AMR Hub

In our AMR Hub, you will find freely accessible, evidence-based knowledge and resources about responsible antimicrobial use, covering antibiotics and anti-parasiticides, including anthelmintics. With over 48 hours of CPD, teams can select from the information provided to embed good antimicrobial stewardship in practice.

If you would like to speak with us about our AMR work, or to suggest materials for inclusion on this page, please get in touch at [email protected]

Latest additions

• VetTeamAMR Learning Platform has over 40 hours of free CPD covering species specific antimicrobial use, communication skills, behaviour change, infection control and biosecurity as well as the legal use of medicines. It includes:

Companion Animal and Equine: designed to refresh your knowledge in areas of antibiotic use in companion animal and equine veterinary medicine and to support your antimicrobial stewardship.

Farm Vet Champions: free CPD covering species-specific antimicrobial use, communication skills, behaviour change and the legal use of medicines, policies and One Health. All members of the veterinary team can use the SMART goal tool to turn their learning into action.

• VetTeamAMR Antibiotic Audit: A tool to help practices audit their antibiotic use and prescribing behaviours. This can be used to audit antibiotic use for clinical conditions or to take a closer look at specific antibiotics. 

• RCVS Knowledge Antimicrobial Stewardship Awards:  All veterinary individuals or teams can apply for an award for their improvements in antimicrobial use. 
• Responsible use of antibiotics in veterinary practice - This RCVS Knowledge collection provides access to evidence and appropriate resources to support responsible antibiotic use. 
• Managing Veterinary Medicines: Staying Legal and Promoting Safety – CPD for all veterinary teams to improve their medication safety.  This learning will prepare practices for a VMD inspection or an RCVS Practice Standards Scheme assessment.
• UK 5-year action plan for antimicrobial resistance 2024 to 2029 - The UK's second 5-year national action plan setting out ambitions and actions for the next 5 years in support of the 20-year vision for antimicrobial resistance (AMR).
• Veterinary Antimicrobial Resistance and Sales Surveillance 2022 (UK VARSS) - This report provides the details of UK veterinary antibiotic resistance and sales surveillance.
• RUMA Targets Task Force 2: Three Years On – A report summarising the third years’ progress against antibiotic use targets identified by the UK livestock industry.
• Antibiotic Amnesty: RCVS Knowledge is supporting the veterinary Antibiotic Amnesty which takes place throughout November. Veterinary teams with a companion animal focus are asked to encourage their clients to return unused antibiotics to be disposed of safely.
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1. Governance on antimicrobial resistance

• UK 5-year action plan for antimicrobial resistance 2024 to 2029 - The UK's second 5-year national action plan setting out ambitions and actions for the next 5 years in support of the 20-year vision for antimicrobial resistance (AMR).
• UK 5-year action plan for antimicrobial resistance 2019 to 2024 - Ambitions and actions for the next 5 years, supporting the 20-year vision for antimicrobial resistance (AMR).
• UK 20-year vision for antimicrobial resistance - This document supports the 20-year vision for antimicrobial resistance (AMR) and how the UK will contribute to containing and controlling antimicrobial resistance by 2040.

• Veterinary Antimicrobial Resistance and Sales Surveillance 2022 (UK VARSS) - This report provides the details of UK veterinary antibiotic resistance and sales surveillance.
• RUMA Targets Task Force 2: Three Years On – A report summarising the third years progress against antibiotic use targets identified by the UK livestock industry.

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2. Current guidelines on antimicrobial stewardship

• BSAVA PROTECT ME - BSAVA and SAMSoc have worked together to provide information that is intended to support practices in discussing and drawing up practice guidelines on responsible antibacterial use.
• BSAVA guidelines for responsible antibacterial use - Following these BSAVA guidelines will help to maximise the therapeutic success of antibacterial agents whilst at the same time minimising the development of antibacterial resistance, thereby safeguarding antimicrobials for future veterinary and human use. 
• BEVA Protect Me Toolkit - Guidelines on responsible antimicrobial use in equines.
• BVA policy statement on anthelmintic resistance and responsible use in livestock: This statement for the veterinary livestock sector sets out BVA’s policy for judicious use of anthelmintics as part of a farm-specific strategic plan, based on sound scientific principles.
• BVA five point plan for the responsible use of parasiticides for cats and dogs: This poster is designed to support veterinary professionals in their decision making, illustrating the guidance found in the BVA, BSAVA, and BVZS position on the responsible use of parasiticides for cats and dogs.
• Responsible Use of Medicines in Agriculture (RUMA) Alliance - RUMA guidelines for responsible antimicrobial use in food-producing animal species.
• RUMA guidance on antiparasitics - advice on the responsible use of antiparasitic medicines in farmed species published by the RUMA Alliance and its member organisations.

