Grow-Your-Own Antimicrobial Stewardship Culture

Veterinary Prescriber presents this practical toolkit for creating a culture of antimicrobial stewardship in the veterinary practice, in five parts: introduction; step 1; step 2; step 3; getting started. The series has also been published as a single module in Veterinary Prescriber’s Virtual Veterinary Medicines Academy. Finish the series with these practical suggestions. The series (like our modules) includes audio, so you can read while you listen. The module was created by Veterinary Prescriber in collaboration with Simon Robinson of Operability.

Antimicrobial stewardship is not simply about following policies and procedures, because these are unlikely to succeed without a conducive environment. In this Veterinary Prescriber module, we are using the concept of a petri dish to illustrate three conditions (represented by three ‘microorganisms’) that are needed in the practice to promote an environment in which staff can practice antimicrobial stewardship. Now that you’ve come to the end of the module that has guided you through the process of building a good antimicrobial stewardship culture, it’s over to you to make a start. We offer some suggestions below to get you going.

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A diagram of a petri dish containingbacteria-like images that illustrate the different conditions needed to grow a culture of antimicrobial stewardship

Five ways to make a start

The overall goal in Antimicrobial Stewardship (AMS) is to reduce the risk of microorganisms becoming resistant to some of the most important medicines we have.  There are three important objectives:

  • Reserve our last line of defence - the antibiotics in the ‘Restrict’ category

  • Minimise any unnecessary use of first-line antimicrobials

  • Maximise the effectiveness of antimicrobials when they are used.  

To make a start on this, here are 5 suggested things to try first:

  1. Nominate an AMS champion.

  2. Study how your practice is performing.  Choose one or two antibiotics in the ‘Restrict’ category (for instance a quinolone such as enrofloxacin (Baytril)  or 3rd generation cephalosporins such as cefovecin (Convenia) and look at their  prescribing history.

  3. Explore overall usage and the reasons why antibiotics were used.

  4. Summarise for your practice team, and discuss where alternative approaches may be justified.

  5. After 3 months, see how prescribing practice has changed, and consider next steps.

The audio version of this series is available as a podcast

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