Opinions of clinical veterinarians at a US veterinary teaching hospital regarding antimicrobial use and antimicrobial-resistant infections

Jacob, Megan E.; Hoppin, Jane A.; Steers, Nicola; Davis, Jennifer L.; Davidson, Gigi; Hansen, Bernie; Lunn, Katharine F.; Murphy, K. Marcia; Papich, Mark G.

doi:10.2460/javma.247.8.938

Cited by 25 publications

(32 citation statements)

References 19 publications

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“…Cost, owner compliance, animal-related factors, the non-healing nature of a given infection, and the desire to adhere to best practices were the primary themes influencing veterinary C/S test ordering behaviours in this study. Previous studies on antimicrobial prescribing practices suggest that human factor-related barriers to judicious use such as ease of administration and perceived owner compliance play a key role in resistance emergence (Mateus and others 2014, Bender 2015, Bender and others 2015a,b, Jacob and others 2015). Two Canadian studies used focus group interview with veterinarians and clients to assess factors related to veterinarian-client communication as well as monetary concerns in practice (Coe and others 2007, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…While a number of studies have assessed the factors influencing antimicrobial prescribing practices of physicians and other human healthcare providers (Morley and others 2005, Isturiz 2010, Escher and others 2011, Mateus and others 2011, Hughes and others 2012, Coyne and others 2014, Mateus and others 2014, Riviere and Fink-Gremmels 2014, Bender and others 2015a, b , Butterweck 2015, Jacob and others 2015), there have been few studies describing antimicrobial prescribing by veterinarians (De Briyne and others 2013, 2014, Summers and others 2014, Schwechler and others 2016). One study of prescribing physicians found that concerns about and factors impacting antimicrobial prescribing practices differed dramatically by job title or specialty, and concluded that interventions would need to be tailored to each specialty group in order to improve antimicrobial stewardship (Schweizer and others 2013).…”

Section: Introductionmentioning

confidence: 99%

“…These studies have found evidence of inappropriate use of antimicrobials such as underdosing in the small animal clinical setting. Furthermore, studies have reported that the use of antimicrobials by veterinarians is influenced by a combination of intrinsic and extrinsic factors including perceived drug efficacy, ease of administration, veterinary preferences and personal experience (Hughes and others 2012, Mateus and others 2014, Jacob and others 2015). …”

Section: Introductionmentioning

confidence: 99%

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Survey of veterinary antimicrobial prescribing practices, Washington State 2015

et al. 2016

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Antimicrobial resistance is a growing global health issue. It is also a recognised problem in veterinary medicine. Between September and December 2015 the authors administered a cross-sectional survey to licensed veterinarians in Washington State to assess factors affecting antimicrobial prescribing practices among veterinarians in Washington State. Two hundred and three veterinarians completed the survey. The majority of respondents (166, 82 per cent) were engaged in small animal or exotic animal practice. 24 per cent of respondents reported not ordering culture and sensitivity (C/S) testing in practice. Of the 76 per cent of veterinarians who reported ordering C/S tests, 36 per cent reported ordering such testing 'often' or 'always' when treating presumptive bacterial infections. Most respondents (65 per cent) mentioned cost as the most common barrier to ordering a C/S test. Only 16 (10 per cent) respondents reported having access to or utilising a clinic-specific antibiogram. This survey demonstrated that while antimicrobials are commonly used in veterinary practice, and veterinarians are concerned about antimicrobial resistance, cost is a barrier to obtaining C/S tests to guide antimicrobial therapy. Summaries of antimicrobial resistance patterns are rarely available to the practising veterinarian. Efforts to promote antimicrobial stewardship in a 'One Health' manner should address barriers to the judicious use of antimicrobials in the veterinary practice setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survey of veterinary antimicrobial prescribing practices, Washington State 2015

et al. 2016

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“…Missing data was treated as such. Antimicrobial drugs were ranked from most to least used and were grouped by name into similar classes as described previously (Green et al 2010;Jacob et al 2015). The commonly prescribed antimicrobial drugs were grouped into medically important antimicrobial classes as grouped by the United States Food and Drug Administration (FDA 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Veterinarians in another U.S. veterinary teaching hospital believed antimicrobials were over-prescribed in veterinary practice. The veterinarians in that hospital (Jacob et al 2015) were concerned about AMR and supported the idea of restricting the use of certain antimicrobial classes in companion animals. Prior to this study, the factors that influenced University of Tennessee Veterinary Medical Center (UTVMC) clinicians to start, delay, or discontinue the use of antimicrobials and/or to determine the class of antimicrobials used were unknown.…”

Section: Introductionmentioning

confidence: 99%

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Background. Antimicrobial drugs in veterinary medical practice are primarily prescribed for the purposes of maintaining or improving health and increasing productivity. However, their value is being eroded by antimicrobial resistance (AMR). Indiscriminate use of antimicrobial drugs is suggested as one of the modifiable factors contributing to the development of AMR. To reduce indiscriminate use and to improve antimicrobial use, veterinary practices are encouraged to adopt good stewardship practices. Therefore, the objectives of this study were: to identify factors influencing clinician decisions to begin using antimicrobials as well as the choice of antimicrobials used at The University of Tennessee Veterinary Medical Center (UTVMC); to evaluate the practices, perceptions, opinions and concerns of veterinary clinicians at UTVMC concerning antimicrobial use, antimicrobial stewardship, and AMR. Methods. This study's protocol was approved by the University of Tennessee Knoxville IRB for the Protection of Human Subjects in Research. Survey software was used to send a questionnaire to 121 eligible participants, where all were UTVMC faculty with clinical appointments and house officers. Cumulative logit models were fitted to investigate associations between categorical explanatory variables and ordinal response variables. Results. A response rate of 51.24% was achieved. Of the 62 respondents, 47 (75.81%) reported that bacteriological culture and antimicrobial susceptibility test results were extremely important in their antimicrobial prescription decision-making. Thirty-two (51.61%) respondents believed antimicrobials are being over-prescribed. The cephalosporin class was the most preferred antimicrobial class, while the lincosamide class was the least preferred. From the multivariable cumulative logit model, year of graduation from veterinary school (P = 0.034) and clinicians' primary patient load (P = 0.009) were significantly associated with clinicians' degree of concern about AMR. Conclusions and clinical relevance. The findings suggest a need for more awareness about AMR among veterinary clinicians. Improvements in antimicrobial stewardship are needed, especially among veterinary clinicians who graduated after 1999. Educational practices that target modification of antimicrobial prescription practices of veterinary clinicians would likely improve a Good Stewardship Practice (GSP) mindset. GSP is important in prolonging the efficacy of currently available antimicrobial drugs.

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