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Robb AR, Ure R, Chaput DL, Foster G. Emergence of novel methicillin resistant Staphylococcus pseudintermedius lineages revealed by whole genome sequencing of isolates from companion animals and humans in Scotland. PLoS One 2024; 19:e0305211. [PMID: 38968222 PMCID: PMC11226068 DOI: 10.1371/journal.pone.0305211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 05/24/2024] [Indexed: 07/07/2024] Open
Abstract
Staphylococcus pseudintermedius is an opportunistic pathogen in dogs, and infection in humans is increasingly found, often linked to contact with dogs. We conducted a retrospective genotyping and antimicrobial susceptibility testing study of 406 S. pseudintermedius isolates cultured from animals (dogs, cats and an otter) and humans across Scotland, from 2007 to 2020. Seventy-five sequence types (STs) were identified, among the 130 isolates genotyped, with 59 seen only once. We observed the emergence of two methicillin resistant Staphylococcus pseudintermedius (MRSP) clones in Scotland: ST726, a novel locally-evolving clone, and ST551, first reported in 2015 in Poland, possibly linked to animal importation to Scotland from Central Europe. While ST71 was the most frequent S. pseudintermedius strain detected, other lineages that have been replacing ST71 in other countries, in addition to ST551, were detected. Multidrug resistance (MDR) was detected in 96.4% of MRSP and 8.4% of MSSP. A single MRSP isolate was resistant to mupirocin. Continuous surveillance for the emergence and dissemination of novel MDR MRSP in animals and humans and changes in antimicrobial susceptibility in S. pseudintermedius is warranted to minimise the threat to animal and human health.
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Affiliation(s)
- Andrew R. Robb
- Scottish Microbiology Reference Laboratories, Glasgow, United Kingdom
| | - Roisin Ure
- Scottish Microbiology Reference Laboratories, Glasgow, United Kingdom
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2
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Mack C, Gibson JS, Meler E, Woldeyohannes S, Yuen N, Herndon A. Antimicrobial susceptibility patterns of aerobic bacteria isolated from canine urinary samples in South East Queensland, 2013 to 2018. Aust Vet J 2024; 102:362-368. [PMID: 38654674 DOI: 10.1111/avj.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/10/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Urinary tract infections are a common diagnosis in dogs presenting to veterinary practice. Veterinarians often treat suspected infections empirically, either in the absence of culture and susceptibility testing results or whilst waiting for them. This study aimed to identify the bacteria most frequently isolated from canine urinary samples and their antimicrobial susceptibility patterns in South East Queensland (SEQ) to help guide responsible empirical antimicrobial prescription by the veterinary community in this geographical location. Cumulative antibiograms were generated from the results of 1284 culture-positive urinary samples in SEQ, obtained from a commercial veterinary laboratory over a 5-year period. Escherichia coli was the most commonly isolated bacterial species (43%), followed by Staphylococcus spp. (23%), Proteus spp. (21%) and Enterococcus spp. (10%). Of the six most common isolates, 97% had susceptibility to at least one low-importance antimicrobial. Susceptibility to the low-importance and first-line antimicrobial recommendation, amoxicillin, was 81% for E. coli and 24% for Staphylococcus spp. Susceptibility of both E. coli and Staphylococcus spp. to medium-importance and commonly recommended empirical antimicrobials, trimethoprim sulphonamides and amoxicillin-clavulanic acid was ≥85% and >92% for high-importance antimicrobials enrofloxacin and ceftiofur. Of the E. coli and Staphylococcus spp. isolates, 8.8% and 4%, respectively, were considered multidrug resistant. There was no increase in resistance to antimicrobials detected over the study period. Susceptibilities suggest low- and medium-importance antimicrobials remain acceptable first-line empirical treatments. However, this should be continually assessed and updated using local surveillance data.
