Australians are high consumers of antibiotics with approximately one in every two Australians collecting at least one antibiotic prescription each year. Most antibiotics for human consumption are prescribed in primary care. Australian GPs overprescribe antibiotics, especially for acute self-limiting respiratory tract infections. Given that unnecessary use drives antibiotic resistance, it is important to reduce the volume prescribed in primary care. “Delayed prescribing” or “wait and see prescribing” is a strategy that has been shown to reduce antibiotic use compared to immediate antibiotic prescribing, with similar patient satisfaction. In this webinar we present the evidence for delayed prescribing and discuss the different strategies that have been trialled. We draw upon examples from human general practice and invite participants to share and inspire delayed prescribing techniques in the care for companion animals.

The VNs role in the prevention of hospital acquired infections A HAI is classified as an infection that occurs: • up to 48 hours after hospital admission • up to 3 days after discharge • up to 30 days after an operation • in a healthcare setting when the patient was admitted for reasons other than an infection Causes of HAIs Bacteria, fungus, and viruses can cause HAIs. In human medicine bacteria alone cause about 90% of cases. Patients who are immunocompromised are at increased risk of contracting an infection during hospitalisation. These microorganisms spread mainly through person-to-patient contact from unclean hands; medical and hospital equipment. HAIs also increase with excessive or incorrect selection of antibiotics, which can lead to emergence of antibiotic resistance bacteria. The most common types of HAIs are: • Surgical site infections • Intravenous catheter and arterial line associated infections • Catheter-associated urinary tract infections • Pneumonia Preventing nosocomial infections A 70% decrease in HAI can be seen when a team is taking steps in prevention and veterinary nurses are well positioned to be at the forefront of infection control within the veterinary practice. In this session we will focus on specific areas where veterinary nurses can have a real impact. General recommendations could include: • Correct kennel selection (is isolation/barrier nursing needed) • Focus on exceptional 5-point hand hygiene • The availability and correct use of personal protective equipment • Correct cleaning of clinical environments • Correct ventilation • The use of strict aseptic techniques (IV catheter care, blood sampling, urinary catheter care etc.) • Removal of unnecessary indwelling devices as soon as no longer required • Provision of high-quality nursing care.

Multi-drug resistant methicillin resistant Staphylococcus pseudintermedius (MDR MRSP) have been increasing in frequency since they were isolated in the late nineties. They have been more of an issue in Australia since 2013 and are now not uncommon, moreso in urban areas. Infections with MDR MRSP often do not respond to conventional antibiotics, and both recognition and treatment can be challenging. Since veterinary hospitals represent a significant risk factor for acquisition of methicillin-resistant staphylococci, it is up to the profession to try and prevent lateral spread of these bacteria between patients. This webinar will focus on both strategies applicable for this in the emergency medicine setting, and also the potential public health issues associated with MRS.