How to Become a Steward of Antibiotic Use

Megin Nichols, DVM, MPH, DACVPM, enteric zoonoses activity lead at the CDC, explains some of the core principles involved in becoming a strong steward of antibiotic use.

“It's really important for all of us who use antimicrobials to really think carefully about how we use them and to be good stewards of antibiotic use. And what that means is that regardless of whether you're a veterinarian that is operating out of a mobile vet truck, or you're someone who has a clinic and practices out of a single area, you can practice judicious use. And there are 5 key core principles that AVMA has actually worked to establish. They're based off of a document that CDC came up with, and these core principles, which are available on the AVMA website, really helped to provide a broad overall way of thinking about implementing stewardship. One of the things that you should do when developing an antibiotic stewardship program at your hospital is commit to stewardship, and this means championing those efforts and making sure that you have folks at your clinic who are really working to ensure that everyone at the practice is on board with those concepts.

The next piece of an antibiotic stewardship program is to advocate for a system of care that prevents many of the diseases that we commonly see in animals. So, this might include using things like vaccines that prevent the diseases, so we don't have to use an antibiotic to treat it. The next piece is to select an antibiotic and use it judiciously, so that means really thoughtful, careful consideration of what antibiotic you're going to choose, and this might be guided by diagnostic testing, or other factors, that help you make a decision about the right antibiotic to use, the right dose to use, and the right duration to use it for.

The next piece is to evaluate antimicrobial drug use practices, and that means looking back and seeing did your treatment work or was there something that you needed to change? The next piece of an antibiotic stewardship program is to educate and evaluate. So once you use antibiotics, looking at educating yourself and others about how to use those antibiotics judiciously in the future, and how what antibiotic you use actually impact use in your practice.”