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Affiliation(s)
- C Mack
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - J S Gibson
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - E Meler
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - S Woldeyohannes
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - N Yuen
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
| | - A Herndon
- School of Veterinary Science, University of Queensland, Gatton, Queensland, Australia
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Robbins SN, Goggs R, Kraus‐Malett S, Goodman L. Effect of institutional antimicrobial stewardship guidelines on prescription of critically important antimicrobials for dogs and cats. J Vet Intern Med 2024; 38:1706-1717. [PMID: 38465850 PMCID: PMC11099728 DOI: 10.1111/jvim.17043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Veterinary hospital antimicrobial stewardship (AMS) guidelines might help combat antimicrobial resistance (AMR). OBJECTIVES Determine the conditions and types of infection for which antimicrobial drugs (AMDs) deemed critically important (CIA) by the World Health Organization (WHO) were prescribed and assess the effect of hospital AMS guidelines on adherence to International Society for Companion Animal Infectious Diseases published guidelines for the treatment of superficial bacterial folliculitis, respiratory tract disease and urinary tract infection in these cases. ANIMALS Dogs and cats managed at an academic veterinary hospital from 1/21 to 6/21 and 9/21 to 6/22. METHODS Prescriptions of cephalosporins (third or fourth generation), glycopeptides, macrolides/ketolides, polymyxins, and quinolones were identified. Data on culture and susceptibility (C/S) testing and previous AMD exposure were collected. Frequencies were compared between time periods using Fisher's exact test with Bonferroni corrections. RESULTS In animals prescribed ≥1 WHO-CIA AMD, fluoroquinolones were the most frequently prescribed WHO-CIA class in dogs (567/1724, 32.9%) and cats (192/450, 42.7%). No animals were prescribed carbapenems, dihydrofolate reductase inhibitors/sulfonamides, or polymyxins. No cats were prescribed aminoglycosides or amphenicols. Institutional guidelines were followed in 57.8% (324/561) cases. The most frequent causes of nonadherence were failure to perform C/S testing 46.0% (109/237) and unnecessary use of a higher-tier AMD 43.0% (102/237). Bacterial C/S testing was more frequently performed after AMS guideline institution (59.7% vs. 46.8%, P = 0.0006). CONCLUSIONS AND CLINICAL IMPORTANCE Adherence to published guidelines remained poor despite an increase in C/S testing. There were no changes in the frequencies of confirmed infections, positive cultures or AMD resistance between time periods.
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Affiliation(s)
- Sarah N. Robbins
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
| | - Robert Goggs
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
| | | | - Laura Goodman
- College of Veterinary MedicineCornell UniversityIthacaNew YorkUSA
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4
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Bacci S, Meucci V, Sgorbini M, De Marchi L, Pirone A, Pretti C, Tognetti R, Intorre L. Pattern of prescriptions and prudent use of antimicrobial in horse practice at a Veterinary Teaching Hospital. Res Vet Sci 2024; 168:105140. [PMID: 38190777 DOI: 10.1016/j.rvsc.2024.105140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/18/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
Antimicrobial prescriptions of the University of Pisa and their compliance with prudent use recommendations were investigated over 11 years (2011-2021). At least one antimicrobial was always prescribed in surgical prophylaxis for the suture of wounds and in 33% of horses with signs of disease of a body system. Antimicrobials were administered in monotherapy (48%) in fixed dose combinations (21%) and empirical combinations (31%). Antimicrobials were mostly (63%) administered by parenteral route, while oral and topical antimicrobials accounted for 14% and 23% of prescriptions, respectively. Gentamicin, benzylpenicillin and ceftiofur were the most prescribed antimicrobials; aminoglycosides, penicillins and cephalosporins were the most common class of antimicrobial prescribed. Protected antimicrobials (WHO HPCIA and rifampicin) represented 24% of antimicrobial dispensations. The pattern of classes of antimicrobial used by body system was broad and included up to eight different pharmaceutical classes. The heterogeneity of antimicrobial use was confirmed by the estimate of the prescription diversity index. Antimicrobial prescriptions were in compliance with prudent use recommendations in terms of availability of diagnosis, respect of the dose range and duration of treatment On the contrary, principles of appropriate antimicrobial use have only been partially observed in relation to off-label use, use of antimicrobials in empirical combination, use of antimicrobial susceptibility tests and use of protected antimicrobials, suggesting that additional interventions are required to improve the responsible use of antimicrobials use in our equine practice.
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Affiliation(s)
- Samanta Bacci
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Valentina Meucci
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy.
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Lucia De Marchi
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Andrea Pirone
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Carlo Pretti
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Rosalba Tognetti
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
| | - Luigi Intorre
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge, 2, Italy
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De Marchi L, Vernaccini M, Meucci V, Briganti A, Lippi I, Marchetti V, Intorre L. Six-Year Prescription Pattern of Antimicrobial Use in Cats at the Veterinary Teaching Hospital of the University of Pisa. Animals (Basel) 2024; 14:521. [PMID: 38338164 PMCID: PMC10854698 DOI: 10.3390/ani14030521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
The use of antimicrobials has greatly contributed to improving animal health. However, their inappropriate use reduces their effectiveness in treating bacterial infections and contributes to the selection of resistance. This study aimed to retrospectively evaluate the six-year pattern (2017-2022) of antimicrobial use in cats visiting the Veterinary Teaching Hospital (VTH) of the University of Pisa (Italy). The total number of prescribed antimicrobials, the number of animals for which an antimicrobial was prescribed, and the total number of antimicrobial prescriptions showed a significant time trend decrease during the study period, except for the fixed-dose combinations. The most frequently prescribed antimicrobials were amoxicillin-clavulanic acid (Synulox) (39.1%) followed by enrofloxacin (29.8%). These antimicrobials were mostly prescribed to treat infections affecting the genitourinary tract (~30%), followed by the gastrointestinal tract, skin, and respiratory system affections. Antimicrobials in empirical associations represented 13.0% of the total antimicrobial prescriptions, and the combination of amoxicillin-clavulanic acid (Synulox) with enrofloxacin accounted for the majority. The oral route represented the main route of administration of prescribed antimicrobials, followed by parenteral and topical ones. Amoxicillin-clavulanic acid (Synulox) (37.2%), ceftriaxone (2.7%), and tobramycin (2.8%) were the most prescribed antimicrobials for the oral, parenteral, and topical routes, respectively. Antimicrobial prescriptions complied with prudent use recommendations in terms of availability of diagnosis, respect to the dose range, duration of treatment, and the use of medicinal products approved for the species. On the contrary, antimicrobial susceptibility tests were used infrequently (5.2%), lacking compliance with the existing guidelines observed in companion animal practice. Overall, additional interventions are required not only to improve the responsible use of antimicrobials in our feline practice but also to implement antimicrobial stewardship programs, enhancing diagnostics such as culture and sensitivity testing in the future.
