VetTeamAMR for equine vets

VetTeamAMR for equine teams
Tim Mair BVSc PhD DEIM DipECEIM DESTS FRCVS

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RCVS Knowledge:
Welcome to this VetTeamAMR podcast from RCVS Knowledge. Leading responsible antimicrobial use in farm, companion and equine teams.

Pam Mosedale:
Hi everyone. Today I’m going to talk to Tim Mair. Tim is clinical lead for Equine VetTeamAMR at RCVS Knowledge and Equine Veterinary Director at CVS. Hi Tim.

Tim Mair:
Hello.

Pam Mosedale:
We’re going to talk today about this VetTeamAMR. What is it?

Tim Mair:
So VetTeamAMR, it’s a project led by RCVS Knowledge, part of their work on antimicrobial resistance. And it’s basically an online electronic system that allows practices or supports practices and enables them to audit and monitor the use of antimicrobials in equine practice. As well as providing some educational material on the use of antimicrobials in practice.

Pam Mosedale:
And why is that important, do you think?

Tim Mair:
So there’s an increasing awareness of the issues around antimicrobial resistance across all species, including equine. And there are increasing numbers of reports of resistant bacteria causing problems in equine hospitals in particular in equine practice. And we’re all aware of the issues and the problems associated with antimicrobial resistance in people and the potential for resistant genes to cross species.

So I think we’re all keen that we do what we can to improve our antimicrobial stewardship, reduce the use of antimicrobials and only use antimicrobials appropriately in cases that actually need it. Thereby trying to reduce the pressure on the development of antibiotic resistance.

Pam Mosedale:
That’s interesting because I think we tend to think of antimicrobial resistance very much along the lines of food producing animals, don’t we, and farming. But it’s interesting that it’s also quite an issue in
equine practice.

Tim Mair:
I think it’s a big issue in equine and companion animals because of the close relationship between people and animals. And the ease of transmission of bacteria between species, so between horses and
people, because of close contact. So when there’s issues relating to antibiotic or antimicrobial resistance, then there is the potential for it to spread from animals to humans and vice versa.

Pam Mosedale:
So what do you think this VetTeamAMR project can achieve then?

Tim Mair:
So I think the aims are basically to improve awareness in equine practice about the importance of carefully considering antimicrobial use and only using it judiciously and where appropriate. And it gives
us a means of actually looking and auditing our use of antimicrobials in equine practice. Makes it a lot easier to actually look at the data of antimicrobial use in our own individual practices. And of course the
data is really important because without data you can only really guess what you’re doing. So it’s a means of us actually looking carefully at what you’re doing and also monitoring some of the resistant bacteria that we are identifying now.

Pam Mosedale:
So it’s got CPD too, hasn’t it, around some of these issues?

Tim Mair:
Yes, so there’s a big educational part to this project as well. And it’s very similar to the Farm Vet Champions for people who are familiar with that. So there are peer reviewed recorded webinars and
podcasts covering a range of topics relating to antimicrobial use and antimicrobial resistance. Both in general but also specific to equine. So it allows people to improve, I guess, and educate themselves
about antimicrobial use and the importance of resistance and diagnosis and deciding on the appropriate drug choice and drug dosages and so on.

Pam Mosedale:
So that’s really important. And that’s free, that CPD, isn’t it, for everyone?

Tim Mair:
Yes. Completely free. Yeah.

Pam Mosedale:
But why is the measuring so important, the audit and benchmark? I think people can benchmark themselves against other practices, can they?

Tim Mair:
Yeah. I think that’s one of the objectives is that individual practices can record basically what antimicrobials they’re using and the quantities and the use and the reasons for that. And then compare
their use to other similar practices. So by benchmarking, hopefully you can see areas that you’re doing well and areas that you’re not doing so well. And then hopefully you can improve as a result of knowing that information.

Pam Mosedale:
Yes, absolutely, you can also celebrate areas you’re doing well, can’t you, it’s not just all about finding out you’ve got to do something. Sometimes practices can just be pleased to know that they are doing
their best in this.

Tim Mair:
Absolutely, yeah. I think this is an issue that’s been, we all in the profession, been aware of it for several years and we do know there have been a number of studies done recently looking at antimicrobial use in equine practice. And I think we are doing well and we are reducing our use of especially the critically important highest priority antimicrobials in equine practice. So I think it’s, yeah, as you say, we can be happy that we are trying to do the right thing, but there’s always room for improvement.

Pam Mosedale:
Absolutely. And is it just for vets, this, the CPD and all this, is it just for the vets in the practice?

