AASV basic guidelines of judicious therapeutic use of antimicrobials in swine

Note: The AVMA has endorsed these guidelines developed by the American Association of Swine Veterinarians.

Position statement

Judicious therapeutic use of antimicrobials is a core principle of the broader goal of antimicrobial stewardship. Antimicrobial Stewardship involves maintaining animal health and welfare by implementing a variety of preventive and management strategies to prevent common diseases.

The American Association of Swine Veterinarians supports and is committed to judicious therapeutic use of antimicrobials and the core principles of antimicrobial stewardship. Judicious therapeutic use of antimicrobials in swine for the prevention, control, or treatment of a bacterial disease requires veterinary oversight in the context of a veterinarian-client-patient relationship. Swine veterinarians are committed to using an evidence-based approach in making decisions to use antimicrobial drugs; and then using antimicrobials judiciously, sparingly, and with appropriate evaluation of the outcomes of therapy. In addition, veterinarians should be involved in the health, well-being, production, and decision-making process of a farm to promote and provide guidance on the core principles of antimicrobial stewardship, thus protecting public and pig health.

Judicious therapeutic use of antimicrobials principles for swine veterinarians

Following the core principles of swine health management is critical to prevent infections and reduce the need for antimicrobials. Veterinarians should work with producers to follow core principles. Veterinarians should:

Implement, review, and audit preventive strategies to optimize pig health. These include husbandry, hygiene, biosecurity, routine health monitoring, welfare, and immunization.
- The Pork Quality Assurance® Plus (PQA Plus®) program of the National Pork Board is an example industry platform for this to occur.

Asses the need for antimicrobials.
- Evaluate and quantify the severity and prevalence of clinical signs.
- Discern if individual treatment of ill or at-risk animals is sufficient to improve the overall group morbidity, mortality and herd well-being; or if herd or group therapy is needed to properly control clinical outcome.
- Assess clinical signs and perform diagnostics to establish the differential diagnosis; and if possible, the definitive diagnosis.
Recognize, investigate, and address the roles played by the various co-factors in the course of the disease(s):
- Genetics,
- Nutrition,
- Housing and environment,
- Management and production practices,
- Health history and preventative strategies.
Consider other therapeutic options prior to, or in conjunction with, antimicrobial therapy.
Optimize regimens for antimicrobial therapy by using current pharmacological science, principles, and regulatory guidance:
- Use antimicrobials following careful review, appropriate selection of drug and regimen.
- Use historical outcomes and clinical experience in the selection of antimicrobials.
- Use adequate laboratory support when available for antimicrobial decision making.
- Follow label directions or, when extra-label use is clinically necessary, follow AMDUCA and FDA regulations.
Follow all requirements of a veterinarian-client-patient relationship (VCPR).
Veterinarians should provide oversight, regardless of the distribution system through which the antimicrobial was obtained.
Minimize environmental contamination with antimicrobials through verification of properly adjusted equipment for delivery of therapeutic antibiotics.
Require records of all antimicrobial treatments.
Evaluate clinical outcomes and adjust therapy if needed.
Re-evaluate need for additional antimicrobial use after corrective actions have been taken on identified co-factors.