat effectively

Enough drug for long enough then stop

Standardise dosing frequency and dose rates across the practice

Sometimes dosing intervals licenced in the marketing authorisation differ from current clinical evidence.

Review the veterinary literature to determine optimal dosing here.

Monitor antimicrobial use, compliance and resistance

Undertake a clinical audit of antimicrobial use within your practice

Formulate a policy to record the use of protected antimicrobials in your practice

Formulate a policy to review antimicrobial susceptibility from any cultures obtained within the practice

Audit emerging antimicrobial resistance and consider adapting guidelines for empirical use.

Educate

Ensure that protocols and changes to protocols are cascaded through the entire team

Educate your clients to reduce pressure for antimicrobial prescribing