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Affiliation(s)
| | | | - Valentina Meucci
- Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (L.D.M.); (M.V.); (A.B.); (I.L.); (V.M.); (L.I.)
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Romero B, Susperregui J, Sahagún AM, Fernández N, López C, de la Puente R, Altónaga JR, Díez R. Drug prescription pattern in exotic pet and wildlife animal practice: a retrospective study in a Spanish veterinary teaching hospital from 2018 to 2022. Front Vet Sci 2024; 10:1328698. [PMID: 38260200 PMCID: PMC10800385 DOI: 10.3389/fvets.2023.1328698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Exotic companion animals have had an important role in our society since ancient times. Preserving animal health is necessary to do a responsible use of veterinary medicines. This study aimed to describe the prescription patterns of drugs in exotic pets and wildlife animals attending the Veterinary Teaching Hospital of the University of León (HVULE). A retrospective study was carried out between 2018 and 2022. Birds were the largest group of exotic animals attending the HVULE. Visits were related to emergency reasons and for musculoskeletal disorders. One-third of the animals were eventually euthanised. Regarding pharmacological treatments, the most frequently active ingredients used were pentobarbital, isoflurane, meloxicam, and within antibiotics, marbofloxacin (category B in the classification of European Medicines Agency).
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Affiliation(s)
- Beatriz Romero
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Julen Susperregui
- Applied Mathematics, Department of Mathematics, University of León, León, Spain
| | - Ana M. Sahagún
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Nélida Fernández
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Cristina López
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Raúl de la Puente
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - José R. Altónaga
- Department of Veterinary Medicine, Surgery and Anatomy, Director of the Veterinary Teaching Hospital of the University of León (HVULE), University of León, León, Spain
| | - Raquel Díez
- Department of Biomedical Sciences, Veterinary Faculty, Institute of Biomedicine (IBIOMED), University of León, León, Spain
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Adebowale OO, Jimoh AB, Adebayo OO, Alamu AA, Adeleye AI, Fasanmi OG, Olasoju M, Olagunju PO, Fasina FO. Evaluation of antimicrobial usage in companion animals at a Veterinary Teaching Hospital in Nigeria. Sci Rep 2023; 13:18195. [PMID: 37875528 PMCID: PMC10598005 DOI: 10.1038/s41598-023-44485-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023] Open
Abstract
This study investigated various qualitative and quantitative indices of antimicrobial use (AMU) in companion animals (CAs) at a Veterinary Teaching Hospital (VTH-A) and its annex (VTH- B) from 2019 to 2021. For 694 documented animals, antimicrobial administrations (AADs) were 5, 278 times, of which 98.8% (5217) and 1.2% (61) were in dogs and cats respectively. At the VTH- A, oxytetracycline (1185 times, 22.5%) was mostly administered in dogs and metronidazole (26 times, 0.5%) in cats. Similarly, at VTH- B, oxytetracycline was administered 895 times (17.0%) in dogs while amoxicillin was given 7 times (0.1%) in cats. The prescription diversity (PD) was estimated at 0.73 and 0.82 in VTH-A and VTH-B respectively. The quantity of antimicrobials (AMs) used was 10.1 kg (A, 6.2 kg and B, 3.9 kg). Oxytetracycline administrations and quantity of metronidazole (P < 0.0001) were higher than other Active Ingredients (AIs). Furthermore, 16.5% of AIs were classified as Critically Important Antibiotics (CIA) with the highest priority, while enrofloxacin, ciprofloxacin, and azithromycin fell under the World Health Organisation (WHO) Watch group. The In-Depth Interview (IDI) indicated that the high frequency of oxytetracycline administrations was linked with being the first choice for blood parasite treatment by the clinicians at the hospital. The quantity of metronidazole used was perceived to be higher due to the clinicians' preference for the treatment of acute gastroenteritis, its wider dose range, and the frequency of administration (bi-daily). The study provides baseline data on AMU indices in CAs, for the development of antimicrobial stewardship (AMS) and communication training, and policy modifications to enhance antimicrobial therapy optimization in tertiary veterinary hospital care in Nigeria.
