AntibioticScout: Online tool for antimicrobial stewardship in veterinary medicine

Ruth, Peter; Müntener, Cedric R; Demuth, Daniel; Heim, Dominik; Mevissen, Meike; Schüpbach‐Regula, Gertraud; Schüller, Simone; Stucki, F; Willi, Barbara; Naegeli, Hanspeter

doi:10.17236/sat00095

Cited by 9 publications

(14 citation statements)

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“…Similar to previous studies,10 17 63 potentiated aminopenicillins were used more commonly than non-potentiated aminopenicillins to treat sporadic UTI in this cohort, although non-potentiated aminopenicillins are the recommended choice 26 30. The use of non-potentiated aminopenicillins is preferred whenever possible, because the addition of clavulanic acid increases AmpC-mediated resistance to first-generation, second-generation and third-generation cephalosporins 65 66.…”

Section: Discussionsupporting

confidence: 70%

Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Lutz

Lehner

Schmitt

et al. 2020

Veterinary Record Open

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BackgroundAntimicrobial resistance is an increasing problem in human and veterinary medicine and is closely linked to the use of antimicrobials. The objective of this study was to describe antimicrobial prescriptions for selected canine diseases in Switzerland during 2016.MethodsDogs presented to two university hospitals and 14 private practices for acute diarrhoea (AD; n=371), suspected or confirmed urinary tract infections (UTIs; n=245), respiratory tract infections (RTIs; n=274) or wound infections (WIs; n=175) were included. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage and duration) were retrospectively assessed. A justification score was applied to evaluate appropriateness of antimicrobial therapy based on available national and international consensus guidelines.ResultsAntimicrobials were prescribed in 65 per cent of dogs with AD, 88 per cent with UTI, 62 per cent with RTI and 90 per cent with WI. The most prescribed antimicrobial classes (monotherapy and combination therapy) were potentiated aminopenicillins (59 per cent), nitroimidazoles (22 per cent), non-potentiated aminopenicillins (16 per cent) and fluoroquinolones (13 per cent). Overall, 38 per cent (95 per cent CI 0.35 to 0.41) of the prescriptions were in accordance with consensus guidelines. In dogs with AD, antimicrobial therapy was associated with the presence of haemorrhagic diarrhoea (P<0.05) and complied in 32 per cent with consensus guidelines, which recommend antimicrobial treatment only when sepsis is suspected. A bacterial aetiology was confirmed via culture and/or sediment examination in 36 per cent of dogs with suspected UTI.ConclusionsOverall, adherence to consensus guidelines was poor both, at university hospitals and private practices. Antimicrobial stewardship measures are therefore needed to improve prudent use.

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Section: Discussionsupporting

confidence: 70%

Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Lutz

Lehner

Schmitt

et al. 2020

Veterinary Record Open

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“…Pretreated cases included both, cases referred from other institutions and treated for the actual disease, as well as cats presented to the same institutions and pretreated for unrelated diseases. Compliance with Swiss guidelines published in December 2016 in the online tool AntibioticScout.ch was evaluated [41][42][43]. For this purpose, indication, antimicrobial class, dose and treatment duration were evaluated and compared with the recommendations given in the guidelines as detailed in Table 5.…”

Section: Methodsmentioning

confidence: 99%

“…In December 2016, an online antimicrobial stewardship tool (AntibioticScout.ch) was introduced to promote Swiss guidelines on prudent antimicrobial use. This tool contains specific recommendations on antimicrobial prescription for various disease complexes [41][42][43]. AntibioticScout.ch has been published and disseminated through different channels, including the official journal of the Swiss Veterinary Society [42,43], in newsletters of the Swiss Veterinary Society, on the website of the Federal Food Safety and Veterinary Office [44], on the website of the Institute of Veterinary Pharmacology and Toxicology of the University of Zurich [41], and in numerous continued education events for practitioners.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial prescriptions in cats in Switzerland before and after the introduction of an online antimicrobial stewardship tool

