A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease.

J Scott Weese,Jason W Stull,Dennis Ballance,Philip J Bergman,Jinelle Webb,Michelle Evason,Talon Mckee

doi:10.1177/1098612x211054815

Abstract

ObjectivesThe aim of this study was to evaluate initial antimicrobial therapy in cats diagnosed with upper or lower bacterial urinary tract infections at veterinary practices in the USA and Canada.MethodsElectronic medical records from a veterinary practice corporation with clinics in the USA and Canada were queried between 2 January 2016 and 3 December 2018. Feline patient visits with a diagnosis field entry of urinary tract infection, cystitis and pyelonephritis, as well as variation of those names and more colloquial diagnoses such as kidney and bladder infection, and where an antimicrobial was prescribed, were retrieved.ResultsPrescription data for 5724 visits were identified. Sporadic cystitis was the most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis. Cefovecin was the most commonly prescribed antimicrobial for all conditions, followed by amoxicillin–clavulanic acid. Significant differences in antimicrobial drug class prescribing were noted between practice types and countries, and over the 3-year study period. For sporadic cystitis, prescription of amoxicillin–clavulanic acid increased significantly and cefovecin decreased between 2016 and 2018, and 2017 and 2018, while fluoroquinolone use increased between 2017 and 2018.Conclusions and relevanceThe results indicate targets for intervention and some encouraging trends. Understanding how antimicrobials are used is a key component of antimicrobial stewardship and is required to establish benchmarks, identify areas for improvement, aid in the development of interventions and evaluate the impact of interventions or other changes.

Highlights

Infectious urinary tract disease is commonly diagnosed in cats, with resultant common use of antimicrobials.[1]
A repeat visit of the same animal within 30 days was removed unless there was a different field code, on the assumption that a new treatment decision would have been made for the second disease occurrence
Sporadic cystitis was the most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis

Summary

Introduction

Infectious urinary tract disease is commonly diagnosed in cats, with resultant common use of antimicrobials.[1]. A core aspect of antimicrobial stewardship is understanding how antimicrobials are used, as this is required to assess antimicrobial use practices, establish benchmarks and targets, identify areas for improvement, develop interventions, and evaluate the impact of interventions or other changes. The objective of this multicenter study was to evaluate initial antimicrobial therapy in cats diagnosed with upper or lower bacterial urinary tract infections at a subset of veterinary practices in the USA and Canada.

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Results

Conclusion