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Affiliation(s)
- O O Adebowale
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria.
| | - A B Jimoh
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - O O Adebayo
- Veterinary Teaching Hospital, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - A A Alamu
- Department of Veterinary Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - A I Adeleye
- Veterinary Teaching Hospital, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - O G Fasanmi
- Department of Veterinary Laboratory Technology, Federal College of Animal Health and Production Technology, Ibadan, Oyo State, Nigeria
| | - M Olasoju
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - P O Olagunju
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Abeokuta, Abeokuta, Ogun State, Nigeria
| | - F O Fasina
- ECTAD, Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
- Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa
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Foglia Manzillo V, Peruzy MF, Gizzarelli M, Izzo B, Sarnelli P, Carrella A, Vinciguerra G, Chirollo C, Ben Fayala NEH, Balestrino I, Oliva G. Examining the Veterinary Electronic Antimicrobial Prescriptions for Dogs and Cats in the Campania Region, Italy: Corrective Strategies Are Imperative. Animals (Basel) 2023; 13:2869. [PMID: 37760269 PMCID: PMC10525136 DOI: 10.3390/ani13182869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Companion animals are increasingly being recognised as important contributors to the spread of antimicrobial-resistant bacteria. The present work aimed to measure the antimicrobial drug prescribing in dogs and cats in the Campania Region, Italy by analysing the Veterinary Electronic Prescriptions (VEPs) between 2019 and 2020. The medical records associated with antimicrobial drug prescriptions were collected according to the drug administration (systemic or topical) and the rationale for the treatment chosen. In the period under investigation, 166,879 drugs were prescribed of which 129,116 (73.4%) were antimicrobial. A total of 83,965 (65%) antibiotics were prescribed to dogs, 40,477 (31.4%) to cats, and 4674 (3.6%) to other companion animals. In dogs, 90.5% of VEPs prescribed for systemic treatment included an antimicrobial Critically Important or Highly Important or Important for human medicine (WHO, 2018). The most widely prescribed class was fluoroquinolones. The antimicrobials prescribed were mainly metronidazole-spiramycin (29.7%), amoxicillin-clavulanic (19.6%), enrofloxacin and cephalexin in dogs (16.5%) and enrofloxacin (22.6%) and amoxicillin-clavulanic acid (21.4%) in cats. Based on the results, the widespread use of broad-spectrum antimicrobials and the use of molecules for which limitations should be observed according to the EMA guidelines has emerged.
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Affiliation(s)
- Valentina Foglia Manzillo
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Maria Francesca Peruzy
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Manuela Gizzarelli
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Berardino Izzo
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Paolo Sarnelli
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Antonio Carrella
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Giuseppina Vinciguerra
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Claudia Chirollo
- Veterinary Pharmacovigilance Center of Campania Region, 80137 Naples, Italy; (B.I.); (P.S.); (A.C.); (G.V.); (C.C.)
| | - Nour El Houda Ben Fayala
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Ines Balestrino
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
| | - Gaetano Oliva
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, 80137 Naples, Italy; (V.F.M.); (M.F.P.); (M.G.); (N.E.H.B.F.); (G.O.)
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Otero Balda I, Fuertes-Recuero M, Penelo Hidalgo S, Espinel Rupérez J, Lapostolle B, Ayllón-Santiago T, Ortiz-Díez G. A Spanish Survey on the Perioperative Use of Antimicrobials in Small Animals. Animals (Basel) 2023; 13:2475. [PMID: 37570284 PMCID: PMC10417378 DOI: 10.3390/ani13152475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Appropriate use of perioperative antimicrobials can significantly reduce the risk of post-operative infections. However, inappropriate antimicrobial use can result in the creation of multidrug-resistant bacteria, increased costs, host flora disruption, side effects and increased risk of hospital-acquired infections. This survey evaluated the current perioperative use of antimicrobials in small animals by Spanish veterinarians using a web-based questionnaire. Responses were represented using descriptive statistics and a statistical analysis of the association between demographic data and perioperative antimicrobial use was performed. Pre-operative antimicrobials were administered in clean surgery by up to 68.3% of participants, 81.0% in clean-contaminated surgery and 71.3% in dirty surgery, while in the post-operative period, antimicrobials were administered by up to 86.3% of participants in clean surgery, 93.2% in clean-contaminated surgery and 87.5% in dirty surgery. Factors considered "very important" for antimicrobial selection were the degree of wound contamination, patient immunosuppression and use of prosthesis. The most frequently used antimicrobial was beta-lactamase-resistant (or potentiated) penicillin. Post-operative antimicrobial use was associated with participants without specific surgical postgraduate training. This study highlights an overuse of antimicrobials in perioperative procedures in small animal surgery in Spain. Therefore, evidence-based guidelines and further education regarding the correct use of antimicrobial prophylaxis are recommended.
