Policy/Programme Suggestions for Vet Practices/Vet Hospitals
When setting up an antimicrobial stewardship programme or policy (ASP) thought needs to be given to who is in charge, who sets policies, what outcomes are measured, and who monitors these.
Discuss why an ASP is required and how each person can contribute to its success.
Make a practice wide commitment that an ASP is a priority for all practice staff (including reception staff who can champion it with clients), focusing positively on optimisation of antibiotic use and protection of antibiotics:
Discuss prescribing habits within the team and decide on priorities (such as monitoring antimicrobial use, resistance patterns, training requirements, which antibiotics can and cannot be used, what proportion of cases are to be sampled).
The ASP should contain a statement of which issues are to be addressed, keeping these simple and achievable, possibly:
Agree interpretation of “under direct clinical care” among vets in practice (RCVS definition).
For consistency and support of less experienced or new team members, agree policy on:
Encourage and promote investigation of underlying causes e.g. using cytology and near patient diagnostic tests to avoid unnecessary or inappropriate antibiotic use.
Agree policy on antibiotic use around surgery and oncology.
Identify a lead person (champion) to be responsible for co-ordination of the stewardship programme, a vet or a nurse, or a multidisciplinary team composed of a co-ordinator and a lead from each sector may be appropriate in large or mixed practices.
An essential element of any antibiotic stewardship programme (ASP) is identification of measures of outcome appropriate for the individual vet practice.
Antimicrobial usage (AMU) could be used as an internal benchmark for the vet practice
Experience from human medicine suggests that some of these simple examples could help to inform individuals within the practice:
Alongside the PROTECT ME poster, BSAVA have developed a form (No antibiotic required ‘non prescription’ form) that can be provided to clients to support a decision not to provide antibacterial medication