Rosanne Jepson and Zoe Halfacree, co-chairs of the Infection Control Group at the Queen Mother Hospital for Animals
There are worldwide concerns about the use of antibiotics and the development of antibiotic resistance and many made news headlines
Every year we treat patients at the RVC that are referred with multi-drug resistant infections and this poses a constant challenge to the way that we manage and care for such patients. It is not that antibiotics should not be used - it is just that they should be used with due consideration.
The overall prevalence of multidrug-resistant infections in both general practice and at specialist referral hospitals is difficult to estimate. There are studies showing
We have to carefully consider whether antibiotics are needed for a patient i.e. do they have a bacterial infection, the type of antibiotic required depending on the bacterial infection, and the location of the infection (i.e. where the antibiotics have to penetrate). We also have to consider the best route of administration, the duration of treatment and ensuring patient and owner compliance to complete the course prescribed and to monitor for resolution of infection.
Our Infection Control Group has representation from every hospital service, including the nursing and pharmacy teams. This is really important so that everyone is working together with the same common goal and that we consider the different requirements of different disciplines.
We have a tiered antibiotic policy for use in the hospital to help monitor, preserve and audit our antibiotic usage and the occurrence of multi-drug resistant infections. Antibiotics are classified into three tiers ranging from Tier 1, which can be used without restrictions, through to Tier 3 which are considered ‘critical’ antibiotics for use only on the basis of culture results and with careful recording and discussion about the rationale for their use.
The Infection Control Group provides a core team of people available to discuss in a multidisciplinary manner antibiotic choice and whether alternative approaches are available to improve treatment and outcome for patients with bacterial infections.
The group has established in-house culture facilities so that rapid turnaround for identification of bacterial infections. This ensures that appropriate cultures are performed for every patient so that the infection is correctly identified and
The group provides a discussion forum if a multi-drug resistant infection is identified which would require
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