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Affiliation(s)
- Ignacio Otero Balda
- Department of Small Animal Surgery, Section of Small Animal Clinical Studies, University College Dublin, D04 W6F6 Dublin, Ireland;
| | - Manuel Fuertes-Recuero
- Department of Physiology, College of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Silvia Penelo Hidalgo
- Hospitalization, Emergencies and Critical Care Service, Veterinary Teaching Hospital, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Benoit Lapostolle
- Veterinary Teaching Hospital, College of Veterinary Medicine, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - Tania Ayllón-Santiago
- Veterinary Teaching Hospital, College of Veterinary Medicine, Alfonso X el Sabio University, 28691 Madrid, Spain;
- Department of Genetics, Physiology and Microbiology, Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain
| | - Gustavo Ortiz-Díez
- Department of Animal Medicine and Surgery, College of Veterinary Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
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Caneschi A, Bardhi A, Barbarossa A, Zaghini A. The Use of Antibiotics and Antimicrobial Resistance in Veterinary Medicine, a Complex Phenomenon: A Narrative Review. Antibiotics (Basel) 2023; 12:antibiotics12030487. [PMID: 36978354 PMCID: PMC10044628 DOI: 10.3390/antibiotics12030487] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
As warned by Sir Alexander Fleming in his Nobel Prize address: “the use of antimicrobials can, and will, lead to resistance”. Antimicrobial resistance (AMR) has recently increased due to the overuse and misuse of antibiotics, and their use in animals (food-producing and companion) has also resulted in the selection and transmission of resistant bacteria. The epidemiology of resistance is complex, and factors other than the overall quantity of antibiotics consumed may influence it. Nowadays, AMR has a serious impact on society, both economically and in terms of healthcare. This narrative review aimed to provide a scenario of the state of the AMR phenomenon in veterinary medicine related to the use of antibiotics in different animal species; the impact that it can have on animals, as well as humans and the environment, was considered. Providing some particular instances, the authors tried to explain the vastness of the phenomenon of AMR in veterinary medicine due to many and diverse aspects that cannot always be controlled. The veterinarian is the main reference point here and has a high responsibility towards the human–animal–environment triad. Sharing such a burden with human medicine and cooperating together for the same purpose (fighting and containing AMR) represents an effective example of the application of the One Health approach.
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Affiliation(s)
| | - Anisa Bardhi
- Correspondence: (A.B.); (A.B.); Tel.: +39-051-2097-500 (Andrea Barbarossa)
| | - Andrea Barbarossa
- Correspondence: (A.B.); (A.B.); Tel.: +39-051-2097-500 (Andrea Barbarossa)
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Glavind AS, Kruse AB, Nielsen LR, Stege H. Monitoring antimicrobial usage in companion animals: exploring the use of the Danish VetStat database. Acta Vet Scand 2022; 64:27. [PMID: 36253805 PMCID: PMC9575193 DOI: 10.1186/s13028-022-00647-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the Danish Veterinary Statistics Program, VetStat, sales data on medicinal products prescribed for veterinary consumption is collected. The Danish Food and Veterinary Administration (DVFA) manages the database and each purchase contains detailed product-specific information linked with a species-specific ID. National surveillance systems are also implemented or being developed in the other European Union Member States. By 2029, all Member States are required to report data on antimicrobial usage for companion animals to the European Medicines Agency. This study aimed to assess the challenges encountered when using the VetStat database to quantify antimicrobial use in Danish companion animals. Raw VetStat data were propagated by the DVFA and originated from veterinary practitioners and Danish pharmacies. RESULTS Comprehensive estimates of antimicrobial use in Danish companion animals were not readily available due to database construct. Antimicrobials sold for use in companion animals (linked to a companion animal ID) comprised a large number of products licensed solely for horses or livestock, while data assigned a replacement code encompassed both topical and peroral antimicrobials licensed for companion animals. Additionally, antimicrobials sold from pharmacies to veterinary practitioners presented the biggest challenge in data retrieval and validation. Treatment data are only transferred to VetStat through the billing systems when Danish veterinarians are treating livestock, but not companion animals. Information on products sold for in-house use in companion animals is only available from pharmacy records without a species-specific ID. As a result, parenteral antimicrobials with multi-species authorization utilized by small animal veterinary practitioners are not accounted for in the overall estimate for companion animals. CONCLUSIONS Owing to the database structure and requirements for data entry, antimicrobial use in companion animals is an approximation. The actual consumption may be significantly higher than what is currently calculated from the database, as the majority of parenteral products are not included. Consumption data can be measured more accurately provided treatment data from veterinary practitioners in small or mixed practices are transferred to the database through the billing system. This would equal the legal requirements for Danish veterinary practitioners treating livestock.
