The guidelines cover 16 core clinical areas
CVS Equine Launches New Antimicrobial Prescribing Guidelines To Support Vets And Strengthen Stewardship Across 22 UK Sites
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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:
- Key principles in decision making
- Myth busting
- Optimising culture results
- 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;
- A comprehensive antimicrobial drugs table; and,
- 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: “This work responds to a clear clinical need. Antimicrobial resistance continues to grow in both human and veterinary healthcare.
“Ensuring we prescribe responsibly - using the right drug, at the right dose, for the right duration - is essential to protecting animal health, human health and the long‑term effectiveness of the medicines we rely on.
“We hope our new guidelines will strengthen consistency, support clinical decision‑making and ultimately reduce inappropriate antimicrobial use across our equine division.”
CVS Equine provides a complete range of industry-leading veterinary services at 21 sites across the UK as well as its out-of-hours clinical and call answering services, Equicall and Equicomms. Its ambulatory veterinary surgeons are supported by a team of over 20 recognised Veterinary Specialists in internal medicine, surgery, dentistry, sports medicine, reproduction and diagnostic imaging based within a network of referral centres. The division offers a multi-disciplinary approach, along with the latest veterinary treatments, diagnostic services, advice, standards and support – as a result of unrivalled investment in people, equipment, facilities and research. For further information about CVS Equine visit www.cvs-equine.com.
[i] The project was led by Zoë Gratwick of Axiom Vet labs. CVS Equine contributors included: Tim Mair – Bell Equine, Karen Coumbe – Bell Equine, Sarah Smith – B&W Equine Hospital, Anna Mitchell – B&W Willesley, Ewan Macaulay – Alnorthumbria, Helen Bryant – Scott Dunn’s, Kim Davies – South Wales Equine Vets, Leire Ruiz – Equicall.
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