Tim Mair:
No, it’s for the whole practice team, so vets, nurses, anyone in that practice can become involved and can enter data. So yes, it’s for the whole team.

Pam Mosedale:
I think that’s really important, don’t you, because sometimes people are going to have to talk to clients about why their horse isn’t getting antibiotics. So I think it’s good the whole team’s on board.

Tim Mair:
Indeed, yeah. So certainly in our practice, our nurses do a lot of communication with clients, and the issue of antimicrobial use gets brought up quite commonly. So yes, it’s important that everybody in the whole team is working off the same hymn sheet.

Pam Mosedale:
And so how do you think it would benefit the team for the whole team to get involved?

Tim Mair:
I think it’s just a way of actually looking at what you’re actually doing, recording it, monitoring it, and looking for areas where you can improve. And communicate that with the clients as well, and try and
help with the education not only of the veterinary team, but also clients.

Pam Mosedale:
So I think there’s going to be a launch event coming up soon. Can you tell us a little bit about that,
please?

Tim Mair:
Yes. There’s a launch event on the 6th of June at seven o’clock online. We’ve got a number of short presentations from some experts in the field. They include April Lawson, who works at the University of
Liverpool, and is running their EVSNET project. And she’ll be discussing some of the results that she’s got recently looking at antimicrobial resistance in equine bacteriology submissions made to UK labs.

Then there’s Bruce Bladon, who’s a surgeon working at Donnington Grove. He’s done some work recently looking at antimicrobial use in equine practices, and he’s going to present that data to us.
Then we have Nathan Slovis who’s from Hagyard’s in Kentucky. And he’s going to talk about antimicrobial use and antimicrobial resistance in foals where there’s increasing problems associated
with resistance in certain bacterial infections in foals such as Rhodococcus equi.

And then lastly, we have Gillian Perkins from Cornell University in the States. And she’ll be looking specifically at the use of antimicrobials in equine respiratory diseases. And trying to determine and
decide how you make the decision as to whether it’s appropriate or not to use antimicrobials in respiratory disease cases.

Pam Mosedale:
Wow. Sounds like you’ve got amazing speakers. And that’s going to be another lot of free CPD, isn’t it,
too?

Tim Mair:
That is, yes. So they’re going to each do a fairly short but concise talk, and then there’ll be some discussion about the audit tool and how to actually sign up to it and how it works.

Pam Mosedale:
Okay. So really for equine practices out there or practices where people are doing any equine work, they don’t have to be specific equine practices, the message would be to get online and watch all that.

Tim Mair:
Yeah, I hope so. I think it’s going to be a really interesting evening. It’s only scheduled to be an hour and a half or something like that, so it won’t go on forever. But there’ll be some really useful information and
it’ll give us all a clear idea of how we can all get more involved in working in this area.

Pam Mosedale:
It sounds really useful and really practical as well, lots of really good practical information by the sound of things.

Tim Mair:
Yeah, I think so. I think some of the initial focus of this project, we will probably focus on things like respiratory diseases because they’re common and they’re a common reason why antimicrobials are
prescribed to horses. And I think there’s many people believe that in many cases antimicrobials aren’t necessarily required in all cases, but there’s lots of reasons why we feel it’s appropriate to give
antimicrobials. Sometimes it’s from owner pressure, sometimes for other reasons. But homing down on trying to work out which cases require antimicrobials and which cases don’t is really important from an antimicrobial stewardship point of view.

Pam Mosedale:
And giving people in practice the confidence to know that the evidence is there I suppose.

Tim Mair:
Yes, indeed. I think, in many respects, we need to break traditions and actually look at what we are doing in so many areas in equine practice. But it’s specifically in the use of anthelmintics drugs, sorry,
antibiotic drugs, and make sure that we are using them appropriately and not overusing them.

Pam Mosedale:
Yeah, because if they weren’t available, it would be a real welfare problem, wouldn’t it?

Tim Mair:
Indeed, indeed. And yeah, we need to preserve them. So this is one way that hopefully we’ll be able to achieve that.

Pam Mosedale:
Well, that’s been amazing. Thank you so much for talking to me about this. And I think, let’s encourage practices, equine practices, or anybody seeing horses, to come along and listen to that and get involved with VetTeamAMR.

Tim Mair:
Thank you very much. Yes, I hope lots of people will join us on Tuesday the 6th of June.

Pam Mosedale:
Thanks very much, Tim.

Tim Mair:
Thank you.

RCVS Knowledge:
Thank you for listening to this VetTeamAMR podcast from RCVS Knowledge. Visit rcvsknowledge.org/amr for free CPD, benchmarking and audit tools to improve your antimicrobial use.