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Affiliation(s)
- Anne-Sofie Glavind
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark.
| | - Amanda Brinch Kruse
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
| | - Liza Rosenbaum Nielsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
| | - Helle Stege
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 3, 1870, Frederiksberg C, Denmark
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Moerer M, Merle R, Bäumer W. A Cross-Sectional Study of Veterinarians in Germany on the Impact of the TÄHAV Amendment 2018 on Antimicrobial Use and Development of Antimicrobial Resistance in Dogs and Cats. Antibiotics (Basel) 2022; 11:484. [PMID: 35453235 PMCID: PMC9028039 DOI: 10.3390/antibiotics11040484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 12/10/2022] Open
Abstract
To minimize the use of third- and fourth-generation cephalosporins and fluoroquinolones, the 2018 amendment to the regulations of veterinary pharmacies (TÄHAV) introduced legal restrictions in Germany. In an online survey among German veterinarians, we investigated the influence of these requirements on the use of antibiotics in the treatment of dogs and cats and the development of resistance rates. It was found that, on average, between 21% and 30% of daily treated dogs and cats received antimicrobial therapy. The TÄHAV amendment led to a less frequent use of highest priority critically important antimicrobials (HPCIA) in 79% (240/303) of respondents and less antimicrobial use in general in 36% (108/303). As a result of these legal changes, 63% (190/303) of participants requested antimicrobial susceptibility testing (AST) more frequently. Participants consulted ASTs particularly frequently for treatment of otitis externa with 63% (190/303), cystitis with 55% (168/303), wounds with 44% (132/303), and pyoderma with 29% (88/303). Veterinarians also noted an increased loss of antimicrobial efficacy, especially when treating these diseases. The results of our survey confirm that the TÄHAV amendment is having a positive impact on prudent antibiotic use, with participants performing more ASTs, using HPCIA less frequently, and choosing alternative antimicrobials for therapy.
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Affiliation(s)
- Marianne Moerer
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany;
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, Department of Veterinary Medicine, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany;
| | - Wolfgang Bäumer
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Koserstraße 20, 14195 Berlin, Germany;
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13
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Schirò G, Gambino D, Mira F, Vitale M, Guercio A, Purpari G, Antoci F, Licitra F, Chiaramonte G, La Giglia M, Randazzo V, Vicari D. Antimicrobial Resistance (AMR) of Bacteria Isolated from Dogs with Canine Parvovirus (CPV) Infection: The Need for a Rational Use of Antibiotics in Companion Animal Health. Antibiotics (Basel) 2022; 11:antibiotics11020142. [PMID: 35203745 PMCID: PMC8868125 DOI: 10.3390/antibiotics11020142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
Canine parvovirus type 2 (CPV-2) represents a major viral threat to dogs. Considering the potential effects of pets on antimicrobial resistance, information on the CPV and associated bacterial co-infections is limited. The aim of this study was to analyze the antimicrobial susceptibility and multidrug-resistance profiles of bacterial species from tissue samples of dogs with canine parvovirus infection. A set of PCR assays and sequence analyses was used for the detection and the molecular characterization of the CPV strains and other enteric viruses. Bacterial isolation, the determination of antimicrobial susceptibility via the disk diffusion method, and the determination of the minimum inhibitory concentration were performed. The detection of β-lactamase genes and toxin genes for specific bacteria was also carried out. CPV infection was confirmed in 23 dogs. Forty-three bacterial strains were isolated and all showed phenotypic resistance. Seventeen multidrug-resistant bacteria and bacteria with high resistance to third- and fourth-generation cephalosporins and metronidazole were detected. Almost 50% of the isolated Enterobacteriaceae were positive for at least one β-lactamase gene, with the majority carrying more genes as well. The evidence for multi-resistant bacteria with the potential for intra- or cross-species transmission should be further considered in a One Health approach.
