Peer-reviewed veterinary case report
How do hospital guidelines affect antibiotic use in dogs and cats?
By Robbins, Sarah N et al.·Published in Journal of veterinary internal medicine·2024·College of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Effect of institutional antimicrobial stewardship guidelines on prescription of critically important antimicrobials for dogs and cats.
- Species:
- cat
Plain-English summary
This study looked at how well veterinary hospitals followed guidelines for using important antibiotics in dogs and cats to help reduce antibiotic resistance. The researchers found that from January 2021 to June 2022, fluoroquinolones were the most commonly prescribed important antibiotics for both dogs and cats, but many cases did not follow the guidelines. In fact, only about 58% of the time did veterinarians stick to the recommended practices, often because they didn't do necessary tests to identify the bacteria or used stronger antibiotics when they weren't needed. Although there was an increase in testing for bacterial infections after the guidelines were put in place, the overall adherence to the guidelines did not improve, and there were no significant changes in infection rates or antibiotic resistance.
Abstract
BACKGROUND: Veterinary hospital antimicrobial stewardship (AMS) guidelines might help combat antimicrobial resistance (AMR). OBJECTIVES: Determine the conditions and types of infection for which antimicrobial drugs (AMDs) deemed critically important (CIA) by the World Health Organization (WHO) were prescribed and assess the effect of hospital AMS guidelines on adherence to International Society for Companion Animal Infectious Diseases published guidelines for the treatment of superficial bacterial folliculitis, respiratory tract disease and urinary tract infection in these cases. ANIMALS: Dogs and cats managed at an academic veterinary hospital from 1/21 to 6/21 and 9/21 to 6/22. METHODS: Prescriptions of cephalosporins (third or fourth generation), glycopeptides, macrolides/ketolides, polymyxins, and quinolones were identified. Data on culture and susceptibility (C/S) testing and previous AMD exposure were collected. Frequencies were compared between time periods using Fisher's exact test with Bonferroni corrections. RESULTS: In animals prescribed ≥1 WHO-CIA AMD, fluoroquinolones were the most frequently prescribed WHO-CIA class in dogs (567/1724, 32.9%) and cats (192/450, 42.7%). No animals were prescribed carbapenems, dihydrofolate reductase inhibitors/sulfonamides, or polymyxins. No cats were prescribed aminoglycosides or amphenicols. Institutional guidelines were followed in 57.8% (324/561) cases. The most frequent causes of nonadherence were failure to perform C/S testing 46.0% (109/237) and unnecessary use of a higher-tier AMD 43.0% (102/237). Bacterial C/S testing was more frequently performed after AMS guideline institution (59.7% vs. 46.8%, P = 0.0006). CONCLUSIONS AND CLINICAL IMPORTANCE: Adherence to published guidelines remained poor despite an increase in C/S testing. There were no changes in the frequencies of confirmed infections, positive cultures or AMD resistance between time periods.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/38465850/