De impact van advies omtrent het gebruik van antimicrobiële middelen op het voorschrijfgedrag in veertien Vlaamse praktijken voor kleine huisdieren

Sarrazin, Steven; Vandael, F.; Cleven, Alexia Van; Graef, Evelyne De; Rooster, H. de; Dewulf, Jeroen

doi:10.21825/vdt.v86i3.16287

Cited by 17 publications

(32 citation statements)

References 35 publications

(43 reference statements)

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“…Therefore, comparisons of AMU and AMR levels between countries and species should be interpreted while keeping in mind the restrictions of this small sample size. Nevertheless, the results did show similar trends with previous studies [25,26,28,[45][46][47][48] and enabled the identification of some significant differences, although some might be missed due to a lack of power. A recent Dutch study reported on the many different factors influencing the antimicrobial prescribing behavior of veterinarians [52].…”

Section: Discussionsupporting

confidence: 86%

“…More specifically, 36% of the total number of treatments was represented by CIAs of high priority, the other 35% were CIAs of the highest priority. Comparable results are highlighted in other studies investigating AMU in companion animals [25,26,28,[45][46][47][48]. A study in the UK, using data from 374 veterinary practices, reported similar proportions of CIAs usage, 60% in dogs and 81% in cats [49].…”

Section: Discussionmentioning

confidence: 53%

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Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries

et al. 2020

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Companion animals have been described as potential reservoirs of antimicrobial resistance (AMR), however data remain scarce. Therefore, the objectives were to describe antimicrobial usage (AMU) in dogs and cats in three European countries (Belgium, Italy, and The Netherlands) and to investigate phenotypic AMR. A questionnaire and one fecal sample per animal (n = 303) were collected over one year and AMU was quantified using treatment incidence (TI). Phenotypic resistance profiles of 282 Escherichia coli isolates were determined. Nineteen percent of the animals received at least one antimicrobial treatment six months preceding sampling. On average, cats and dogs were treated with a standard daily dose of antimicrobials for 1.8 and 3.3 days over one year, respectively. The most frequently used antimicrobial was amoxicillin-clavulanate (27%). Broad-spectrum antimicrobials and critically important antimicrobials for human medicine represented 83% and 71% of the total number of treatments, respectively. Resistance of E. coli to at least one antimicrobial agent was found in 27% of the isolates. The most common resistance was to ampicillin (18%). Thirteen percent was identified as multidrug resistant isolates. No association between AMU and AMR was found in the investigated samples. The issue to address, regarding AMU in companion animal, lies within the quality of use, not the quantity. Especially from a One-Health perspective, companion animals might be a source of transmission of resistance genes and/or resistant bacteria to humans.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 53%

Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries

et al. 2020

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“…Indeed, in 41 per cent of cases, antimicrobial treatment was in partial or complete disagreement with national and international guidelines. These findings concur with studies in human and veterinary medicine showing that antimicrobials are commonly prescribed without clear indication,10 11 13 16 18 19 21 34 35 that HPCIAs are used as first-line agents12 15 23 and that adherence to general guidelines is often poor, both in hospital10 21 36 37 and first opinion practice settings 12 16 38. The results also concur with the situation in selected feline conditions in Switzerland where 38 per cent of antimicrobial treatments were found to be in in partial or total disagreement with consensus guidelines.…”

Section: Discussionsupporting

confidence: 84%

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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“…To date, only very few studies have investigated the impact of those guidelines on antimicrobial prescription in companion animals. A decrease of antimicrobial prescriptions after the introduction of prudent use guidelines has been reported in Flemish small animal practices and in a veterinary teaching hospital in Canada [9,36]. In a Europe-wide survey, veterinarians in countries with national policies for antimicrobial use, as for example Sweden, seemed to prescribe critically important antibiotics less frequently than in countries without such policies [11].…”

Section: Introductionmentioning

confidence: 99%

“…A One Health approach is required to combat the development and spread of antimicrobial-resistant bacteria [1,2]. Antimicrobial use is thought to be a major driving force towards antimicrobial resistance [3,4] and overprescription of antimicrobials seems to be common in human and veterinary medicine [5][6][7][8][9]. The largest proportion of antimicrobials sold in Europe are used to treat food producing animals and the role of companion animals in this context has been neglected for a long time [10].…”

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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De impact van advies omtrent het gebruik van antimicrobiële middelen op het voorschrijfgedrag in veertien Vlaamse praktijken voor kleine huisdieren

Cited by 17 publications

References 35 publications

Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries

Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries

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

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