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Use of Antimicrobials in a French Veterinary Teaching Hospital: A Retrospective Study. Antibiotics (Basel) 2021; 10:antibiotics10111369. [PMID: 34827307 PMCID: PMC8615259 DOI: 10.3390/antibiotics10111369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/27/2021] [Indexed: 12/20/2022] Open
Abstract
Antibiotic resistance has become a major concern for not only human health, but also for animal health. To preserve the efficacy of antibiotics, it has become essential to establish measures to regulate the prescription of antibiotics to ensure their prudent use. In France, these measures have been translated into regulations for animal health since 2015, with the publication of three important regulatory texts. The results obtained on a national scale in terms of reducing the use of antibiotics have been satisfactory. The aim of our study was to evaluate the differences related to the prescription of antimicrobials at the veterinary teaching hospital of the Veterinary School of Lyon (CHUV) before and after the implementation of French regulations. Prescriptions and consumption of antimicrobials were examined, along with bacteriological analyses, for the period of 2014–2020, for companion animals and horses. The most frequently prescribed compounds were broad-spectrum antimicrobials, including penicillins with β-lactamase inhibitors, as well as first-generation cephalosporins tetracyclines and sulfamides. The prescription and consumption of critically important antibiotics (CIA) strongly decreased during the study period, with an increase of bacteriological analyses. This study shows the interest of having computerized tools to monitor the use of antimicrobials to implement corrective measures if needed.
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Tompson AC, Mateus ALP, Brodbelt DC, Chandler CIR. Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts. Front Vet Sci 2021; 8:719547. [PMID: 34692805 PMCID: PMC8531418 DOI: 10.3389/fvets.2021.719547] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022] Open
Abstract
Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.
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Affiliation(s)
- Alice C Tompson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana L P Mateus
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Dave C Brodbelt
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
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Lhermie G, La Ragione RM, Weese JS, Olsen JE, Christensen JP, Guardabassi L. Indications for the use of highest priority critically important antimicrobials in the veterinary sector. J Antimicrob Chemother 2021; 75:1671-1680. [PMID: 32240295 DOI: 10.1093/jac/dkaa104] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Among the measures taken to preserve the clinical efficacy of highest priority critically important antimicrobials (HP-CIAs), the WHO has recommended avoiding their use in food-producing animals. Little is known regarding the indications for which different antimicrobial classes are used in animals, even in countries where data on antimicrobial use are available. OBJECTIVES To outline, in a narrative review, the diseases for which HP-CIAs are used in veterinary medicine, highlighting incongruences with international guidelines and disease conditions where effective alternatives to HP-CIAs are missing. METHODS Scientific literature, national reports and expert opinion were used to describe the indications for the use of HP-CIAs in the main food-producing (pigs, cattle and poultry) and companion (horses, dogs and cats) animal species. RESULTS The most common indications for use of HP-CIAs are enteric and respiratory infections in pigs, cattle and poultry, urogenital infections in dogs and cats and respiratory infections in horses. In some instances, no valid and convenient alternatives to colistin and macrolides are available against certain porcine enteric and bovine respiratory pathogens. Effective, legal and convenient alternatives to HP-CIAs are also lacking for managing common infections in cats, for which oral administration is difficult, Rhodococcus equi infections in horses, some enteric and respiratory infections in poultry and MDR infections in all companion animal species. CONCLUSIONS Future research and stewardship programmes should focus on the disease conditions identified by this review to reduce the use of HP-CIAs in the veterinary sector.
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Affiliation(s)
- Guillaume Lhermie
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.,IHAP, Université de Toulouse, INRA, ENVT, Toulouse, France
| | - Roberto Marcello La Ragione
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, UK
| | - J Scott Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - John Elmerdahl Olsen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Jens Peter Christensen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - Luca Guardabassi
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark.,Department of Pathobiology & Population Sciences, Royal Veterinary College, Hawkhead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK
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17
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Schnepf A, Kramer S, Wagels R, Volk HA, Kreienbrock L. Evaluation of Antimicrobial Usage in Dogs and Cats at a Veterinary Teaching Hospital in Germany in 2017 and 2018. Front Vet Sci 2021; 8:689018. [PMID: 34250070 PMCID: PMC8260837 DOI: 10.3389/fvets.2021.689018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
In contrast to food-producing animals, where the documentation of the usage of antimicrobials is regulated by law, antimicrobial usage (AMU) in dogs and cats is only sparsely monitored. We collected data generated by an electronic practice management software (EPMS) between January 1, 2017 and December 31, 2018 to investigate AMU. All information was obtained from clinical routine data from the Department of Small Animal Medicine and Surgery (DSAM), University of Veterinary Medicine Hannover (TiHo). In 2017, 78,076 drug administrations were documented for 5,471 dogs and cats, of which 14,020 (17.96%) were antimicrobial drugs (AMs) specifically documented in 2,910 (51.31%) dogs and cats. In 2018, 104,481 drug administrations were documented for 5,939 dogs and cats. Of these drug administrations, 18,170 (17.39%) AM administrations were documented for 3,176 (53.48%) dogs and cats. Despite the increasing documentation of AM administrations, differences between 2017 and 2018 were not statistically significant [odds ratio (OR), 1.01; 95% confidence interval (CI), 0.98–1.03]. Prescription diversity (PD) in 2017 for dogs was 0.92 and for cats 0.89. In 2018, PD for dogs was 0.93 and for cats 0.88. As well as the documented number of AM administrations, the documented amount of active ingredients administered in 2018 (total: 17.06 kg; dogs: 16.11 kg, cats: 0.96 kg) increased compared with 2017 (total: 15.60 kg; dogs: 14.80 kg, cats: 0.80 kg). In 2017 and 2018, the most commonly administered antimicrobial groups were penicillins, nitroimidazoles, and quinolones for dogs and cats, respectively. While the in-house point-of-care administration accounts for the largest share of the documented amount of AMs administered, the highest number of documented AM administrations was assigned to inpatient care in 2017 and 2018, respectively. However, AM administration in outpatient care remained the lowest in both years. Since no statistically significant difference in AM administrations was observed between 2017 and 2018 and the most commonly used AMs at the DSAM were ranked, data can be used as a baseline to evaluate how changes in in-house guidelines and future legal requirements affect the prescribing culture. Data generated within the DSAM should be evaluated annually.
