Survey of veterinary antimicrobial prescribing practices, Washington State 2015

Abstract

Antimicrobial resistance is a growing global health issue. It is also a recognised problem in veterinary medicine. Between September and December 2015 the authors administered a cross-sectional survey to licensed veterinarians in Washington State to assess factors affecting antimicrobial prescribing practices among veterinarians in Washington State. Two hundred and three veterinarians completed the survey. The majority of respondents (166, 82 per cent) were engaged in small animal or exotic animal practice. 24 per cent of respondents reported not ordering culture and sensitivity (C/S) testing in practice. Of the 76 per cent of veterinarians who reported ordering C/S tests, 36 per cent reported ordering such testing 'often' or 'always' when treating presumptive bacterial infections. Most respondents (65 per cent) mentioned cost as the most common barrier to ordering a C/S test. Only 16 (10 per cent) respondents reported having access to or utilising a clinic-specific antibiogram. This survey demonstrated that while antimicrobials are commonly used in veterinary practice, and veterinarians are concerned about antimicrobial resistance, cost is a barrier to obtaining C/S tests to guide antimicrobial therapy. Summaries of antimicrobial resistance patterns are rarely available to the practising veterinarian. Efforts to promote antimicrobial stewardship in a 'One Health' manner should address barriers to the judicious use of antimicrobials in the veterinary practice setting.

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

“…the north western United States cost of culture and sensitivity was a commonly listed barrier (43). The antimicrobial use guidelines for UTI were recently updated (17) and incorporate a change in the recommended duration of antimicrobial therapy to 3-5 days rather than 7-10 days previously suggested.…”

Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK

“…Mateus et al (2014) [8] also highlighted factors related to diagnostic use as important influences on decision-making in antibiotic prescribing. Studies have shown that the rate of use of laboratory tests to support prescribing decisions can be very low [14–16]. Eschler and colleagues (2011) [14] found that only 3.7% cases of fluoroquinalone prescriptions for companion animals were supported with laboratory testing; and only around half of the respondents in Hughes and colleagues (2012) [15] survey of antimicrobial prescribing patterns in small animal practice identified laboratory tests to be an important influence on their antimicrobial decision-making.…”

Comparison of immediate versus delayed streak plate inoculation on urine bacterial culture and susceptibility testing in dogs and cats

“…Urinary tract disease is a common indication for antimicrobial prescribing in small animal veterinary practices. However, given the cost of QBC and financial limitations of owners, urinary tract infection (UTI) diagnoses are inconsistently confirmed . Routine use of QBC and susceptibility testing in dogs and cats with suspected UTIs supports antimicrobial stewardship by guiding effective treatment and allowing veterinarians to monitor for antimicrobial resistance.…”

“…Quantitative bacterial culture (QBC) and susceptibility testing with concurrent urinalysis are the gold standard for diagnosing infection and selecting treatment. Cost is the most common barrier cited by veterinarians to performing QBC . When a urine QBC is recommended, veterinarians and owners should have assurance of the reliability and diagnostic utility of the test.…”

“…Cost is the most common barrier cited by veterinarians to performing QBC. 4 When a urine QBC is recommended, veterinarians and owners should have assurance of the reliability and diagnostic utility of the test. Studies evaluating the impact of a delay in urine culture processing have been primarily performed in institutions with on-site bacteriology laboratories.…”