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3. Evidence from research

Find below the available research regarding antibiotic use within practice and published Knowledge Summaries from Veterinary Evidence. These talk about antimicrobial usage, but not necessarily a reduction in usage. However, the evidence may help you to use antibiotics more responsibly in practice.

• in the Spotlight

1. Responsible use of antiparasitic medications in veterinary practice – This RCVS Knowledge collection provides access to published evidence and other appropriate resources to enable veterinary surgeons to make responsible decisions in the use of antiparasitic medications in order to protect animal health and welfare, and in some cases human health, while minimising detrimental effects.
2. Veterinary medicines and the environment - This RCVS Knowledge collection provides access to a wide literature base regarding the impact of pharmaceuticals on the environment. 
3. Responsible use of antibiotics in veterinary practice - This RCVS Knowledge collection provides access to evidence and appropriate resources to support responsible antibiotic use. 

• inFOCUS journal watch: 

1. Antimicrobial prescribing and antimicrobial resistance surveillance in equine practice - This study provides some evidence of current antimicrobial prescribing in equine practice and indicates that there has been a reduction in antimicrobial use when compared to previous studies and an increase in antimicrobial policies in practice.
2. Antimicrobial & antiparasitic use and resistance in British sheep and cattle: a systematic review - This systematic review provides some evidence on the use and resistance of antimicrobials and antiparasitics in cattle and sheep production in Britain.
3. Antimicrobial resistance in clinical bacterial isolates from horses in the UK - This study summarises evidence about patterns of antimicrobial resistance in equine pathogens in the UK.
4. Effect of an antimicrobial stewardship intervention on the prescribing behaviours of companion animal veterinarians: A pre–post study - This study summarises evidence that an AMS intervention can have an impact on antimicrobial prescribing behaviour, though this may not lead to a reduction in overall prescribing rates.
5. Randomized controlled field trial comparing quarter and cow level selective dry cow treatment using the California Mastitis Test - This study summarises evidence suggesting that on low SCC farms, antibiotic treatment at quarter level in cows with high SCC at dry off can result in a reduction in antibiotic use with only minor consequences for udder health.
6. Randomised positive control trial of NSAID and antimicrobial treatment for calf fever caused by pneumonia - This summarises evidence that shows that in some cases the use of NSAIDs can reduce the requirement for antimicrobials in calves with pneumonia and improve clinical outcomes. 
7. Ceasing the use of the highest priority critically important antimicrobials does not adversely affect production, health or welfare parameters on dairy cows - This study summarises evidence that shows that discontinuing the use of Highest Priority Critically Important Antimicrobials did not have a negative effect on the productivity parameters or health and welfare of dairy cows.

• Veterinary Evidence: 

1. This Knowledge Summary explores the literature surrounding veterinary telemedicine
2. This Knowledge Summary explores whether we should prescribe oral metronidazole or probiotics for acute gastroenteritis in dogs
3. This Knowledge Summary explores antibiotic choices for the best treatment outcomes for Chlamydophila Felis infection in cats. 
4. This Knowledge Summary explores the outcomes from the use of antibiotics in bitches with pyometra as a standalone therapy or when combined with ovariohysterectomy. 
5. This Knowledge Summary summarises the evidence on pregnancy rate outcomes for post-service treatment with or without antibiotics for broodmares with endometritis. 
6. This Knowledge Summary summarises the evidence to support the duration of antibiotic treatment for placentitis in mares and reflects on the outcomes on foal viability. 
7. This Knowledge Summary explores whether outcomes were better from antibiotic or non-antibiotic topical treatment for digital dermatitis in dairy cattle. 

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4. Podcasts and training

• The VetTeamAMR Learning platform provides a substantial selection of bite sized free CPD for companion animal, farm animal, and equine veterinary professionals to help you your team use antimicrobials more responsibly.   The platform consists of over 40 hours of free CPD and includes:

Farm Vet Champions covers species-specific antimicrobial use, communication skills, behaviour change and the legal use of medicines, infection control and biosecurity, policies and One Health. You can also create and track SMART Goals with your team, with our intuitive SMART Goals tool.

