3.4.1 Guidelines for prescribing or giving antimicrobials to animals
You have probably heard the terms ‘appropriate’, ‘responsible’, ‘prudent’ or ‘judicious’ used in relation to antimicrobial use many times. Have you thought about what these terms mean to you?
Appropriate use means different things to different people. For example, suppose you are a veterinarian deciding to prescribe antimicrobials for a group of animals. You are likely to consider ‘appropriate use’ to mean ensuring that you are using the right antibiotic, at the right time, at the right dose, and for the right duration.
Someone who is not a veterinarian may think of appropriate use as ensuring that:
- antimicrobials are only prescribed by a veterinarian
- label directions and veterinary directions are followed
- the full course of antimicrobials is given
- HP-CIAs are not used as the
first line of defence or for preventative purposes with scientific justification.
A prescribing creed commonly used is the MINDME acronym:
- M – microbiology guides therapy where possible
- I – indications should be evidence-based
- N – narrowest spectrum possible
- D – dosage appropriate to site and type of infection
- M – minimise the duration of therapy
- E – ensure monotherapy if possible (one drug rather than combinations).
Determining appropriateness is not a straightforward task in food animals. It depends on several variables:
- access to diagnostic services
- training of veterinarians, farmers, and others in the supply chain
- availability and access to quality antimicrobials.
Fortunately, there are many resources to help ensure decisions about antimicrobial use are appropriate. For example, the OIE has detailed guidelines on responsible and prudent use of antimicrobials, which you can read on the OIE [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] website when you have time.
Prescribing guidelines are freely available on many public websites for veterinarians. Prescribing guidelines help with choosing the most appropriate antimicrobial based on the animal species and the bacterial pathogen that is causing the disease. The best prescribing guidelines are those that are evidence-based, designed to be flexible, and specific to the local context.
Here are some prescribing guideline resources you can review in your own time:
https://www.ruma.org.uk/ antimicrobials/ guidelines/
3.4 Factors influencing decisions to give antimicrobials animals
