Rational antimicrobial use and resistance

Knowledgeable and rational use of antimicrobials in horses is essential in the antimicrobial-tolerant and antimicrobial-resistant world. The tenets in the previous lecture on strategies of antimicrobial use in equine respiratory disease hold true for use of antimicrobials in other organ systems. The use of topical disinfectants such as chlorhexidine have a place in management of skin wounds and infections.

Important questions to answer are how do we treat horses, achieve client compliance and avoid antimicrobial-tolerance and antimicrobial-resistance? Steps should be taken to ensure clients can not obtain antimicrobials unless prescribed specifically by their veterinarian. Unverified internet sales appear to be an international crisis. Client education is key, as we all understand that client-determined administration and brief, inconsistent exposure to an antimicrobial may prime bacteria to become tolerant and eventually resistant. Veterinarians need to be more aware and engaged in surveillance of antimicrobial resistance in equine pathogens, especially in their practice region, as well as staying abreast of national and international trends. Such knowledge will allow us to ascertain if resistance is increasing and whether previously unrecognised resistance is occurring. Veterinarians must be vigilant about particular classes of antimicrobials being over-represented in resistance patterns and whether a definitive type of resistance is associated with particular outbreaks.

Dr CJ (Kate) Savage BVSc(Hons), MS, PhD, Diplomate ACVIM has enjoyed a wonderful career in equine internal medicine. Kate is now a board member of the Victorian Racing Integrity Board (VRIB) in Australia. Her interests include cardiology and respiratory medicine in horses, and the advancement of welfare and health in horses, including those in competition.