CVMA GUIDELINES ON THE PRUDENT USE OF ANTIMICROBIAL DRUGS IN CATTLE

Following are general guidelines for the prudent therapeutic use of antimicrobials in beef and dairy cattle:

1. Veterinarians should concentrate their efforts on assisting clients with the design of management, immunization, housing, and nutritional programs that will reduce the incidence of disease, and decrease the requirement for antimicrobial use.

2. Veterinarians should dispense and prescribe antimicrobials only within the confines of a valid veterinarian-client-patient relationship.

3. Veterinarians should properly select and use antimicrobial drugs.

   1. Veterinarians should participate in continuing education programs that deal with antimicrobial use and antimicrobial resistance issues.

   2. Veterinarians should have strong clinical evidence (based upon clinical signs, history, necropsy examination, laboratory data, and past experience) that the disease they are treating is being caused by a bacterial pathogen, as well as some idea as to of the identity of the target organism.

   3. Veterinarians should select antimicrobial drugs appropriate for the target organism and administer them at a dosage and route likely to achieve effective concentrations in the target organ.

   4. Veterinarians should base antimicrobial drug selection and treatment regimens on available laboratory and package insert information, on additional published data, and with consideration of the pharmacokinetic and pharmacodynamics properties of the drug.

   5. Veterinarians should use antimicrobial drugs labeled for the condition diagnosed whenever possible. The label dose and the route, frequency, and duration of treatment should be followed, whenever possible.

   6. Veterinarians should use antimicrobial drugs for as short a period of time as reasonable; that is, therapy should be discontinued when it is apparent that the immune system can manage the disease, reduce pathogen shedding, and minimize recurrence of clinical disease or development of the carrier state.

   7. Veterinarians should select antimicrobial drugs that have the narrowest spectrum of activity known efficacy in vivo against the pathogen causing the disease problem.

   8. Veterinarians should avoid use of combination antimicrobial therapy, unless there is evidence that the combination increases efficacy or suppresses the development of resistance in the target organism.

   9. Veterinarians should use local over systemic therapy, when appropriate.

   10. Veterinarians should use antimicrobial drugs of lesser importance in human medicine in preference to newer generation drugs that may be in the same class as drugs currently used in humans, provided that this can be achieved while still protecting the health and safety of animals under their care.

   11. Veterinarians should avoid use of compounded antimicrobial formulations.

   12. Veterinarians should use antimicrobial drugs with specific clinical outcome(s) in mind, such as fever reduction, return of mastitic milk to normal, or to reduce shedding, contagion, and recurrence of disease.

   13. Veterinarians should periodically monitor herd pathogen susceptibility and therapeutic response, especially for routinely employed treatments (e.g. dry cow intramammary antibiotics), in order to detect changes in microbial susceptibility patterns and to reevaluate antimicrobial selections.

   14. Veterinarians should counsel against treatment of chronic cases or animals with a poor chance of recovery. Chronic cases should be removed or isolated from the remainder of the herd.

   15. Veterinarians should employ prophylactic or metaphylactic use of antimicrobial drugs, based on a group, source, or production unit evaluation, rather than utilizing them as standard practice.

   16. Veterinarians should protect drug integrity through proper handling, storage, and observation of the expiration date.

4. Veterinarians should endeavor to ensure proper on-farm drug use.

   1. Veterinarians should prescribe or dispense drug quantities appropriate to the production-unit size and expected need, so that stockpiling of antimicrobial drugs on the farm is avoided.

   2. Veterinarians should train farm personnel who use antimicrobials on indications, dosages, withdrawal times, route of administration, injection site precautions, storage, handling, record keeping, and accurate diagnosis of common diseases. The veterinarian should ensure that labels are accurate to instruct farm personnel on the correct use of antimicrobial drugs.

   3. Veterinarians should be encouraged to provide written guidelines to clients, whenever possible, to describe conditions and instructions for antimicrobial use on the farm or unit.

(November 2001)