Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts

Abstract

Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.

Comparison of Short- versus Long-Course Antimicrobial Therapy of Uncomplicated Bacterial Pneumonia in Dogs: A Double-Blinded, Placebo-Controlled Pilot Study

“…Similar to humans, it is likely that multidrug-resistant infections can be associated with longer hospitalization time, greater economic impact and potentially even poorer outcomes [ 9 ]. The need to improve guidelines related to the use of antimicrobials in companion animals is particularly relevant since they are in close contact with humans and may share or amplify resistant bacteria or act as reservoirs for their human owners [ 10 , 11 ]. All users of antimicrobial drugs, including veterinarians, have a responsibility to use them judiciously and prudently.…”

“…All users of antimicrobial drugs, including veterinarians, have a responsibility to use them judiciously and prudently. While this has yet to gain traction for the treatment of canine bacterial pneumonia, an urgent need to implement antimicrobial stewardship programs in companion animals has been recognized and an American Veterinary Medical Association Task Force for Antimicrobial Stewardship in Companion Animal Practice has been formed [ 11 , 12 , 13 ]. It is highly likely that the current standard of care using protracted courses (3–6 weeks or more) of antimicrobials for uncomplicated canine bacterial pneumonia opposes guidelines for good antimicrobial stewardship and may be a harmful practice.…”

Canine saliva is a source of interspecies antimicrobial resistance gene transfer

“…In contrast, in studies conducted by other research groups from countries including the U.S. 46 , the U.K. 47 , the Netherlands 48 or Australia 49 , clinical settings were ranked of a much higher importance than client expectations. Broad-spectrum amoxicillin-clavulanate is the flagship of antimicrobial agents applied in dogs in many countries, while first-generation cephalosporins are also routinely used 22,50,51 . Lincosamides (clindamycin), macrolides, tetracyclines (doxycycline), nitroimidazoles and trimethoprim/sulphonamides have also been reported to be frequently used in small animal practice 22 .…”

Implications of Veterinary Medicine in the comprehension and stewardship of antimicrobial resistance phenomenon. From the origin till nowadays.

“…Pets and owners have long life expectancy, have similar pathologies, and can undergo to similar therapeutic protocols using the same classes of antibiotics: this led to some important considerations about the fact that in small animal practice, CIAs can be used representing a major threat of AMR for humans ( World Health Organization 2019 ; Collignon and McEwen, 2019 ; Tompson et al., 2021 ). The decision to use antibiotics in pet clinical practice is linked to the treatment of a single sick patient and less frequently for prophylactic purposes ( Collignon and McEwen, 2019 ).…”

“…Often in clinical practice due to the need to initiate therapy, the veterinarian may decide to set up empirical therapy, considering that the optimal choice is an antibiotic with a narrow spectrum of action ( Joint scientific report of ECDC, EFSA and EMEA, 2009 ; Singleton et al., 2020 ). However, this should be limited as much as possible by a correct diagnosis and the guidelines that assist the veterinarian choosing the most appropriate antibiotic to use, but a complete uniformity in protocols, and in guidelines are not defined but will be with the new European regulatory ( Papich, 2021 ; Regulation EU 2019 /6; Singleton et al., 2020 ; Tompson et al., 2021 ). In all cases, it is important to prescribe an antimicrobial agent considering the clinical signs shown by the patient, pharmacological criteria such as the pharmacokinetic and pharmacodynamic characteristics of antibiotics and microbiological criteria ( Rodríguez-Gascón et al., 2021 ).…”