Page 7 - Clinical Connections - Spring 2023

Antimicrobials
A PRECIOUS RESOURCE: ANTIMICROBIAL
STEWARDSHIP IN THE QMHA

Rosanne Jepson, Professor Small Animal Internal Medicine, and Tom Greensmith, Lecturer in Small
Animal Emergency and Critical Care
n November 2022 the Queen Mother
Hospital for Animals (QMHA) participated
I in ‘World Antimicrobial Awareness
Week’, an international event coordinated
by the World Health Organisation. In 2022,
the theme was ‘Preventing Antimicrobial
Resistance Together’. It was an important
opportunity to consider both the preservation
of antibiotics for human health and the
role that the veterinary profession plays in
preventing antimicrobial resistance.
Antimicrobial stewardship is always at the
forefront of the clinical work that we do at the
QMHA. Ensuring antimicrobial stewardship
means that you establish a coordinated
programme that promotes appropriate use
of antimicrobials (including antibiotics), work
to improve patient outcome, aim to reduce The antibiotic amnesty took place in Novemeber
microbial resistance and help to decrease
the spread of infections caused by multi- restricted and require authorisation for use antibiotics, but no data is currently available.
drug resistant organisms. (Tier 3). Regular auditing is an important The Antibiotic Amnesty was a national
Since 2015, the QMHA has had an part of our antimicrobial stewardship to initiative in conjunction with the NHS, RCVS
established antimicrobial stewardship ensure hospital-wide compliance and to Knowledge¹, the BSAVA and RUMA-CA&E
programme, which includes a hospital- understand our use of antibiotics. (Responsible Use of Medicines Alliance –
based policy on the use of antibiotics in Companion Animal and Equine). During the
cats and dogs, along with a designated World Antimicrobial Awareness Week amnesty, clients attending the QMHA for
antimicrobial stewardship team. The and antibiotic amnesty an appointment were asked to return any
QMHA antimicrobial stewardship team is Antimicrobial Awareness Week provided an unused antibiotics they had at home so that
comprised of key clinicians across many opportunity to focus on the importance of these could be disposed of in a clinically and
of the hospital’s specialist disciplines, who careful use of antibiotics. Specific initiatives environmentally safe manner. There was
have a keen interest in this area. In addition, included a hospital-wide seminar, a social also an opportunity for clients to complete
we work very closely with a veterinary media campaign, podcast recording, a survey² to help the veterinary profession
clinical microbiologist and are fortunate infographics updating our team and clients gain a better understanding of why these
to have an onsite diagnostic microbiology on the latest progress on our antibiotics use, antibiotics had been returned.
service giving rapid turnaround of results, and increased engagement of our veterinary Data on the type and amount of unused
which is critical for decision-making in the students in all elements of clinical decision- antibiotics returned to the QMHA has been
sickest patients. making in relation to antibiotic prescribing. submitted as part of this national veterinary
Increasingly, as in human medicine, Together with World Antimicrobial initiative. By joining forces with the wider
multi-drug resistant bacterial organisms Awareness Week, the QMHA also joined the veterinary profession, we were pleased to
are recognised in some of the pets that we ‘Antibiotic Amnesty’ throughout the whole be part of this important ongoing work to
treat, which can create challenging clinical of November. Although unused antibiotics keep antibiotics safe for the future.
situations. The antimicrobial stewardship prescribed to humans can be returned to
team provides an advice service for the pharmacies, many of them are disposed in 1. https://knowledge.rcvs.org.uk/amr/
hospital when these complex cases arise, household waste or down sinks or drains. 2. https://rumacae.org.uk/antibioticamnesty/
with careful consideration for all clinical This raises concerns about the possibility
options that may be available. of environmental contamination. Even low
To help guide the use of antibiotics, the levels of antibiotics in the environment can
hospital has a tier-based system for antibiotic contribute to selection pressure for the
prescribing. This tiered system indicates development of multi-drug resistant bacteria.
antibiotics that are considered first-line (Tier Responsible prescribing, administration
1), those which should always have culture and disposal of antibiotics where they are For small animal referrals, please call:
01707 666399
performed to confirm susceptibility prior to not used, is of vital importance. The same Email:
prescribing (Tier 2) and those which are situation could be occurring with veterinary qmhreception@rvc.ac.uk

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