Antimicrobial use in veterinary practice

Antimicrobial stewardship and judicious use

Judicious therapeutic use of antimicrobials is critically important regardless of your patient's species. Proper antimicrobial use optimizes therapeutic efficacy, enhances treatment success, and minimizes resistance to antimicrobials. Antimicrobial resistance threatens animal health and welfare, food production, and public health, and can impact the results of biomedical research. Veterinarians have a unique and important role in helping protect antimicrobial effectiveness. AVMA supports veterinarians in this role with educational materials and policies outlining principles for antimicrobial stewardship and judicious use.

Veterinary Feed Directive (VFD) and GFI 263

Before the federal Veterinary Feed Directive (VFD) took effect, medically important antibiotics could be—and were—administered to food animals for production purposes such as growth promotion and feed efficiency. Adding veterinary oversight of the use of medically important antibiotics in food animals ensures that these antimicrobials are only used when medically necessary to protect the health of an animal. Learn more about the Veterinary Feed Directive, and use AVMA tools to help write VFDs when they're needed.

Further combatting antimicrobial resistance, federal guidance for the industry #263 (GFI 263) outlines the process for animal drug sponsors to voluntarily change the approved marketing status of certain medically important antimicrobial drugs from over-the-counter (OTC) to prescription (Rx) by June 2023. Once transitioned to Rx, these drugs can only be used in animals under the supervision of a licensed veterinarian, even if the animals are not intended for food production. Learn more about GFI 263 and how it protects people and animals.

Tools for your veterinary clinic

These resources can help you communicate the importance of judicious antimicrobial use to clients and your community. Posters and brochures provide clear, concise information for clients, and other materials help with more in-depth conversations.

resources for the veterinary team

• Veterinary checklist for antimicrobial stewardship (PDF)
• Antimicrobial stewardship (Back-office poster)
• Antimicrobial-resistant pathogens affecting animal health (Report and reference cards)
• Does this cat need antibiotics? (Veterinarian reference sheet)
• Does this dog need antibiotics? (Veterinarian reference sheet)
• AVMA extralabel drug use (ELDU) algorithm
• VET09 - Understanding Susceptibility Test Data as a Component of Antimicrobial Stewardship in Veterinary Settings, 1st Edition

Client education materials

• Antibiotic use is changing: Guidance for clients
• Be careful with antibiotics: Client education posters
• Does my cat need antibiotics? (Client handout)
• Does my dog need antibiotics? (Client handout)
• Antimicrobial do's and don'ts (cat) (Client handout)
• Antimicrobial do's and don'ts (dog) (Client handout)
• Disposing of unwanted medicine (Client brochure)
• Antimicrobial use and antimicrobial resistance FAQ
• Quiz: How much do you really know about antibiotics? 

Guidance by species

Veterinarians use professional expertise and discretion in making clinical decisions based on factors unique to each patient, client, or veterinary practice. The following resources should not be interpreted as establishing standards of care. Variations may be warranted based on factors unique to the patient, client, or veterinary practice.

Aquatic

• Judicious therapeutic use of antimicrobials in aquatic animal medicine
• Aquaculture Fish Health (NOAA)

Bovine

• AABP judicious therapeutic use of antimicrobials in cattle

Companion animal

• Report of the AVMA Task Force on Antimicrobial Stewardship in Companion Animal Practice
• AAFP/AAHA antimicrobial stewardship guidelines
• Antimicrobial use guidelines for treatment of urinary tract disease in dogs and cats (ISCAID – International Society for Companion Animal Infectious Diseases)
• Antimicrobial use guidelines for treatment of respiratory tract disease in dogs and cats (ISCAID)
• Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis (ISCAID)
• Advice on responsible use of antimicrobials (FECAVA - Federation of European Companion Animal Veterinary Associations)
• Recommendations for appropriate antimicrobial therapy (FECAVA)
• Key recommendations for hygiene and infection control in veterinary practice (FECAVA)
• Advice to companion animal owners on responsible use of antibiotics and infection control (FECAVA)
• Handbook of antimicrobial stewardship in companion animal veterinary settings
• Commentary: Using antibiograms to promote antimicrobial stewardship during treatment of bacterial cystitis and superficial bacterial folliculitis in companion animal practice
• Development of a method for creating antibiograms for use in companion animal private practices

Equine

• American Association of Equine Practitioners (AAEP) judicious use of antimicrobials guidelines

Honeybees

• Honeybees 101 for veterinarians

Poultry

• AAAP guidelines for judicious therapeutic use of antimicrobials in poultry
• Backyard chickens 101: A quick guide to urban poultry for small animal veterinarians

Small ruminants

• American Association of Small Ruminant Practitioners’ (AASRP) stewardship guidelines

Swine

• AASV basic guidelines of judicious therapeutic use of antimicrobials in swine

Other resources

• Viewpoint article: Call to action to collect antimicrobial use data to support medical decision-making and antimicrobial stewardship
• Viewpoint article: AVMA's definitions of antimicrobial uses for prevention, control, and treatment of disease
• FDA: Antimicrobial resistance
• FDA: Judicious use of antimicrobials
• FDA: Strategy on antimicrobial resistance
• FDA: Veterinary Feed Directives (VFDs)
• FARAD: Food Animal Residue Avoidance Database
• CDC: National antimicrobial resistance monitoring system for enteric bacteria (NARMS)