Use of cefovecin in a UK population of cats attending first-opinion practices as recorded in electronic health records

Abstract

Objectives The objective was to use electronic health records to describe the use of cefovecin (Convenia; Zoetis UK), a third-generation long-acting injectable antimicrobial, in a UK population of cats attending first-opinion practices, and to compare the use of Convenia with the licensed uses described on the UK Convenia datasheet. Methods Data were obtained as an Excel database from the Small Animal Veterinary Surveillance Network for all feline consultations containing the word Convenia and/or cefovecin from 1 September 2012 to 23 September 2013 inclusive. Entries were classified according to body system treated, confirmation or suspicion of an abscess, evidence of microbiological evaluation being performed, any concurrent therapies given and whether any reason was given for use of Convenia over alternative antimicrobials. Data were exported to IBM SPSS Statistics and descriptive analysis performed. Results In total, 1148 entries were analysed. The most common body system treated was skin in 553 (48.2%) entries, then urinary (n = 157; 13.7%) and respiratory (n = 112; 9.8%). Microbiological evaluation was recorded in 193 (16.8%) entries, with visible purulent material most commonly cited (in 147 [12.8%] entries). A reason for prescribing Convenia over alternative antimicrobials was given in 138 (12.0%) entries; the most cited was an inability to orally medicate the cat in 77 (55.8%) of these entries. Excluding 131 entries where no body system or multiple body systems were described, the use of Convenia complied with a licensed use in the UK datasheet in 710 (69.8%) of 1017 entries. Conclusions and relevance Most administrations were licensed uses; however, most entries did not describe any microbiological evaluation, or a reason for prescribing Convenia over alternative antimicrobials. Further education of the public and the veterinary profession is needed to promote antimicrobial stewardship in the UK. Health records provide a valuable tool with which to monitor, both locally and at scale, the use of important therapeutics like antimicrobials. Information relevant to decision-making should be recorded in individual animal health records.

Patterns of antimicrobial agent prescription in a sentinel population of canine and feline veterinary practices in the United Kingdom

“…Such differences may reflect an increased prevalence of pruritus (and other dermatological diseases) in dogs compared to cats (Sánchez-Vizcaíno et al, 2016). They may also reflect the challenge of giving oral and topical medication to cats when compared to injectable antimicrobial agents (Burke et al, 2016). …”

“…This suggests that there has been a recent shift in choice of antimicrobial agents for cats. Prescription of cefovecin was common for MPCs associated with authorised indications for use, such as pruritus and kidney disease17 (Burke et al, 2016). However, cefovecin was also prescribed frequently in MPCs, such as respiratory and gastroenteric disease in cats, where there was no apparent indication for prescription by the datasheet1 or practice prescribing policy 18 , 19.…”

“…It is also possible that relying on MPCs as declared by veterinary practitioners might fail to include other clinical conditions found during the same consultation. Collection and analysis of clinical free text present an opportunity to characterise each consultation based on clinical signs and duration, which would provide further information to support the rationale for any given prescription (Burke et al, 2016). …”

“…In our study, it was not possible to determine to what extent the use of cefovecin is in compliance with these recommendations. A recent study showed that veterinary surgeons prescribing cefovecin rarely justified its use within the clinical narrative (Burke et al, 2016). Relative ease of administration and duration of action, together aiding compliance, may be important motivating factors for the use of cefovecin in veterinary practice.…”

Antimicrobial Prescribing in Dogs and Cats in Australia: Results of the Australasian Infectious Disease Advisory Panel Survey

“…Further, survey findings highlight the need for LUTI in cats to be confirmed by in‐house microscopic evaluation of a urine sample before initiating antimicrobial therapy due to the high prevalence of noninfectious cystitis in cats . The reported high usage of 3rd‐generation cephalosporins in cats likely reflects poor compliance in administration of oral drugs to cats compared to dogs, as cats are less likely to ingest medications in food, as has been found in a recent study from the United Kingdom …”