Forums » Internal Medicine - Small Animal

• VetVine Specialty Consulting Service

  

  • 239 posts
   

  April 30, 2019 5:41 PM EDT

  Antimicrobial drugs are used to treat bacterial, fungal, and viral infections. Accordingly, these drugs fall into one of 3 categories - antibiotics, antifungals, or antiviral medications; These drugs are among the most commonly prescribed medications on a daily basis by veterinarians.
  
  The emergence of drug-resistant infections (antimicrobial resistance) is a global health concern and one that affects both humans and animals. On a day-to-day basis however, consideration of factors that contribute to this problem is not top of mind for the clinician. This is understandable given our busy schedules, short appointment slots, and demands of clients who request refills of medications (e.g. chronic or recurrent ear infections) or who decline our recommendations to perform additional diagnostic testing (e.g. culture and sensitivity).

  Drug-resistant infections can develop for many reasons and excessive or inappropriate use of antimicrobial drugs can compound the problem. Examples of excessive or inappropriate use include:

  • Prescribing of antibiotics when the illness is not due to a confirmed bacterial infection (e.g. the patient has a "cold" or viral infection)
  • Not administering the proper dose of drug (e.g. a client that splits pills to save money or to make a medication last longer)
  • Not completing a full course of treatment (e.g. a client that stops administering the medication after a few days because the problem appears to be resolved)
  • Giving medication left over from a previous illness to treat a presumed flare-up or a new problem

  The consequences of drug-resistant infections and antimicrobial resistance include prolonged illness, increased mortality rates, increased costs related to treatment, and the transmission of drug-resistant pathogens between humans and other animals. 

  To combat the problem, antimicrobial stewardship programs and prescribing guidelines have been established in both human and veterinary medicine. These guidelines encourage prescribers to select the optimal drug for the problem at hand including the appropriate drug dosage, duration of therapy, and route of administration. Examples of published antimicrobial guidelines include:

  • ACVIM Consensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance
    
    
  • Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases
    
    
  • Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis (Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases)
    
    
  • Other Guidelines from ISCAID (International Society for Companion Animal Infectious Diseases)
    
    

  Equally important is patient and/or pet owner compliance in adhering to the prescribing doctor’s instruction. In the case of veterinary medicine pet owners are at the forefront of good antimicrobial stewardship as most antimicrobials are sent home to be administered on an outpatient basis.

  Dr. Laurel Redding, VMD, PhD from the University of Pennsylvania recently discussed the issue of antimicrobial resistance and highlighted some key takeaways for veterinarians and points they can share with pet owners:
  
  

• VetVine CE

  

  • 418 posts
   

  May 1, 2019 8:22 AM EDT

  Veterinary professionals can earn 0.25 hours of CE credit by logging in to view this presentation and completing an evaluation / post-test.