ANTIMICROBIAL STEWARDSHIP
Australia’s National Antimicrobial Resistance Strategy - 2020 and Beyond (Department of Health 2019) outlines a One Health framework for combating antimicrobial resistance in Australia that includes guidance on antimicrobial stewardship.
The strategy draws on expertise and existing programs in veterinary and human health institutes and universities. In 2017 The University of Melbourne Asia Pacific Centre for Animal Health and the National Centre for Antimicrobial Stewardship released the Australian veterinary prescribing guidelines for domestic and production animals. Antimicrobial Stewardship guidelines for veterinarians are based on medical practice because limited evidence from the veterinary field hampers development of risk analyses and interventions. The veterinary resources arising from the implementation plan do not cover wildlife treatment; however, those for companion and farm animals provide useful guidelines that can be applied to wildlife. Resources available at, Wildlife Health Australia Fact Sheet on Antimicrobial resistance and Australian wildlife (https://wildlifehealthaustralia.com.au/Resource- Centre/Fact-Sheets), and the Australian Pesticides and Veterinary Medicine Authority (https://www.apvma. gov.au/registrations-and-permits/data-guidelines/veter- inary-data-guidelines/special-data/antibiotic-resistance) provide information that can be extended to veterinary care of wildlife.Recommendations for the use of antimicrobials in wildlife to minimise spread of antimicrobial resistance are as follows.
• Antibiotics should always be prescribed by a veterinarian for treating any wildlife.
• Use of antibiotics by wildlife carers must be under veterinary supervision. Prescribed antibiotics should only be administered to the animal they were intended for. The entire course should be administered and leftover antibiotics returned to veterinarians for correct disposal.
• Antibiotics should only be used when the presence of a bacterial disease is confirmed through early and thorough diagnostic investigation to rule in or out bacterial infection.
• Use antibiotics only when clearly indicated by clinical and other diagnostic findings.
• Select the optimal antibiotic, dose and duration of antimicrobial treatment for the diagnosis
• Determine the most effective antibiotic through culture and susceptibility testing.
• Choose antibiotics that are not classified by the WHO as ‘critically important antimicrobials’. These include: quinolones, 3rd- and higher generation cephalosporins, macrolides and ketolides, glycopeptides and polymyxins (also known as colistin).
• Use measures other than antimicrobials to prevent infection (e.g. hygiene, appropriate environment, minimising stress).
• Wherever possible use topical rather than systemic antibiotics.
• Consider alternatives to the use of antibiotics for initial treatment of wounds such as antiseptics, saline and Manuka honey. Carefully consider the need for antibiotics and avoid inappropriate and excessive use of antibiotics.
• Antimicrobial use for properties other than their antimicrobial effect (anti-inflammatory, immunomodulatory, prokinetic) should be based on evidence.
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