Quantifying Antimicrobial Use in Dutch Companion Animals

Abstract

Antimicrobial resistance (AMR) is an increasing threat, both in human and in veterinary medicine. To reduce the selection and spread of AMR, antimicrobial use (AMU) should be optimized, also in companion animals. To be able to optimize AMU, a feasible method to quantify AMU and information on current AMU are needed. Therefore, a method to quantify AMU was developed, using the number of Defined Daily Doses Animal (DDDA). This method was used to explore applied antimicrobial classes and to identify differences in prescribing patterns in time and between veterinary clinics. Antimicrobial procurement data of the years 2012-2014 were collected retrospectively from 100 Dutch veterinary clinics providing care for companion animals. The mean number of DDDAs per clinic per year decreased significantly from 2012 to 2014. A shift in used classes of antimicrobials (AMs) was seen as well, with a significant decrease in use of third choice AMs (i.e., fluoroquinolones and third generation cephalosporins). Large differences in total AMU were seen between clinics ranging from 64-fold in 2012 to 20-fold in 2014. Despite the relative low and decreasing AMU in Dutch companion animal clinics during the study, the substantial differences in antimicrobial prescribing practices between clinics suggest that there is still room for quantitative and qualitative optimization of AMU.

Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries

“…Therefore, comparisons of AMU and AMR levels between countries and species should be interpreted while keeping in mind the restrictions of this small sample size. Nevertheless, the results did show similar trends with previous studies [25,26,28,[45][46][47][48] and enabled the identification of some significant differences, although some might be missed due to a lack of power. A recent Dutch study reported on the many different factors influencing the antimicrobial prescribing behavior of veterinarians [52].…”

“…A study in the UK, using data from 374 veterinary practices, reported similar proportions of CIAs usage, 60% in dogs and 81% in cats [49]. The most frequently used antimicrobial agent and CIA for dogs and cats was amoxicillin-clavulanate, which corresponds to previous research [26][27][28]50,51].…”

“…More specifically, 36% of the total number of treatments was represented by CIAs of high priority, the other 35% were CIAs of the highest priority. Comparable results are highlighted in other studies investigating AMU in companion animals [25,26,28,[45][46][47][48]. A study in the UK, using data from 374 veterinary practices, reported similar proportions of CIAs usage, 60% in dogs and 81% in cats [49].…”

“…The weight of the animals was not specified in the questionnaires and therefore a standard weight was used. The same weights have been used in a recent Dutch study [28] and are based on a survey using over 40,000 dogs and 13,000 cats to calculate the mean weight of both species [64]. The biggest limitation of the collected data lies in the small sample size analyzed in our study, which makes extrapolation of the results to a national level challenging.…”

Low occurrence of extended-spectrum cephalosporinase producing Enterobacteriaceae and no detection of methicillin-resistant coagulase-positive staphylococci in healthy dogs in Sweden

“…One potential explanation for the difference might be that use of extended spectrum cephalosporins (ESCs) is very limited in Sweden, while in the Netherlands, ESCs, i.e. cefovecin, was frequently used for companion animals [10,16]. The low usage in Sweden is partly due to a regulation implemented in 2013 which limits the veterinarians' right to prescribe ESCs, stating that these can only be used if alternative choices cannot be expected to be successful (The Swedish Board of Agricultures regulations on drugs and drug usages (In Swedish), SJVFS 2013:42, https ://www.jordb ruksv erket .se).…”