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.
Develop protocols for antimicrobial usage based on common clinical scenarioas
Classify key antibiotics as PROTECTED or AVOIDED
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
Reduce or replace antimicrobials with other methods for bacterial reduction
• Utilise wound debridement / lavage
• Consider topical preparations or local intravenous administration
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)
e.g. penicillin, rather than drug combinations
Use bacterial culture promptly
Especially when
clinical response is less than expected
when long term therapy is suspected
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.
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.
Ensure that protocols and changes to protocols are cascaded through the entire team
Educate your clients to reduce pressure for antimicrobial prescribing