A quarterly survey of antibiotic prescribing in small animal and equine practices—Minnesota and North Dakota, 2020

Abstract

Antimicrobials are critical for medicine, but the problem of antimicrobial resistance (AMR) threatens the effectiveness of these valuable drugs. In USA, there are no national‐ or state‐level programs or policies in place to track antibiotic use (AU) in dogs, cats, and horses, despite acknowledgement of this sector's importance to both the AMR problem and its solution. AU measurement is a key part of antibiotic stewardship and AMR prevention. This study aimed to fill existing gaps in the veterinary professions' knowledge of antibiotic prescribing in small animals and horses. To address this aim, medical record data were collected on a single day per quarter for 1 year from 19 Minnesota and North Dakota small animal and equine practices, totaling 1,899 veterinarian consults of dogs, cats, and horses. Overall, 25.8% of all canine, feline, and equine consults involved an antibiotic prescription. Third‐generation cephalosporins were the most commonly prescribed systemic antibiotic drug class, and the long‐acting injectable drug, cefovecin, was the most commonly prescribed antibiotic for cats (34.5%). Topical antibiotic preparations were prescribed frequently, especially in dogs (42.5% of canine prescriptions), though systemic antibiotics were often prescribed concurrently. Common general indications, based on problem or diagnosis recorded in the medical record, for antibiotics in all species combined were skin conditions (24.4%), otitis (22.1%), ophthalmic (9.4%), gastrointestinal (8.3%), respiratory (8.3%), and urinary tract (7.6%) diseases. While 44.2% of patients for which antibiotics were prescribed had cytology performed, only 3.9% had bacterial culture and susceptibility performed. In a pre‐study survey, veterinarians' recommendations for AU differed from actual prescribing, suggesting collection of AU data provides more accurate assessments of veterinary prescribing behaviour than surveys. This study shows feasibility of AU measurement in small animals and horses. The data collection tool and standard operating procedures described prove suitable for national AU data collection.

Impacts of the COVID‐19 pandemic on antimicrobial use in companion animals in an academic veterinary hospital in North Carolina

“…Our findings agree with previous reports that dogs were more likely to be prescribed an antimicrobial than cats; however, cats were more likely than dogs to receive drugs of higher importance (Tables S1 and S2)—specifically third‐generation cephalosporins (Buckland et al, 2016; Goggs et al, 2021; Hardefeldt et al, 2018; Hur et al, 2020; Singleton et al, 2017). Typically, the most frequently prescribed antimicrobials are cefpodoxime and amoxicillin/clavulanic acid for dogs and cefovecin for cats (Bollig et al, 2022; Goggs et al, 2021; Hardefeldt et al, 2018; Hur et al, 2020; Singleton et al, 2017). When choosing a cephalosporin or beta‐lactam combination agent, the relatively longer duration of action of cefpodoxime (24 h) and cefovecin (14 days) can make these agents more desirable in terms of client adherence compared to other agents in the same drug classes.…”

“…These disruptions included limited appointment slots, reduced client-clinician interactions, and staffing shortages (Bollig et al, 2022;Powell et al, 2022). All these events have created the opportunity for changes in veterinary AMU, which could have potential downstream consequences for AMR (Bollig et al, 2022). To most accurately reflect this location-specific implementation, the pre-pandemic period in this study ranged from 01/01/2019 to 03/15/2020 (14.5 months), and the pandemic period ranged from 03/16/2020-12/31/2020 (9.5 months).…”

“…Both veterinary and human medical facilities were subject to extended periods of highly modified operations (i.e., limited hospital capacity, reduced personnel, and medical equipment shortages) as a result of supply chain disruptions and state/federal health‐related mandates such as social distancing (AVMA A, 2020; Cheeyandira, 2020; FDA, 2022). These disruptions included limited appointment slots, reduced client‐clinician interactions, and staffing shortages (Bollig et al, 2022; CDC A, 2022; Powell et al, 2022). All these events have created the opportunity for changes in veterinary AMU, which could have potential downstream consequences for AMR (Bollig et al, 2022).…”

“…These disruptions included limited appointment slots, reduced client‐clinician interactions, and staffing shortages (Bollig et al, 2022; CDC A, 2022; Powell et al, 2022). All these events have created the opportunity for changes in veterinary AMU, which could have potential downstream consequences for AMR (Bollig et al, 2022).…”

Minnesota One Health Antibiotic Stewardship Collaborative: A Reproducible Approach to Facilitate Antimicrobial Stewardship Progress

“…The OH Minnesota AS Strategic Plan included several metrics by which success could be measured, including number of individuals participating, number of persons reached through communications like email, social media, and the website. There are also unmeasured benefits of a strengthened Minnesota AS community, including collaborative publications [ 13–15 , 17 , 18 ] and routine 2-way communication of AS opportunities and challenges between clinical organizations and state agencies.…”