Australian Veterinary Prescribing Guidelines

The Australian veterinary prescribing guidelines are evidence-based guidelines that have been created in a collaborative effort between the University of Melbourne’s Asia Pacific Centre for Animal Health (APCAH) and the National Centre for Antimicrobial Stewardship. These guidelines are not static and we hope that you will also take an active role in this evolutionary process. Please suggest a disease or syndrome for guideline development where you think this would be of value. 

Importantly, these guidelines are independent, and we have no conflicts of interest to declare. All peer-reviewed research findings will be considered and critiqued, and guidelines adjusted as we see appropriate for the level of confidence we have in the research completed. Where evidence is lacking, this is stated and our recommendations are then based on human literature and expert opinion.

These have been created to simply serve as guidelines for the practitioner and the veterinary industry. As such, they do not have the force of law. All guidelines issued here should be regarded as one of several tools a practitioner may take into consideration in the context of his or her practice. Many of the recommendation in this guide represent off-label use of antimicrobials. All practitioners are encouraged first and foremost to understand and comply with the laws, regulations and standard of care of their appropriate jurisdiction. While guidelines are intended to promote a standard for veterinary practice, lack of adherence to any specific guideline does not constitute grounds for disciplinary action. The University of Melbourne and APCAH shall have no liability whatsoever for any guideline.

Patterns and Rationales for Antimicrobial Usage in Companion Animals

While there is greater microbiological monitoring of infectious disease in companion animals as compared to farm animals, and data available within veterinary diagnostic laboratories on resistance patterns in a number of important indicator species, including Staphylococcus aureus, Staphylococcus pseud-intermedius and Escherichia coli, there is limited data available about usage patterns or the rationale behind these usage patterns.

Through our research, we have been identifying factors driving antimicrobial prescribing in companion animal, bovine and equine practices, and have identified and designed strategies for future interventions, including improved prescribing guidelines and suitable mechanisms to ensure appropriate use; educational programs through continuing education courses; and, potentially, the incorporation of responsible prescribing into veterinary hospital accreditation programs. 

Patterns and Impacts of Antimicrobial Usage in Livestock

While very large quantities of antimicrobials are administered to food producing animals, usage in animal production is generally restricted to specific registered classes of antimicrobials and administration is generally for restricted periods of time in relatively isolated populations of animals. In contrast, antimicrobial usage in companion animals (dogs, cats and horses) is across a wider range of classes, within less isolated populations and in animals in near constant contact with humans. While some of this usage may not result in increased risk of transfer of resistance into humans, other patterns of prescribing may have a high risk, but there is little information available about the approaches to usage that pose the greatest risk. Any education of veterinary prescribers, or change in regulation of antimicrobial usage in veterinary practice, will depend on the acquisition of data to differentiate high-risk behaviour from that posing much lower risks. The data currently available about veterinary usage of antibiotics, as reported by the Australian Pesticides and Veterinary Medicines Authority (APVMA), is limited to the total tonnages of antimicrobials imported for veterinary purposes, with no differentiation of the distribution of these drugs to different animal species or production systems, and no information about the stage of the animals’ lives when the drugs are administered. Administration for a short period of time to neonates is likely to have much less impact on transfer of resistance into the human food chain than administration over an extended period of time to older animals closer to the time of harvest.
The aim of our studies has been to gain a clear understanding of the volumes of antimicrobials administered to different food animals, the specific antimicrobials used in typical herds and flocks, and the distribution of this usage over the lifetime of these animals. The indications that serve as signals to prescribers have been explored to identify those that are justifiable and those that are questionable, as well as to identify health problems that might be the focus of alternative solutions. In addition, the rationales for specific choices of drugs have been assessed and analysed in relation to the evidence available to support this use. This has assisted in identifying gaps in evidence for different prescribing patterns that can be addressed to guide improved behaviour.

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