ANTIMICROBIAL RESISTANCE • Antimicrobial resistance (AMR) is a critical global health challenge in human medicine and an emerging problem in companion animal medicine. • In addition to rendering some animal infections more difficult, or even impossible to treat, the development of AMR in pets poses a risk to human health. The close relationship between companion animals and humans facilitates the transfer, directly or indirectly, of shared resistant organisms or genetic determinants. There is potential for bi-directional flow, with the transfer of resistant organisms/ genes from animal-to-human or vice versa, and thus a One Health approach to the problem is essential. • The role and contribution of companion animals to AMR in humans is complex and incompletely understood. It is clear however that antimicrobial use in animals, as in humans, is a risk factor for colonisation or infection with resistant pathogens. Prudent use of antimicrobials by the veterinary profession is an important component of addressing the threat of AMR in animals, and by extension in minimising the contribution animals may play in human AMR. Surveys of companion animal veterinarians and a review of veterinary antimicrobial prescribing practices report the regular use of broad-spectrum antibiotics of high importance to human health, highlighting a need for an increased focus on the principles of prudent use in the profession. 1,2 • The prevalence and impact of AMR varies globally, and not all resistant organisms have a potential zoonotic component. Specific organisms of concern which have a demonstrated or potential involvement of companion animals in their transmission include methicillin-resistant S. aureus (MRSA), methicillin-resistant S. pseudintermedius (MRSP), extended-spectrum beta- lactamase producing Enterobacterales (ESBL-E), carbapenemase-producing Enterobacterales (CPE), and Clostridioides difficile . Antimicrobial resistance in Campylobacter and Salmonella are also a potential zoonotic concern and are discussed in the relevant sections on pages 24 and 71 respectively.
ACAZAP RECOMMENDATIONS
MINIMISING SELECTION FOR RESISTANCE IN ANIMALS • Prescribing veterinarians should follow established guidelines for the prudent use of antimicrobials. The Australian Antibacterial Importance Ratings, developed by the Australian Strategic Technical Advisory Group (ASTAG) on Antimicrobial Resistance, categorises antimicrobials as
of high, medium or low importance. Veterinarians should avoid the use of antimicrobials of high importance in human medicine, such as third generation cephalosporins and fluoroquinolones, where possible. Lower-importance, narrow-spectrum antimicrobials should be used as first line treatment options when antimicrobial agents are deemed clinically necessary.
CONTENTS
8 Companion Animal Zoonoses Guidelines
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