ACAZAP RECOMMENDATIONS continued
ASTAG ANTIBACTERIAL IMPORTANCE RATING
High Importance: These are essential antibacterials for the treatment or prevention of infections in humans where there are few or no treatment alternatives. These have also been termed “last resort” or “last line” antibacterials.
Medium Importance: There are some alternative antibacterials in different classes available to treat or prevent human infections, but less than for those rated as Low Importance.
Low Importance: There are a reasonable number of alternative antibacterials in different classes available to treat or prevent most human infections even if antibacterial resistance develops.
– Fluoroquinolones, e.g. enrofloxacin, marbofloxacin, pradofloxacin
– Amoxicillin with clavulanic acid
– Amoxicillin/Ampicillin
– Cephalexin/Cephazolin
– Chloramphenicol (topical)
– Fusidic acid (topical)
– Clindamycin
– Doxycycline
– Polymyxin B (topical)
– Gentamicin
– Neomycin
– Third generation cephalosporins, e.g. cefovecin, ceftiofur
– Metronidazole
– Procaine penicillin
Importance ratings for some antibacterials commonly used in dogs and cats
• Antimicrobial prescribing guidelines provide a useful framework to help inform treatment decisions. A range of prescribing guidelines and tools to support prudent antimicrobial use can be found through the AMR Vet Collective.
• Animals should be bathed after visiting hospitals or aged care facilities to minimise the risk of acting as mechanical vectors. Animals with known AMR infections should not be used in animal assisted therapy programs. For additional information see Animals in Care Facilities on page 93. • For animals with documented active AMR infections additional precautions are recommended: - Enhanced infection control should be practiced in the veterinary clinic setting including appropriate isolation and use of PPE (gowns and gloves). Consideration of the pathogen(s) involved and mode of transmission are important in determining the appropriate level of infection control practices (inclusive of PPE and isolation requirements) to be implemented. The AVA Guidelines for Veterinary Industry Personal Biosecurity are a useful resource in this regard. - Owners should be counselled to avoid contacting the infected area. Skin lesions or infections should be covered with impermeable dressings to avoid environmental contamination. - Thorough homecare instructions should be provided, specifically regarding wound management and environmental cleaning. - Contact should be minimised with other animals in the household. - Animal faeces should be promptly collected and disposed of.
• Culture and susceptibility (C&S) results should be used to guide antimicrobial choice whenever possible. If broad-spectrum higher-importance antimicrobial therapy is implemented in critical patients, de-escalation of antimicrobial therapy should occur if indicated when C&S results are available. Clinicians need to reconsider duration of therapy to match the clinical needs of the patient. • Veterinarians should discuss with owners the importance of antimicrobials to human and animal health and the need to preserve their efficacy through prudent use. Veterinarians should reinforce to pet owners the importance of following the directions for use of any prescribed antimicrobial. MINIMISING TRANSFER OF RESISTANT ORGANISMS BETWEEN PETS AND PEOPLE • Good infection control practices are essential to help prevent transmission of potentially zoonotic bacteria between pets and people, whether AMR or not. This encompasses not only hand hygiene but also regular cleaning of contaminated surfaces, as a failure to do either may contribute to transmission of resistant organisms.
CONTENTS
Companion Animal Zoonoses Guidelines 9
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