VETERINARY USE OF ANTIBIOTICS HIGHLY IMPORTANT TO HUMAN HEALTH

The World Health Organization, the Food withholding periods and export and Agriculture Organization and the slaughter intervals in the case of food- World Organization for Animal Health producing animals. Where possible, are working to protect the effectiveness choices should be based on culture and of antimicrobials in the face of rapidly susceptibility testing and the narrowest increasing resistance in serious and life- spectrum drugs effective against the threatening pathogens. infection. Antimicrobial use in animals contributes Alternatives to antimicrobial use — such to the selection and spread of resistance. as changes in husbandry, management, Veterinarians must help preserve vaccination and infection prevention existing antibiotics and fight the serious and control — should also be explored public health threat of antimicrobial in each case. The overriding principle resistance. Veterinarians need to of antimicrobial prescribing is to use carefully consider how they prescribe as little as possible but as much as antibiotics, especially those that are necessary to address the infection. critical in human medicine, to help Following diagnosis, consider using preserve these lifesaving drugs for the the first line antimicrobials along with future. alternative treatment approaches. The table on the next page outlines Second line use should be limited where in a broad and general sense how possible to when susceptibility testing or veterinarians should use the antibiotics clinical results have proven that first line highly important to human medicine identified by the Australian Strategic antibiotics are not effective. and Technical Advisory Group on Third line antimicrobials are for AMR (ASTAG). Responsible use of use as a last resort. They should be these antibiotics should have a limited used only when other options are impact on human medicine. In making a unavailable and wherever possible only therapeutic decision, you will also need after susceptibility testing has been to consider other issues, for example, completed. Pigs Poultry Cattle Sheep Aquaculture Horses Dogs and Cats (no products registered)

First line use Amoxicillin Amoxicillin (not Ampicillin/ Amoxicillin Oxytetracycline Amoxicillin Amoxicillin Erythromycin layers) Amoxicillin Erythromycin Florfenicol Bacitracin Bacitracin Chlortetracycline Erythromycin (not Erythromycin Chlortetracycline Oxytetracycline Chlortetracycline Oxytetracycline layers) Oxytetracycline Oxytetracycline Sulphonamides Doxycycline Sulphonamides Neomycin Sulphonamides Framycetin Penicillin Penicillin Kitasamycin Tylosin (not Oleandomycin Neomycin Chloramphenicol Chloramphenicol Tilmicosin layers) Tilmicosin Penicillin Framycetin Framycetin Tylosin Chlortetracycline Tylosin Neomycin Neomycin Penicillin Oxytetracycline Penicillin Streptomycin Streptomycin Florfenicol (not layers) Florfenicol Neomycin Zinc bacitracin Framycetin Neomycin Streptomycin

Second line use Amoxicillin- Apramycin (not Amoxicillin- Amoxicillin- Amoxycillin- Amoxicillin- clavulanate layers) clavulanate clavulanate clavulanate clavulanate Apramycin Spectinomycin Cefuroxime Cloxacillin Cloxacillin Cephalexin Lincomycin Lincomycin Cloxacillin Framycetin Gentamicin Cephalonium Trimethoprim- Tiamulin (not Apramycin Trimethoprim- Trimethoprim- Cloxacillin Sulphonamides layers) Lincomycin sulphonamide sulphonamides Clindamycin Tiamulin Trimethoprim- Trimethoprim- Lincomycin Tulathromycin sulphonamides sulphonamides Gentamicin Spectinomycin (not layers) Tulathromycin Trimethoprim- sulphonamides Spiramycin/ metronidazole

Third line use Ceftiofur Virginiamycin (not Ceftiofur Virginiamycin Ceftiofur Ceftiofur layers) Polymyxin B* Polymyxin B* Fluoroquinolones Cefovecin Virginiamycin (Enrofloxacin) Fluoroquinolones Virginiamycin (Enrofloxacin Polymyxin B* Marbofloxacin Nitrofurans Orbifloxacin Ibafloxacin Pradofloxacin) Nitrofurazone Polymyxin B*

Use prohibited Fluoroquinolones Fluoroquinolones Fluoroquinolones Fluoroquinolones Gentamicin Gentamicin Gentamicin Gentamicin Chloramphenicol Chloramphenicol Chloramphenicol Chloramphenicol Nitrofurans Nitrofurans Nitrofurans Nitrofurans

Highly important Amikacin Meropenem antimicrobials not Rifampicin Vancomycin registered for use Teicoplanin in animals that Amikacin should not be used Aztreonam off-label except Tigecycline in exceptional Ceftaralone circumstances for Ceftriaxone individual animals Cefotaxime Linezolid Nitrofurans Fusidanes Ticarcillin- clavulanate Rifampicin

Australian Commission on Safety and Quality in Healthcare. Importance Ratings and Summary of Antibacterial Uses in Humans in Australia (Reviewed by ASTAG) Version 1.1 February, 2015.

* Polymixin B – may be first line if used only as individual animal topical treatment (ear/eye ointment)

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