Abstract
Antimicrobial stewardship is a cornerstone of efforts to curtail antimicrobial resistance. To determine factors potentially influencing likelihood of prescribing antimicrobials for animals, we analyzed electronic health records for unwell dogs (n = 155,732 unique dogs, 281,543 consultations) and cats (n = 69,236 unique cats, 111,139 consultations) voluntarily contributed by 173 UK veterinary practices. Using multivariable mixed effects logistic regression, we found that factors associated with decreased odds of systemic antimicrobial prescription were client decisions focused on preventive health: vaccination (dogs, odds ratio [OR] 0.93, 95% CI, 0.90–0.95; cats, OR 0.92, 95% CI 0.89–0.95), insurance (dogs, OR 0.87, 95% CI 0.84–0.90; cats, OR 0.82, 95% CI 0.79–0.86), neutering of dogs (OR 0.90, 95% CI 0.88–0.92), and practices accredited by the Royal College of Veterinary Surgeons (OR 0.79, 95% 95% CI 0.68–0.92). This large multicenter companion animal study demonstrates the potential of preventive healthcare and client engagement to encourage responsible antimicrobial drug use.
Highlights
Antimicrobial drug use is a key driver of the promotion and transmission of antimicrobial resistance in humans, livestock, and companion animals [1,2,3,4,5]
Associations between antimicrobial prescription and a range of veterinary practice, practitioner, client, and animal-related factors for animals presented primarily for investigation of disease
Systemic antimicrobial drugs were prescribed during 25.7% of consultations, topical antimicrobials during 14.2%, and systemic highest priority critically important antimicrobial (HPCIA) during 1.4%
Summary
Antimicrobial drug use is a key driver of the promotion and transmission of antimicrobial resistance in humans, livestock, and companion animals (e.g., dogs, cats) [1,2,3,4,5]. To identify factors potentially influencing antimicrobial prescribing in the clinical environment, we analyzed EHRs for a large, diverse population of dogs and cats, collected from a network of volunteer firstopinion (general) veterinary practices across Great Britain (England, Scotland, and Wales). Antimicrobial Drugs for Dogs and Cats, UK associations between antimicrobial prescription (including antimicrobials authorized for systemic administration, antimicrobials authorized for topical administration, and HPCIAs) and a range of veterinary practice, practitioner, client, and animal-related factors (including socioeconomic factors and preventive healthcare interventions) for animals presented primarily for investigation of disease
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