AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine

Ruth, Peter; Demuth, Daniel; Müntener, Cedric R; Lampart, Marina; Heim, Dominik; Mevissen, Meike; Schüpbach‐Regula, Gertraud; Schüller, Simone; Stucki, F; Willi, Barbara; Burkhardt, W; Francey, Thierry; Nett, Claudia; Tschuor, F; Naegeli, Hanspeter

doi:10.17236/sat00129

Cited by 7 publications

(12 citation statements)

References 11 publications

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“…The problem is also recognised in companion animals (Peter et al . ), with serious potential concerns for human health associated with methicillin‐resistant Staphylococcus aureus (MRSA) (Rossi et al . ).…”

Section: Antibacterial Resistancementioning

confidence: 99%

“…Antibiotic resistance represents one of the most serious and imminent health-related problems worldwide (WHO 2017); the last joint EFSA/ECDC report Antimicrobial resistance in Europe, (http://www.efsa.europa.eu/it/interactive_pages/AMR_ Report_2016) based on 2016 data reflects on this alarming situation. The problem is also recognised in companion animals (Peter et al 2017), with serious potential concerns for human health associated with methicillin-resistant Staphylococcus aureus (MRSA) (Rossi et al 2017). More specifically, for complaints related to the digestive tract, the gut microbiota has been considered as a dynamic reservoir of antibiotic resistance, termed the ("gut resistome"), which can be affected by the administration of ABs (Rizzatti et al 2018).…”

Section: Antibacterial Resistancementioning

confidence: 99%

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Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea

Cerquetella

Rossi

Suchodolski

et al. 2020

J of Small Animal Practice

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Chronic diarrhoea is a frequent complaint in canine practice and the diagnostic path is often characterised by numerous diagnostic tests and stepwise empirical treatments, often applied before gastrointestinal endoscopy/mucosal biopsies. These include dietary interventions (novel protein, hydrolysed protein diet), parasiticides and still, in many cases, antibacterials. Indiscriminate use of antibacterial drugs risks detrimental consequences for both the individual patient (antimicrobial resistance, long‐term disruption of intestinal bacterial populations, potential worsening of gastrointestinal signs) and the general public. For that reason, in this Perspective essay we advocate use of antibacterials only after histopathologic evaluation of gastrointestinal biopsies or, for those cases in which endoscopy is not possible, after other therapeutic trials, such as diet/pre‐probiotics or anti‐inflammatory drugs have proven unsuccessful. They should be reserved, after appropriate dietary trials, for those canine chronic diarrhoeic patients with signs of true primary infection (i.e. signs of systemic inflammatory response syndrome or evidence of adherent‐invasive bacteria) that justify antibacterial use.

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Section: Antibacterial Resistancementioning

confidence: 99%

Section: Antibacterial Resistancementioning

confidence: 99%

Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea

Cerquetella

Rossi

Suchodolski

et al. 2020

J of Small Animal Practice

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“…Pretreated cases included both, cases referred from other institutions and treated for the actual disease, as well as cats presented to the same institutions and pretreated for unrelated diseases. Compliance with Swiss guidelines published in December 2016 in the online tool AntibioticScout.ch was evaluated [41][42][43]. For this purpose, indication, antimicrobial class, dose and treatment duration were evaluated and compared with the recommendations given in the guidelines as detailed in Table 5.…”

Section: Methodsmentioning

confidence: 99%

“…In December 2016, an online antimicrobial stewardship tool (AntibioticScout.ch) was introduced to promote Swiss guidelines on prudent antimicrobial use. This tool contains specific recommendations on antimicrobial prescription for various disease complexes [41][42][43]. AntibioticScout.ch has been published and disseminated through different channels, including the official journal of the Swiss Veterinary Society [42,43], in newsletters of the Swiss Veterinary Society, on the website of the Federal Food Safety and Veterinary Office [44], on the website of the Institute of Veterinary Pharmacology and Toxicology of the University of Zurich [41], and in numerous continued education events for practitioners.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial prescriptions in cats in Switzerland before and after the introduction of an online antimicrobial stewardship tool

