Responsible use of antibacterials

Statement

The British Small Animal Veterinary Association (BSAVA) strongly recommends that the veterinary profession embraces the responsible use of antibacterials in order to:

• Minimise the selection of resistant veterinary pathogens, and therefore safeguard national health.
• Minimise possible transfer of resistance to human pathogens.

The BSAVA recommends that veterinary surgeons develop and implement a practice policy to encourage responsible prescribing of antibacterials in their practice e.g. PROTECT, this could include advice on:

• reducing antibacterial use
• appropriate first line antibacterials
• peri-operative antibacterial use
• hand hygiene
• appropriate use of topical antibacterials

The BSAVA strongly recommends against the use of antibacterials with restricted use in human medicine ( e.g. Imipenem and Vancomycin) in any circumstances and that antibacterials such as Amikacin should only be used when culture and sensitivity results indicate that it will be effective and other agents are inappropriate.

The BSAVA recommends consideration should be given, on a case by case basis, before the use of 3rd or 4th generation Cephalosporins of Fluoroquinolones.

The BSAVA recommends that veterinary surgeons implement hygiene and biosecurity practices to minimise the need for use of antibacterials.

The BSAVA recommends that veterinary surgeons report antibacterial treatment failure (where culture and sensitivity results indicating that an appropriate antibacterial class had been used, or where a particular antibacterial product is authorised for the specific condition and species) to the Veterinary Medicines Directorate (VMD) using the Suspected Adverse Reaction Surveillance Scheme (SARSS)

Background information

Antibacterials are essential drugs for treating bacterial infections. They have brought great benefits to humans and domestic animals by enabling the treatment of diseases that previously caused significant morbidity and mortality.

Unfortunately antibacterials have become victims of their own success and their increasing usage has encouraged the development of antibacterial resistance. Although the use of antibacterials does not in itself induce antibacterial resistance, exposure to antibacterials favours the survival of organisms carrying resistance genes.

At the same time as antibacterials have become less effective as a result of the development of antibacterial resistance, there has been a reduced rate of development of new drugs. These two factors mean that we need to protect the effectiveness of the antibacterials we have through responsible use and stewardship.

While antibacterial resistance is currently not a serious issue in companion animal practice it is recognised that this is a “One Health” issue affecting humans, animals and the environment. It can only be tackled through an integrated strategy that aims to

• improve the knowledge and understanding of AMR
• conserve and steward the effectiveness of existing treatments through optimal use of antibiotics in both humans and animals,
• stimulate the development of new antibiotics, diagnostics and novel therapies.
  As detailed in the UK 5 year Antimicrobial Resistance Strategy

In the UK all veterinary antibacterials are prescription-only medicines (POM-V), therefore the responsibility for and control of antibacterial use rests with the prescribing veterinary surgeon.

The BSAVA and Small Animal Medicine Society (SAMSOC) have produced the PROTECT poster and guidance to encourage responsible antibacterial prescribing.

Related statements

Cascade prescribing

Further information 

UK 5 year antimicrobial strategy
Worms and Germs blog (University of Guelph)
Bella Moss Foundation

Provenance 

BSAVA Scientific Committee
BSAVA Council, November