Chapter 31 : Antimicrobial Stewardship in Veterinary Medicine

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Stewardship implies a process of caring and responsible management ( ), and as we face the progressive extension of multiresistance amongst bacteria in veterinary and human medicine, and in agriculture, there is a need to apply stewardship efficiently to the use of antimicrobial drugs so that we can preserve and extend their efficacy.

Citation: Lloyd D, Page S. 2018. Antimicrobial Stewardship in Veterinary Medicine, p 675-697. In Schwarz S, Cavaco L, Shen J (ed), Antimicrobial Resistance in Bacteria from Livestock and Companion Animals. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.ARBA-0023-2017
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Figure 1

Key elements of antimicrobial stewardship. 1. GSP requires embedded thinking and action to improve antimicrobial use and minimize resistance selection and impact. 2. Responsibility implies high-level commitment, with everybody taking and sharing responsibility 3. The 3Rs of responsible use—reduce, refine, and replace—should be applied wherever possible. 4. Review antimicrobial use and infection control and develop objectives to improve current practice and implementation of the stewardship plan. 5. Every cycle of 5R stewardship reflects continuous improvement () and leads to best practices in infection prevention and control and antimicrobial use. (Figure graphics by Ed Hewson.)

Citation: Lloyd D, Page S. 2018. Antimicrobial Stewardship in Veterinary Medicine, p 675-697. In Schwarz S, Cavaco L, Shen J (ed), Antimicrobial Resistance in Bacteria from Livestock and Companion Animals. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.ARBA-0023-2017
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Figure 2

Decision-making and application of GSP in suspected bacterial infection.

Citation: Lloyd D, Page S. 2018. Antimicrobial Stewardship in Veterinary Medicine, p 675-697. In Schwarz S, Cavaco L, Shen J (ed), Antimicrobial Resistance in Bacteria from Livestock and Companion Animals. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.ARBA-0023-2017
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Figure 3

Interventions that can guide enhanced AMS.

Citation: Lloyd D, Page S. 2018. Antimicrobial Stewardship in Veterinary Medicine, p 675-697. In Schwarz S, Cavaco L, Shen J (ed), Antimicrobial Resistance in Bacteria from Livestock and Companion Animals. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.ARBA-0023-2017
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