et al. 2020

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Background: Antimicrobial stewardship activities are essential to improve prudent antimicrobial use. The aim of the present study was to evaluate changes in antimicrobial prescriptions in cats after the introduction of prudent use guidelines promoted by an online antimicrobial stewardship tool (AntibioticScout.ch) in Switzerland. Data from 792 cats presented to two university hospitals and 14 private practices in 2018 were included and compared to 776 cases from 2016. Cats were diagnosed with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses. Clinical history, diagnostic work-up and antimicrobial prescriptions (class, dosage, duration) were assessed. Type and proportions [95% confidence intervals] of antimicrobial prescriptions were compared between the two evaluation periods and a mixed effects logistic regression model was applied to evaluate compliance with Swiss prudent use guidelines. Results: From 2016 to 2018, the proportion of antimicrobial prescription in all included cases decreased from 75.0% [71.8-78.0] to 66.7% [63.3-69.9]; this decrease was most pronounced for treatments at university hospitals (67.1% [59.5-74.0] to 49.3% [40.9-57.8]) and for cats with FLUTD (60.1% [54.6-65.4] to 48.8% [43.2-54.4]). Use of 3rd generation cephalosporins in private practices declined from 30.7% [26.5-35.1] to 22.1% [18.4-26.2], while overall use of non-potentiated aminopenicillins increased from 19.6% [16.4-23.0] to 27.8% [24.1-31.9]. In cases where antimicrobial therapy was indicated, compliance with guidelines did not increase (33.3% [26.6-40.6] to 33.5% [27.2-40.2]), neither at universities nor in private practices. On the other hand, antimicrobial treatment was more often withheld in cases with no indication for antimicrobial therapy (35.6% [30.1-41.4] to 54.0% [47.6-60.4]); this was found for private practices (26.7% [20.8-33.4] to 46.0% [38.4-53.7]) and for aURTD cases (35.0% [26.5-44.2] to 55.4% [44.7-65.8]).

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“…Fourteen (42%) isolates were susceptible to aminopenicillins, which are regarded as the first-line empirical treatment for bacterial cystitis in dogs in Switzerland. 1,34,42 A total of 22 (67%) of the isolates were susceptible to potentiated aminopenicillins, 21 (64%) to sulfonamides and combinations (trimethoprim) and 20 (61%) to fluoroquinolones.…”

Section: Isolated Pathogensmentioning

confidence: 99%

Urinary tract infections in dogs with spontaneous hypercortisolism – frequency, symptoms and involved pathogens

DuPont

Burkhardt

Boretti

et al. 2020

SAT

Self Cite

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Dogs with hypercortisolism are predisposed to developing bacteriuria associated either with clinical signs of cystitis or without clinical signs (subclinical bacteriuria). Based on current guidelines, dogs with subclinical bacteriuria should not be treated with antibiotics because there is no evidence that treatment improves outcome and because unnecessary treatments should be avoided. Before these guidelines were published in 2019, dogs with hypercortisolism and bacteriuria were commonly treated with antibiotics irrespective of clinical signs. Comprehensive data on the frequency of bacterial cystitis, subclinical bacteriuria and the outcome of antimicrobial treatment in dogs with hypercortisolism is sparse. The aims of this study were to investigate dogs with hypercortisolism for the presence of bacterial cystitis and subclinical bacteriuria, to address the pathogens involved, and to assess the outcome of antibiotic treatment. Dogs newly diagnosed with hypercortisolism between 2005 and 2015 from which a urine bacterial culture was available were included. Statistical analysis was performed with non-parametric tests. Of the 161 client-owned dogs included, 29 (18%) showed bacteriuria, which was subclinical in 24 (83%) cases. Escherichia coli was the most commonly isolated pathogen (58%). Bacteriuria was not associated with sex or neutering status. In 14 dogs, follow-up data was available, of which 13 (93%) were treated with antimicrobials for 14 to 28 days. Follow-up bacterial culture (1 to 118 days after cessation of therapy) was negative in 10 (77%) treated dogs; a negative follow-up culture was not associated with gender, age or duration of treatment. Bacteriuria persisted in three treated dogs and the one untreated dog. The prevalence of positive bacterial urinary culture in dogs with hypercortisolism was lower than previously reported. In the majority of dogs, bacteriuria was subclinical. Most dogs had a negative bacterial culture result after antimicrobial treatment; however, more resistant bacteria were detected in persistently positive urine. Hund mit Hyperkortisolismus neigen dazu eine Bakteriurie zu entwickeln, die entweder mit oder ohne klinische Anzeichen einer Blasenentzündung verbunden sein kann. Nach den aktuellen Behandlungsempfehlungen sollten Hunde mit subklinischer Bakteriurie nicht mit Antibiotika therapiert werden, da es keine Hinweise auf eine Verbesserung des Therapieerfolges gibt und unnötige Behandlungen vermieden werden sollten. Bevor diese Richtlinien im Jahr 2019 veröffentlicht wurden, wurden Hunde mit Hyperkortisolismus und Bakteriurie unabhängig von den klinischen Symptomen standardmässig mit Antibiotika behandelt. Daten zur Häufigkeit von bakteriellen Blasenentzündungen, subklinischer Bakteriurie und zum Ergebnis einer antimikrobiellen Behandlung bei Hunden mit Hyperkortisolismus liegen nur spärlich vor. Ziel dieser Studie war es, Hunde mit Hyperkortisolismus auf das Vorhandensein einer bakteriellen Blasenentzündung und subklinischen Bakteriurie zu untersuchen, die beteiligten Krankh...

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AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine

Cited by 7 publications

References 11 publications

Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea

Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea

Antimicrobial prescriptions in cats in Switzerland before and after the introduction of an online antimicrobial stewardship tool

Urinary tract infections in dogs with spontaneous hypercortisolism – frequency, symptoms and involved pathogens

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