Introduction

Prior to Alexander Fleming’s work on the development of penicillin in 1928, the first antimicrobial drug was developed by Paul Ehrlich in the early twentieth century and released onto the market in 1910. Salvarsan, an arsenic-containing organic compound with anti-syphilitic properties, rapidly became the most prescribed drug in the world.

Other organoarsenic compounds soon followed Salvarsan onto the market, and shortly thereafter drug resistance developed. W.H. Brown and L. Pearce (The Rockefeller Institute for Medical Research) documented in 1921 that rabbits experimentally infected with syphilis and then treated with subcurative doses of Salvarsan became refractory to treatment over time.

The exponential development of antimicrobials throughout the twentieth and twenty-first centuries has in many ways improved the lives and lengthened the lifespans of humans and animals, but the development of drug resistance has not slowed. The Centers for Disease Control and Prevention (CDC) now warns that antimicrobial resistance is one of the most serious health threats facing mankind, sickening 2 million and killing more than 23,000 people per year in the United States. The number of veterinary patients similarly affected by resistance is unknown, but both companion and farm animals are not immune to the threat of antimicrobial resistance.

Resistant infections in animals of all species contribute to increased veterinary care costs and emotional strain for owners, endanger the food supply, and put the general public at risk. The fairly recent development of antimicrobial stewardship programs seeks to promote responsible use practices which will conserve antimicrobials for the future. One of the core elements of antimicrobial stewardship is educating medical practitioners about drug resistance and optimal prescribing.

The purpose of this guidebook is to give recommendations about which antimicrobial is the best choice for a given medical condition, both from the standpoint of treating the disease, and from a stewardship perspective.

Rachel C. Soltys, DVM