Stick a label on all CIA packages with red writing saying 'Critically important antimicrobial. Do you really need to use this?'

Start asking owners if they have had the horse weighed recently or have a weigh tape, it's surprising how many do, and then you can get your dose accurate.

Use culture and sensitivity testing routinely, trust the results and trust the antibiotics. Use first line, licensed antimicrobials unless a lack of sensitivity dictates otherwise.

Re-organise your pharmacy. Put first line antibiotics on the bottom shelf and HP-CIA's on the top shelf.

Just because the critically important antibiotic (CIA) amikacin comes in a conveniently-sized vial for joint injections does not make it OK to use as a prophylactic antibiotic with steroid medication.

You wouldn't deliberately expose yourself to unnecessary radiation. Likewise with antimicrobials, use the ALARA principle to reduce your antibiotic usage to 'As Low As is Reasonably Achievable'.

Have minimal stock of the HP-CIA's on the shelf in your pharmacy.

Reduce the volume and increase the efficacy of CIAs when used in essential cases by using local high concentration antimicrobial treatment (IVRP or intra-articular).