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Antimicrobial Stewardship Made Practical for Practitioners

    • 310 posts
    August 12, 2020 9:46 AM EDT

    Companion animal veterinarians are increasingly confronted with patients suffering from antimicrobial resistant (AMR) infections. AMR is a problem across health sectors, though the focus has largely been on human and agricultural animals. Cats and dogs share our environments, and sometimes our ice cream cones, and we prescribe the same antibiotic drug classes as those used in human health. Recently, more attention is being payed to this oft ignored population in regards to AMR.

    Antimicrobial stewardship (AS) is the actions that prescribers take to improve patient outcomes while minimizing unintended consequences of antibiotic use, such as drug toxicity and the development of AMR. The American Veterinary Medical Association has outlined five core concepts of AS in veterinary medicine.[1] The AVMA has charged veterinarians, in service to our patients the community, to evaluate our antibiotic use practices and commit to use antibiotics judiciously.

    In human outpatient practice, it is estimated that at least 30% of antibiotic prescriptions are unnecessary.[2]  It has been postulated that inappropriate and over-prescribing in small animal medicine is at least as prevalent.[3]  In fact, one publication reports that 40% of dogs receiving an antibiotic prescription in a single hospital had no clinical evidence of infection.[4]  Often, too, veterinarians empirically prescribed antibiotics with a broader than needed antimicrobial spectrum or those of critical importance to human medicine. This means that there is much low hanging fruit and easy opportunities to take small steps towards AS in our practices.

    The need for enhanced antibiotic stewardship efforts in small animal medicine is clear to those of us who treat dogs and cats. The question for many is how?

    In this webinar Dr. Jennifer Granick, DVM, PhD, DACVIM (SAIM) - associate professor of small animal internal medicine at the University of Minnesota College of Veterinary Medicine - provides an overview of AMR and AS in companion animals. It will offer simple steps and accessible tools so that every veterinary practice can start small with AS and make meaningful change.

    Learning Objectives:

    1Understand the significance of antimicrobial resistance both as a one health issue and specifically for companion animals

    2. Understand basic concepts of antimicrobial stewardship

    3. Determine which of the simple actions presented you can take as the first small step towards improving antimicrobial stewardship in practice

    Registrants will be provided a downloadable packet of materials including:

    • Handbook of Antimicrobial Stewardship in Companion Animal Veterinary Settings
    • Pocket guide: Antimicrobial prescribing for common small animal diseases
    • Checklist for Core Principal Implementation
    • Antibiotic Use Talking Points for Vet Clinics
    • "No Antibiotic Today" Handout / Prescription - a fillable PDF that can be provided to clients in lieu of a vial of pills (when antimicrobials are not indicated)

    Approved for 1 hour of CE credit by AAVSB RACE, NY State, and the NJVMA
    and meets CA state requirements for antimicrobial prescribing CE.

    Fee: $50

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    References:

    1. American Veterinary Medical Association (AVMA). Antimicrobial stewardship definition and core principles. In: 2018. Available at: https://www.avma.org/KB/Policies/Documents/AntimicrobStewardshipDef_CorePrinciplesFlyer_052318.pdf

    2. Fleming-Dutra KE, Hersh AL, Shapiro DL, et al. Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. JAMA 2016;315(17):1864-1873.

    3. American Veterinary Medical Association (AVMA). Report: Task force on antimicrobial stewardship in companion animal practice activities, August 2013–December 2015; 2016. Available at: https://www.avma.org/KB/Resources/Reports/Pages/Antimicrobial-Stewardship-in-Companion-Animal-Practice.aspx

    4. Wayne A, McCarthy R, Lindenmayer J. Therapeutic antibiotic use patterns in dogs: observations from a veterinary teaching hospital. J Small Anim Pract 2011;52(6):310-8.