Companion Animal and Equine is designed to help you refresh your knowledge in areas of infection control and biosecurity, legal use of medicines, antibiotic use in common conditions, and laboratory skills. Covering both companion animals and equines.

• RCVS Knowledge and Veterinary Medicines Directorate’s free online course on Managing Veterinary Medicines: Staying Legal and Promoting Safety – 6 hours of CPD for all veterinary teams (not species specific) to improve their medication safety in practice.  This learning will prepare practices for a VMD inspection or an RCVS Practice Standards Scheme assessment.
• Quality Improvement Boxset: Farm Vet Champions (an introduction) with Pam Mosedale and Fiona Lovatt from RCVS Knowledge [13 May 2022].
• Quality Improvement Boxset: Lucy Coyne introduces VetTeamAMR, RCVS Knowledge’s initiative championing responsible use of antimicrobials within companion animal, farm animal, and equine veterinary teams [18 May 2022].
• Reflections on lambing with Fiona Lovatt and Emily Gascoigne Fiona speaks with Farm Vet Champion and Veterinary Surgeon, Emily Gascoigne about responsible antimicrobial use at lambing time [20 June 2022]. 
• Responsible Antimicrobial Use in Backyard Poultry with Dr Henrietta Kodilinye-Sims from BVPA [13 April 2022].
• Research Focus - STOP on Sunday (SOS) Urinary Tract Infection Trial - In this RCVS Knowledge podcast, Fergus Allerton spoke to Sally Everitt about the SAMSoc 'STOP on Sunday (SOS) Urinary Tract Infection Trial', which is recruiting first opinion practice vets [16 December 2021].
• The Steward - Animal health Matthew Stone, Deputy Director General of International Standards and Science at the World Organisation for Animal Health (OIE), and Fiona Lovatt, RCVS Knowledge, explore antimicrobial stewardship and infection control [June 2021].
• BCVA Cattlecast with Kat Hart, a cattle vet, and Fiona Lovatt from RCVS Knowledge on how farm vet practices can engage with the Farm Vet Champions project [6 May 2021].
• The Knowledge Sessions: Antimicrobial resistance UK Chief Veterinary Officer Christine Middlemiss chaired a roundtable discussion on challenges presented by antimicrobial resistance and ways to tackle it, with guests Ian Battersby (Davies Veterinary Specialists/Mission Rabies), Steve Howard (PDSA), Kristen Reyher (Bristol Veterinary School) and David Singleton (Small Animal Veterinary Surveillance Network) [22 November 2019]. 

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5. VetTeamAMR - championing responsible antimicrobial use 

• The VetTeamAMR Learning platform provides a substantial selection of bite sized free CPD for companion animal, farm animal, and equine veterinary professionals to help you your team use antimicrobials more responsibly.   The platform consists of over 40 hours of free CPD and includes:

Farm Vet Champions covers species-specific antimicrobial use, communication skills, behaviour change and the legal use of medicines, infection control and biosecurity, policies and One Health. You can also create and track SMART Goals with your team, with our intuitive SMART Goals tool.

Companion Animal and Equine is designed to help you refresh your knowledge in areas of infection control and biosecurity, legal use of medicines, antibiotic use in common conditions, and laboratory skills. Covering both companion animals and equines.

• The VetTeamAMR Antibiotic Audit: A tool to help practices audit their antibiotic use and prescribing behaviours. This can be used to audit antibiotic use for clinical conditions or to take a closer look at specific antibiotics.  
• RCVS Knowledge Antimicrobial Stewardship Awards - Applications are now open for veterinary individuals or teams that have demonstrated improvements in antimicrobial use in farm, equine, and companion animals. 

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6. Clinical case examples from practices

These case examples are from practices that have either reduced and refined their antimicrobial use or audited and improved their infection control and biosecurity. These examples will show you how individual practices have worked and inspire you to assess your own protocols.

