The Horse

SEP 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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Page 39 of 59

40 THE HORSE September 2018 compromise equine health. So what do we do that contributes to AMR? What is your veterinarian doing to curb it? And what can you do to help minimize anti- biotic resistance? Read on to learn what these veterinarians recommend. What's the Difference? When we talk about antibiotics and antimicrobials, what do we mean? Sim- ply defined, microbes are organisms too small for the eye to see. They're found everywhere on earth and include bacteria, viruses, fungi, and parasites. Most are harmless. Some are even beneficial. But many (known as pathogens, germs, bugs, etc.) can cause disease in humans, ani- mals, and/or plants. All types of microbes can develop resistance to the drugs (anti- microbials) created to destroy them. Among antimicrobials, antibiotics tar- get bacteria. Antivirals, antifungals, and antiparasitics (aka anthelmintics) fight viruses, fungi, and parasites, respectively. Antimicrobial-resistant bacteria— rather than viruses, fungi, or parasites— pose the major threat in horses. "We rarely use antivirals and antifungals for horses, and parasites are not typically considered microbes in this context," Weese says. While AMR refers to all types of mi- crobes, for this article's purpose it refers to antibiotics. Why Is AMR So Concerning? Once bacteria develop resistance, we've lost our ability to control their prolifera- tion. This throws medical options for treating infectious diseases back to the early 1900s, before penicillin became widely used. There simply isn't "just an- other antibiotic." "New classes of antibiotics are screened first for use in human medicine," says Vaala. "Only if a drug is deemed unsuit- able for humans is it likely to be consid- ered for use in animals. This additional filter will further slow the development of new drugs for the veterinary field." The CDC says that while antibiotics are life-saving drugs, up to 50% of the time they aren't "optimally prescribed." This means they're used incorrectly, dosed im- properly, or taken for the wrong duration, all of which promote AMR. The food chain can also promote AMR bacteria when antibiotics are used inappropriately in food animals (for growth rather than to treat infectious disease), subsequently passing antibiotic- resistant bacteria to humans. Human medicine plays a pivotal role in AMR, as well, because many harmful or- ganisms can spread not only from animal to animal but also from human to human and from animals to humans (in ways besides the food chain) and vice versa. What Are Veterinarians Doing About AMR? A multifaceted problem, AMR calls for a multifaceted response. It requires the cooperation of everyone involved in diagnosing, making treatment decisions for, and treating bacterial infections. This includes doctors and veterinarians, livestock producers, and horse and pet owners. "Veterinarians are trying to implement the concept of antimicrobial stewardship, which involves improving antimicrobial use practices," Weese says. "The Ameri- can College of Veterinary Internal Medi- cine (ACVIM) Consensus Statement from 2015 highlights some of those." You can search for this document at onlinelibrary. "Also, the American Association of Equine Practitioners' (AAEP) Prudent Drug Usage Guidelines are a pending source of information," he adds. "Essen- tially, antimicrobial stewardship focuses on only using antimicrobials when they are needed, using the right drug for the right situation at the right dose, and tak- ing practical measures to reduce the risk of disease." The present AAEP Guidelines also stress continuing education for veterinar- ians that focuses on using antimicrobial drugs appropriately. Veterinarians can Smart Antibiotic Use Among drug-resistant threats in the United States, the CDC labels C. difficile as urgent, Salmo- nella and MRSA serious, and group A Streptococcus and Enterobacteriaceae concerning. COURTESY CDC; ALISSA ECKERT AND JENNIFER OOSTHUIZEN Clostridium Difficile Salmonella (top) & MRSA (bottom) Streptococcus (left) & Enterobacteriaceae (right) COURTESY CDC/JAMES ARCHER COURTESY NIAID; ALISSA ECKERT AND JENNIFER OOSTHUIZEN

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