CPD Article | EQUINE
Focus on Antibiotic Stewardship –
What’s Hot and What’s Not?
Catriona Lyle
BVM&S MSc CertEM(IntMed) DipECEIM
[email protected]
Antibiotic stewardship can be defined as a systematic
approach to optimise appropriate use of antimicrobials
in order to improve patient outcome and limit
emergence of resistant pathogens.
The SAEVA Antibiotic Use Policy is available on the
SAEVA website to help guide appropriate antibiotic use -
http://www.saeva.co.za/wp-content/uploads/2018/07/
Antibiotic-Use-Policy-edited.pdf
This article is not intended as a fully comprehensive
article on antibiotic stewardship but provides an
update on some topical issues in antibiotic stewardship
both in the context of one health and specific to equine
practice.
What’s Hot?
1. One Health
While there is growing awareness of multi-drug resistant
pathogens within equine practice it is also important to
consider the impacts of antibiotic use not only on the
patients they are prescribed for but on other animals,
people and the environment. One Health can be
defined as an integrative effort of multiple disciplines
and multiple government sectors and partners working
locally, nationally, and globally to attain optimal
health for people, animals, and the environment.
SAEVA is represented in The South African Antibiotic
Stewardship Programme (SAASP) which is engaging
with stakeholders involved in human, animal and
environmental health.
2. Being AWaRe
The 2017 revision of the World Health Organisation’s
(WHO) Essential Medicines List classified antibiotics
into 3 categories (Access, WAtch and REserve) with
the aims of improving access and clinical outcomes,
reducing development of antibiotic resistance and
preserving effectiveness of “last-resort” antibiotics.
Access antibiotics are first-choice and second-
choice antibiotics that are generally narrow-spectrum
with lower resistance potential. WAtch antibiotics
are broader-spectrum and therefore have greater
resistance potential. A small number of antibiotics from
the Watch group were also recommended for first- or
second-line treatment for a few specific conditions in
humans. REserve antibiotics should be treated as last-
resort options i.e. used when alternatives have failed or
cannot be used.
WHO list of antibiotics categorised into Access,
Watch and Aware groups to help improve prescribing
decisions (Sharland 2018)
Access
Amoxicillin
Amoxicillin and clavulanic acid
Ampicillin
Benzathine benzylpenicillin
• Volume 21 Issue 2 | May 2019 •
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