• Paul Stanley and Emily Parr from White Lodge Veterinary Surgery carried out a prospective audit to review the use of antibiotics, with a focus of antibiotic use in cat bite abscesses. With the introduction of checklists and in-house CPD they were able to treat 86% of their patients successfully without antibiotics without compromising welfare. Listen to Paul and Emily discuss their audit in this podcast.
• Alex Royden’s case example shows that using Plan Prevent Protect on a layer site, there was a reduction of antimicrobial use, a dramatic improvement in the flock’s health and welfare, above target egg production and other production parameters, and >50% increase in net profit for the site.
• Plymouth Veterinary Group created guidelines for performing cytology on patients presenting with ear pathology, utilising the whole teams' skillset and reducing the overall prescription of antibiotics.
• Meghan Conroy performed a process audit on aural cytology, before and after treatment for otitis was given. By introducing training, the team were able to improve their prescribing practices across their branch practices. You can listen to Meghan discuss her case example in a podcast.
• Kay Lockwood, from Riversbrook Veterinary Group, performed a process and an outcome audit to monitor the use of antibiotics during feline dental extractions. 
• The Blue Cross developed guidelines within the practice to deliver a consistent approach to diagnosis and treatment throughout the charity for more than 60 common syndromes and conditions. 
• The Laurels used an audit to monitor hand hygiene and compliance to uniform protocols, to keep on top of their infection control in practice. 
• Vale Vets performed a hygiene audit through self-assessment to maintain a just culture and to identify any at-risk areas and further training required. 
• Vets Now Referrals Glasgow assessed their hand hygiene by completing a clinical audit that assessed adherence to WHO handwashing. 
• After incidences of phlebitis, one practice implemented a peripheral catheter care checklist and monitored its use and effectiveness through clinical audit.
• This peripheral catheter care and phlebitis score checklist has been designed in collaboration with Sarah Hancill RVN and Anne Ward PGCertTLHE DipAVN(Surgical) RVN. The template can be used in practice and adapted to suit your own practice protocols. 
• After a bulk tank failure after a case of mastitis, the QI Vets team perform a Significant Event Audit to identify what happened.

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7. Tools and recommendations

• The VetTeamAMR Antibiotic Audit: A tool to help practices audit their antibiotic use and prescribing behaviours. This can be used to audit antibiotic use for clinical conditions or to take a closer look at specific antibiotics. 
• The Farm Vet Champions’ free SMART Goals tool is for all veterinary individuals and teams who treat farm animals.  Set your own goals and measure your progress. This user-friendly online platform makes is easy to work together to improve appropriate use of antimicrobials.
• Our antibiotic usage self-assessment checklist is adapted from the Public Health England and the Royal College of General Practitioners, and help vets to better understand their antibiotic usage. 
• SAVSNET is a surveillance tool for companion animals run by the University of Liverpool that harnesses electronic health and environmental data for rapid and actionable research and surveillance. This includes a specific project on antimicrobial resistance called mySAVSNET AMR, which is aimed at all those working in veterinary practice in the UK. It allows any practices to send data to researchers at the University of Liverpool to receive a free benchmark, comparing their antibiotic prescriptions to other anonymised practices across the country.
• VetCompass is an initiative focused on improving companion animal health run by the Royal Veterinary College. VetCompass are investigating the range and frequency of companion animal health problems through computerised practice records including AMR as a major research focus. 

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8. Organisations

• The Bella Moss Foundation is a non-profit charity that promotes prudent antimicrobial use and hygiene in human and veterinary medicine. On the website, you will find links to key veterinary bodies and guidelines concerning diagnosing and managing bacterial infections and AMR.
• Controlling ANTiparasitic resistance in Equines Responsibly (CANTER) is a new pan-industry group which has been formed to tackle the increasing threats that wormer resistance poses to horse health and the equine industry.
• Control Of Worms Sustainably (COWS) is a voluntary initiative aiming to provide the best available evidence-based information to the beef and dairy cattle industries in relation to the sustainable control of both internal and external parasites.
• Responsible Use of Medicines in Agriculture (RUMA) Alliance – a not-for-profit alliance of 26 organisations that has an ongoing focus on antimicrobial resistance (AMR). RUMA uses evidence-based information to promote the livestock industry’s responsible use of medicines.
• RUMA Companion Animal and Equine Alliance - RUMA CA&E will focus initially on the responsible use of antibiotics.
• Sustainable Control of Parasites in Sheep (SCOPS) is a voluntary, industry-led group that develops sustainable, responsible and practical strategies for parasite control in sheep.  The group facilitates and oversees the delivery of recommendations which incorporate new research and developments. 

We are constantly working to provide further resources to support you with improving antimicrobial stewardship in practice. To be alerted when new content is released, sign up to our regular newsletter, intheKNOW.

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