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For Equine Vets Everywhere

Protect Me ToolKit

Antimicrobial resistance is a clinical problem that is recognised internationally as one of the largest threats to human and animal health. We believe that effective, self-regulation on the responsible use of antimicrobials is a more suitable option than a legislative solution. 

Our award-winning ToolKit, modelled on the BSAVA PROTECT guidelines, has been developed to support you in using antibiotics responsibly. 

There is considerable evidence in human health that auditing antimicrobial use can be a powerful tool to changing prescribing practices. If the highest priority critically important antibiotics are used sparingly then we can preserve their effectiveness for the future. BEVA has created a flexible framework allowing veterinary surgeons to undertake effective clinical audit without significantly impacting on working practices. This will help members comply with their obligations under the RCVS practice standards scheme.

To use the Protect Me Toolkit please click on each letter below to jump straight to a section or simply scroll down through each section.

Practice Policy

Develop protocols for antimicrobial usage:

1

Identifying common clinical scenarios

2

Formulating protocols for the first line and alternative antimicrobial therapy for these conditions


3

Consider appropriate antimicrobial dosing using an evidence based approach

4

Develop protocols for the use of protected antimicrobials and avoided antimicrobials


Reduce Prophylaxis

Develop rational protocols for prophylaxis

1. Define surgical procedures as clean, contaminated or high risk

2. Rationalise disease control (e.g. the neonate, strangles)

3. Discontinue use where the evidence indicates there is no clinical benefit (e.g. intraarticular medication)


Other Options

Reduce or replace antimicrobials

1

wOUND dEBRIDEMENT

2

Topical preparations

3

Use the BEVA no antibiotic prescription form when antibiotics are not required



Types of Drugs and Bacteria

Select appropriate guidelines

1

Use cytology where possible

2

Consider the dose and pharmacokinetics of the drugs selected

3

Consider the suitability of the drug, compliance and risks of sub-therapeutic dosing that may accelerate the development of resistance


Employ narrow spectrum drugs

1

e.g. penicillin, rather than drug combinations. Use bacterial culture and susceptibility promptly

2

Culture when clinical response is less than expected

3

Culture when long term therapy is suspected



Culture and Susceptibility

Use bacterial culture promptly, especially when:

1

Clinical response is less than expected

2

Or when long term therapy is suspected


Treat Effectively

Enough drug for long enough then stop

1

Ensure dosing protocols provide therapeutic dosing

2

Consider that marketing authorisation are sometimes at odds with research evidence



Monitor

Monitor the emergence of bacterial resistance

1. Record use of protected antimicrobials
2. Record when a cultured bacteria is ineffective with your protocol
3. Respond to emerging resistance and modify protocols
4. Use this information as part of your clinical audit log
Monitor the emergence of bacterial resistance


Educate

Inform your team and your clients
1. Ensure that protocols and changes to protocols are cascaded through the entire team. Education is a vital part of changing practice and promoting responsible use. When constructing and reviewing local policies it is vital to develop buy in from all members of the practice.
2. Educate your clients to reduce pressure for antibiotics



Toolkit resources

To help you develop your policy, we've provided the below resources:

The templates can be downloaded and completed, but are by no means presented as the ‘ideal antimicrobial policy’. They are to be used as an example that you can change/amend as appropriate for your practice. 

Where members choose to, they may share their own version of this document with BEVA (via the submit button on the template) in the hope that consensus can be achieved for a least some of these clinical conditions.

POLICY TEMPLATE 

PROTECTED POLICY TEMPLATE.

Experience from practices that have developed a protected policy have seen a 90% reduction in the use of these agents

RESISTANCE REPORTING TEMPLATE

Regular review of emerging AMR is as important as the establishment of your initial practice policy. It will enable you to monitor the effectiveness of your practice protocol in reducing the emergence of resistance, while making it respond to changes in bacterial susceptibility in your practice.

Antibiotic LEAFLET 

This leaflet is designed to provide clients with a better understanding of antimicrobial resistance and how to use medicines responsibly. The leaflet can accompany the medicine.

ANTIBIOTIC LABELS

Labels can be printed and attached before or at the time of dispensing the medicine to raise client awareness

NO ANTIBIOTIC PRESCRIPTION FORM

PRACTICE POSTER

EVJ ANTIMICROBIAL FREE VIRTUAL ISSUE