Reviewing your antibiotic prescribing policies? Tap into these tools

Covid and geopolitical tensions have understandably dominated the world news in the last few years, yet it is important not to lose sight of the other major threats to animal and public health, not least antimicrobial resistance (AMR).

Tackling antimicrobial resistance is a priority for vets, with considerable collaborative work having gone into championing responsible stewardship within the profession and among our clients.

There has been impressive progress to reduce agricultural antibiotic use across several livestock species, with BVA supporting the work of the Responsible Use of in Animals Alliance (RUMA) since its launch. The latest UK Veterinary Antibiotic Resistance and Sales Surveillance (UK-VARSS) report shows that sales of antibiotics for use in livestock have reduced by 55% since 2014 to their lowest ever recorded level. Crucially, sales of the highest priority, critically important antibiotics, which have been designated by the World Health Organisation as antibiotics crucial for treating disease in humans, have declined for a seventh year in a row, with an 83% reduction since 2014.

BVA is also actively involved with and contributing to the creation of the Animal Health and Welfare Pathway in England and the devolved equivalents, which are part of the new post-Brexit agricultural framework. The focus on preventative healthcare should mean improved animal welfare as well as attaining sustainability goals, including improved antimicrobial stewardship.

Antimicrobial stewardship in practice

Knowing what needs to be done is one thing, having the motivation to really question one’s own, or one’s workplace’s, established ways of prescribing is another. Sometimes it’s the emotional pull from seeing a relative or friend suffer from an antibiotic-resistant pathogen that provides that motivation and triggers action.

In my case it was a simple, thought-provoking statement from a much-respected veterinary dermatologist that renewed my practice’s focus on AMR. ‘I use 20 times more topical treatments than first-opinion practitioners,’ they said. Really? Why was that, I wondered. Where did I and my practice colleagues fit in with that comment? Time for an audit!

Dermatology cases are common, often chronically debilitating for the animal whilst being time consuming and expensive for the animal care giver. They can require considerable thought in managing owner expectations and occasional frustrations. The trigger to review our dermatology case prescribing led not just to a comprehensive review of the practice pharmacy and medicine processes, protocols and policies, but to a much better understanding of the diagnosis, treatment, management and communication around skin cases. Double win!

Useful resources for vets

What might trigger your practice to review and refresh medicine policies and continue the profession’s work on AMR and antibiotic use reduction? There is an expanding plethora of practical resources for #TeamVet to use to make a difference in the workplace.
I would urge everyone to display the ‘Are you Antibiotic Aware?’ poster in practice waiting rooms. This is endorsed by the UK Health Security Agency as it mirrors the messages for the human supply and use of antimicrobials and gives clear and straightforward direction to pet owners about responsible antibiotic use.

The 7-Point Plan poster about the responsible use of antimicrobials in practice in another helpful tool for the vet profession. It offers seven fundamental ways in which individual vets can knit AMR thinking and action into their daily work.

BSAVA and SAMSoc jointly produced the well-received PROTECT Me poster and useful ‘no antibiotics required’ prescription pad. BEVA has developed a useful PROTECT Me Toolkit and 2022-23 will see the organisation renew its focus on antibiotic and anthelmintic resistance in horses.

The RCVS Practice Standards Scheme has a module dedicated to medicine use and if you want to monitor how your practice or individuals compare with peers in antibiotic prescribing, look no further than the work that SAVSNET are doing.

Vets in farm practice can sign up for free training on responsible antibiotic use courtesy of the Farm Vet Champions platform, a collaborative project spearheaded by RCVS Knowledge, whilst Arwain Vet Cymru’s Prescribing Champions project supports farm vets in Wales to prescribe responsibly to the animals under their care.

Last push for 2022

This past month saw several veterinary practices signing up for the first-ever antibiotic amnesty campaign, which encouraged clients to return unused or out-of-date antibiotics prescribed for their pets to their local vet practice for safe disposal.

It has been a fantastic opportunity to engage vet team members in the AMR discussion, initiate medicine policies and reviews and raise awareness amongst the public about responsible medicine use for people and the environment. As the campaign draws to a close, I’d encourage all participating vet practices to take stock of the number of medicine packs returned and client feedback received, then share it with BSAVA via this online form. All reporting practices will be entered into a prize draw!

Please do continue to share your AMR actions and stories which can inspire others and help maintain momentum within the profession on this very important subject.