A cluster analysis of veterinarians' antimicrobial prescription preferences for companion animals in Portugal.

Abstract

BACKGROUND: Antimicrobial stewardship is essential to tackle antimicrobial resistance, particularly in veterinary practice where antimicrobials of high importance for human health require careful oversight. This study assessed prescribing patterns and concordance with FECAVA recommendations for prudent antimicrobial use across common clinical scenarios, providing a Europe-wide framework for responsible antimicrobial prescribing in companion animals. METHODS: A cross-sectional survey was conducted among veterinarians in Portugal (October 2019-January 2020), covering 11 clinical scenarios and 18 therapeutic options, including 'no antimicrobial therapy'. Descriptive, inferential, and cluster analyses were performed. RESULTS: Among 416 respondents, amoxicillin-clavulanic acid (27.4%) and fluoroquinolones (13.8%) were most frequently chosen. Six prescribing clusters were identified: Cluster D (33.2%) was the largest, followed by Clusters C (23.3%) and F (22.1%). Younger veterinarians (<42&#xa0;years) were more likely to belong to Cluster A (p&#xa0;<&#xa0;0.001). Clusters A and F frequently selected 'no antimicrobials,' whereas Cluster B predominantly relied on amoxicillin-clavulanic acid and aminoglycosides. Concordance with FECAVA recommendations was highest in Cluster A and lowest in Cluster B. Importantly, consensus across clusters was observed for post-operative prophylaxis, wound treatment, and osteomyelitis, where prescription patterns aligned with FECAVA guidance. LIMITATIONS: Limitations include potential recall and social desirability bias inherent to self-reported data, and the hypothetical scenarios did not account for case severity or previous antimicrobial exposure. CONCLUSION: Six distinct prescribing profiles were identified, with broad-spectrum antimicrobials frequently selected. The variability in antimicrobial prescription recommendation between the profiles underscores the need for targeted antimicrobial stewardship interventions to strengthen adherence to guidelines in companion animal practice.