et al. 2020

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Background: Antimicrobial stewardship activities are essential to improve prudent antimicrobial use. The aim of the present study was to evaluate changes in antimicrobial prescriptions in cats after the introduction of prudent use guidelines promoted by an online antimicrobial stewardship tool (AntibioticScout.ch) in Switzerland. Data from 792 cats presented to two university hospitals and 14 private practices in 2018 were included and compared to 776 cases from 2016. Cats were diagnosed with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses. Clinical history, diagnostic work-up and antimicrobial prescriptions (class, dosage, duration) were assessed. Type and proportions [95% confidence intervals] of antimicrobial prescriptions were compared between the two evaluation periods and a mixed effects logistic regression model was applied to evaluate compliance with Swiss prudent use guidelines. Results: From 2016 to 2018, the proportion of antimicrobial prescription in all included cases decreased from 75.0% [71.8-78.0] to 66.7% [63.3-69.9]; this decrease was most pronounced for treatments at university hospitals (67.1% [59.5-74.0] to 49.3% [40.9-57.8]) and for cats with FLUTD (60.1% [54.6-65.4] to 48.8% [43.2-54.4]). Use of 3rd generation cephalosporins in private practices declined from 30.7% [26.5-35.1] to 22.1% [18.4-26.2], while overall use of non-potentiated aminopenicillins increased from 19.6% [16.4-23.0] to 27.8% [24.1-31.9]. In cases where antimicrobial therapy was indicated, compliance with guidelines did not increase (33.3% [26.6-40.6] to 33.5% [27.2-40.2]), neither at universities nor in private practices. On the other hand, antimicrobial treatment was more often withheld in cases with no indication for antimicrobial therapy (35.6% [30.1-41.4] to 54.0% [47.6-60.4]); this was found for private practices (26.7% [20.8-33.4] to 46.0% [38.4-53.7]) and for aURTD cases (35.0% [26.5-44.2] to 55.4% [44.7-65.8]).

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“…As part of its implementation, an online tool (AntibioticScout.ch) assisting veterinarians in the selection of prudent empirical antimicrobial treatment based on international guidelines was created. 14,15 The tool allows users to retrieve short and specific recommendations for antimicrobial treatment online after selection of species, organ system, and suspected or confirmed diagnosis. The result of a search may also recommend to refrain from antimicrobial treatment in the absence of specific indications.…”

Section: Introductionmentioning

confidence: 99%

“…This tool became available to veterinarians in December 2016 as an extension of a well-established and highly frequented drug information web site (CliniPharm.ch). AntibioticScout.ch was promoted to Swiss veterinarians in various ways, including publications, 14,15 newsletters of the Swiss Veterinary Society, flyers, and continuing education events for practitioners. The prescribing habits of veterinarians for selected diseases in cats and dogs in Switzerland before introduction of AntibioticScout.ch have been reported.…”

Section: Introductionmentioning

confidence: 99%

Effect of antimicrobial stewardship on antimicrobial prescriptions for selected diseases of dogs in Switzerland

Lehner

Hubbuch

Schmitt

et al. 2020

Veterinary Internal Medicne

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Background: Antimicrobial stewardship programs (ASPs) are important tools to foster prudent antimicrobial use. Objective: To evaluate antimicrobial prescriptions by Swiss veterinarians before and after introduction of the online ASP AntibioticScout.ch in December 2016. Animals: Dogs presented to 2 university hospitals and 14 private practices in 2016 or 2018 for acute diarrhea (AD; n = 779), urinary tract infection (UTI; n = 505), respiratory tract infection (RTI; n = 580), or wound infection (WI; n = 341). Methods: Retrospective study. Prescriptions of antimicrobials in 2016 and 2018 were compared and their appropriateness assessed by a justification score. Results: The proportion of dogs prescribed antimicrobials decreased significantly between 2016 and 2018 (74% vs 59%; P < .001). The proportion of prescriptions in complete agreement with guidelines increased significantly (48% vs 60%; P < .001) and those in complete disagreement significantly decreased (38% vs 24%; P < .001) during this time. Antimicrobial prescriptions for dogs with AD were significantly correlated with the presence of hemorrhagic diarrhea in both years, but a significantly lower proportion of dogs with hemorrhagic diarrhea were unnecessarily prescribed antimicrobials in 2018 (65% vs 36%; P < .001). In private practices, in 2018 a bacterial etiology of UTI was confirmed in 16% of dogs. Prescriptions for fluoroquinolones significantly decreased (29% vs 14%; P = .002). Prescriptions for antimicrobials decreased significantly in private practices for RTI (54% vs 31%; P < .001).

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AntibioticScout: Online tool for antimicrobial stewardship in veterinary medicine

Cited by 9 publications

References 0 publications

Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Antimicrobial prescriptions in cats in Switzerland before and after the introduction of an online antimicrobial stewardship tool

Effect of antimicrobial stewardship on antimicrobial prescriptions for selected diseases of dogs in Switzerland

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