New graduates and academic veterinarians' intentions to treat canine acute diarrhea align with antimicrobial stewardship guidelines, January 2025.

Abstract

OBJECTIVE: To evaluate veterinarians' intention to use metronidazole for treatment of canine acute diarrhea (CAD) and compare their knowledge, attitudes, and beliefs to evidence-based guidelines. To determine whether intentions of more recent DVM graduates and veterinarians in academic settings were more closely aligned with guidelines. METHODS: Veterinarians were surveyed in January 2025 via an online platform to understand their knowledge and intention to use antibiotics for the treatment of CAD using the Theory of Planned Behavior model. Data were analyzed descriptively and inferentially to determine relationships between variables. RESULTS: Veterinarians (n = 1,626), who broadly endorse the principles of antimicrobial stewardship (AS), continue to prescribe metronidazole under conditions of clinical uncertainty. While a minority of veterinarians reported frequent use of metronidazole (18% [295/1,626]), nearly half believed that both clients (49% [796/1,626]) and their professional peers (44% [718/1,626]) often or always expected it. New graduates and veterinarians in academic settings demonstrated attitudes and intentions more aligned with current prescribing guidelines for CAD than their peers. Awareness of AS guidelines for CAD did not significantly correlate with a reported lower frequency of prescribing metronidazole. CONCLUSIONS: Veterinarians' intentions to prescribe metronidazole for CAD are shaped more profoundly by their attitudes toward clinical risk and their perceptions of social pressure than by their knowledge of clinical guidelines alone. CLINICAL RELEVANCE: Future AS efforts must explore the efficacy of educational campaigns to address the complex, human elements of clinical decision-making, fostering practice environments that make the right choice the easy choice.