LI, low-income countries; LMIC, low- and middle-income countries; HMI, high- and middle-income countries; HIC, high-income countries.
Resource web link:https://arsi.umn.edu/sites/arsi.umn.edu/files/2020-06/Handbook_Final_3June2020.pdf (Full classification scheme available at: http://bsac.org.uk/wp-content/uploads/2019/03/Educational-resource-review-classification-scheme.pdf).
WHO region and country (World Bank): Region of the Americas, USA (HIC).
Peer review commentary
The Handbook of Antimicrobial Stewardship in Companion Animal Veterinary Settings provides tiered guidance for the creation and implementation of the core principles of antimicrobial stewardship. The resource is suitable for all veterinary practices working with small animals. It offers a framework that can be introduced afresh for those with limited prior stewardship experience yet is sufficiently flexible to be incorporated into existing policies. Suggested steps have been classified as basic, intermediate or advanced according to clinical resource availability (a reflection of the time, experience and training commitment required). Although the handbook is a text-based instrument, by linking to multiple other useful and freely available online resources it serves as a comprehensive repository with practical guidance and client-information tools.
The handbook has been well designed with input from global experts in veterinary infectious disease. The structure encourages veterinary practitioners to make stepwise progress through a process of antibiotic-use audit, reflection and feedback to achieve tangible improvements that can be measured and serve as the foundation for future change. The inclusion of checklists after each stage enables the practice antimicrobial stewardship committee (guidance on how to establish this group is also provided) to monitor advancement and build sequentially via feasible steps. Each point is supported by accessible links including letter templates outlining to practice members the role of the antimicrobial stewardship committee, ‘no antibiotics prescribed today’ forms and client-facing posters highlighting the practice’s engagement with this topic.
For users based in Europe, the handbook may be further complemented by reference to antimicrobial use guidance documents produced by national organizations (all listed here: https://www.mdpi.com/2079-6382/10/4/409/html).
This resource represents an exquisitely structured and practical tool that would be useful for veterinarians working in small animal practice wishing to implement concrete antimicrobial stewardship steps within their clinics.