CVS Equine, in collaboration with CVS’s Axiom Vet Labs, has developed a comprehensive set of new antimicrobial use guidelines to support responsible, evidence‑based antimicrobial use across its 22 equine practices in the UK.
The guidelines - due for publication in the coming weeks - represent a major step in CVS Equine’s ongoing commitment to antimicrobial stewardship, clinical excellence and the wider One Health agenda.
The creation of these guidelines forms a key part of CVS’s broader antimicrobial resistance (AMR) strategy, first outlined in the organisation’s Five‑Point Plan for 2025. The decision to develop formal prescribing guidance followed an antimicrobial stewardship workshop held in December 2024, where clinicians across the equine division agreed that practical, evidence‑informed resources would support vets in making effective and responsible prescribing decisions. The guidelines form an up-to-date concise go-to resource for vets.
Internal audits and published research from CVS Equine showed that although antimicrobial use across the division was broadly sound, there remained room for improvement in specific areas - particularly around accurate dosing and consistency of understanding across teams.
Recognising the importance of a unified approach, CVS Equine has worked with Axiom Vet Labs to ensure the final guidance was both scientifically robust and grounded in real‑world equine practice. The project also encompassed contributions from specialists, advanced practitioners and experienced clinicians across the CVS Equine network[i]. This collaborative approach ensured the guidelines reflect current best practice, based on a blend of published literature, expert opinion, and varied practical clinical experience.
The guidelines contain succinct, practically relevant information to help vets make confident, evidence‑informed prescribing decisions. Content includes:
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Key principles in decision making
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Myth busting
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Optimising culture results
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Clinical scenarios;
- Guidance on when systemic antimicrobials are - and are not - indicated;
- Recommendations on drug choice, dosing intervals and duration;
- The role of adjunctive support;
- Non antimicrobial alternatives;
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A comprehensive antimicrobial drugs table; and,
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Underlying principles explaining the rationale behind each recommendation.
The guidelines cover 16 core clinical areas, including strangles, Streptococcus equi ssp zooepidemicus respiratory disease, coughing, foal respiratory disease, endometritis, retained placenta, liver disease, diarrhoea, pyrexia of unknown origin, skin disease, joint injections, wounds, open castration, dental extraction, exploratory laparotomy and arthroscopy.
To develop the guidelines, throughout 2025, the working group met regularly to review available evidence, discuss clinical experience, compare specialist opinion where evidence was limited, and refine multiple iterations of each guideline chapter.
Once published, the guidelines will be made available to veterinary teams across all 22 CVS Equine practices nationwide. Practices will be encouraged to discuss antimicrobial stewardship at monthly team meetings, share and review the guidelines at local level, and use them as part of case discussions and peer‑to‑peer learning. They will be hosted on CVS unique Knowledge Hub learning platform.
CVS Equine Veterinary Medical Director Charlotte Sinclair said: