Abstract
BackgroundMulti-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice.This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N = 16). The objective of the research was to explore the drivers of companion animal veterinary surgeons’ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n = 4), Scotland (n = 11), Northern Ireland (n = 1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours.ResultsFive components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors.ConclusionThis paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeons’ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR.
Highlights
Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine
Inappropriate antibiotic use in companion animals has been identified as potentially contributing to antimicrobial resistance (AMR) [1]
These studies use a range of research methodologies and show that antimicrobial prescribing among large-animals in the agricultural sector is influenced by a wide range of social, cultural and political factors [6], provide a pan-European perspective on veterinary surgeon antibiotic prescribing habits and use of sensitivity testing [12], explore the factors influencing prescribing in antibiotic dry cow therapy [13], and document factors influencing decision-making in antimicrobial prescribing in small animal veterinary practice in the UK [8]
Summary
Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, ; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice. Inappropriate antibiotic use in companion animals (dogs, cats, rabbits that live in households) has been identified as potentially contributing to antimicrobial resistance (AMR) [1]. The proximity of humans and companion animals in domestic environments means that there is potential for the transfer of antibiotic resistant bacteria between species [3, 4]. This inter-species transmission of resistant bacteria has implications for both human and animal health [5]
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