15 Nov 2017
New antimicrobial prescribing guidelines for veterinarians in Australia
Antimicrobial resistance (AMR) has been recognised internationally as a pressing global public health issue. AMR emerges naturally among bacteria and other microbes in response to antimicrobial use, but a host of factors, including inappropriate and excessive use of antimicrobials, has contributed to increasing rates of drug-resistant infections globally.
Antimicrobial use in veterinary and agricultural settings accounts for the largest proportion of antimicrobial consumption globally. Guidelines for veterinary antimicrobial prescribing can help optimise antimicrobial use in the veterinary setting.
In 2017, Australian veterinary researchers, from the National Centre for Antimicrobial Stewardship (NCAS) and the University of Melbourne’s Asia Pacific Centre for Animal Health (APCAH), have developed evidence-based veterinary antimicrobial prescribing guidelines. These address bovine, equine and companion animal antimicrobial prescribing.
NCAS veterinary researchers have been assessing antimicrobial prescribing practices in bovine, equine and companion animal veterinary settings across Australia, identifying patterns of (and factors driving) antimicrobial use. Drawing on their research, they have identified common areas where guidance is required and these data have informed the new veterinary antimicrobial prescribing guidelines.
Educational resources for veterinarians have been developed, along with an antimicrobial stewardship policy template and a framework for the potential incorporation of responsible prescribing into veterinary accreditation programs.
The guidelines are being provided as an online resource (open-access) as well as posters for display in clinics, and have been disseminated through clinical fora.
While the guidelines provide general recommendations to veterinary prescribers, it is acknowledged that specific treatments are expected to still be determined on a case-by-case basis, informed by these guidelines. A protocol and proposal for peer-review and validation of the guidelines is in the process of being completed.
Prof. Glenn Browning of the University of Melbourne’s Faculty of Agricultural and Veterinary Sciences, who leads the National Centre for Antimicrobial Stewardship’s veterinary stream, says:
“Many veterinarians have told us that the lack of readily available guidelines is a major impediment to good antimicrobial stewardship in veterinary practice. We hope the online accessibility of these guidelines, and the other tools we have developed and disseminated, will help provide the support veterinarians have told us they need. We also hope the capacity to provide feedback on the guidelines will enable us to identify gaps and continue to improve these tools into the future.”
Evidence-based prescribing guidelines are necessary as they help set the parameters of appropriate prescribing and enable clinicians to optimise use. In Australia, national evidence-based antimicrobial prescribing guidelines for human use have been available since 1978. Evidence-based antimicrobial prescribing guidelines for veterinarians should help guide efforts in this setting.
Veterinarians are encouraged to refer to the guidelines as well as provide feedback on implementation.
About the National Centre for Antimicrobial Stewardship
The National Centre for Antimicrobial Stewardship (NCAS) is a National Health and Medical Research Council-funded Centre of Research Excellence, and a collaboration between the University of Melbourne, Royal Melbourne Hospital and Monash University. NCAS is based at the Peter Doherty Institute for Infection and Immunity (a partnership between the University of Melbourne and Royal Melbourne Hospital). Researchers from the University of Melbourne’s Faculty of Veterinary and Agricultural Sciences comprise the NCAS animal health stream and are undertaking research on antimicrobial use and stewardship in veterinary and agricultural settings. The Asia Pacific Centre for Animal Health is a faculty-based research centre.