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Affiliation(s)
- Anne Schnepf
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sabine Kramer
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rolf Wagels
- Information and Data Service (TiHo-IDS), University of Veterinary Medicine Hannover, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, WHO Collaborating Centre for Research and Training for Health in the Human-Animal-Environment Interface, University of Veterinary Medicine Hannover, Hannover, Germany
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18
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Karahutová L, Mandelík R, Bujňáková D. Antibiotic Resistant and Biofilm-Associated Escherichia coli Isolates from Diarrheic and Healthy Dogs. Microorganisms 2021; 9:microorganisms9061334. [PMID: 34205399 PMCID: PMC8234098 DOI: 10.3390/microorganisms9061334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022] Open
Abstract
Bacteria isolated from companion animals are attracting concerns in a view of public health including antimicrobial resistance and biofilm development, both contributing to difficult-to-treat infections. The purpose of this study was to evaluate the minimum inhibitory concentrations (MIC) of 18 antibiotics in Escherichia coli isolated from two groups of dogs (healthy and diarrheic). Isolates were classified into phylogroups, examined for the presence of resistance genes and biofilm-formation capacity. In healthy dogs, phylogenetic analysis showed that 47.37% and 34.22% of E. coli isolates belonged to commensal groups (A; B1) in contrast to diarrheic dogs; 42.2% of isolates were identified as the B2 phylogroup, and these E. coli bacteria formed a stronger biofilm. The results of healthy dogs showed higher MIC levels for tetracycline (32 mg/L), ampicillin (64 mg/L), ciprofloxacin (8 mg/L) and trimethoprim-sulphonamide (8 mg/L) compared to clinical breakpoints. The most detected gene encoding plasmid-mediated resistance to quinolones in the healthy group was qnrB, and in dogs with diarrhea, qnrS. The resistance genes were more frequently detected in healthy dogs. The presence of the integron int1 and the transposon tn3 increases the possibility of transfer of many different cassette-associated antibiotic-resistance genes. These results suggest that dogs could be a potential reservoir of resistance genes.
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Affiliation(s)
- Lívia Karahutová
- Institute of Animal Physiology, Centre of Biosciences of the Slovak Academy of Sciences, Šoltésovej 4-6, 040 01 Košice, Slovakia;
| | - René Mandelík
- Department of Epizootiology, Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 040 01 Košice, Slovakia;
| | - Dobroslava Bujňáková
- Institute of Animal Physiology, Centre of Biosciences of the Slovak Academy of Sciences, Šoltésovej 4-6, 040 01 Košice, Slovakia;
- Correspondence: ; Tel.: +421-55-727-62-76
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Nocera FP, Ambrosio M, Fiorito F, Cortese L, De Martino L. On Gram-Positive- and Gram-Negative-Bacteria-Associated Canine and Feline Skin Infections: A 4-Year Retrospective Study of the University Veterinary Microbiology Diagnostic Laboratory of Naples, Italy. Animals (Basel) 2021; 11:ani11061603. [PMID: 34072316 PMCID: PMC8227065 DOI: 10.3390/ani11061603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Pet animals’ bacterial skin infections represent the main reason for presentation in small animal practice and are generally secondary complications of other pathological conditions. Pyoderma and otitis externa are generally caused by Staphylococcus spp., and particularly Staphylococcus pseudintermedius is often isolated from dogs and cats suffering from skin disorders. However, also Gram-negative bacteria, such as Pseudomonas aeruginosa and Escherichia coli, can be responsible for both otitis externa and pyoderma. Since multi-drug-resistant bacterial strains have become a relevant threat in veterinary medicine, this study aimed to identify the bacteria most frequently associated with the most common clinical cases of skin infections in dogs and cats attending the University Veterinary Teaching Hospital of Naples in the period from January 2016 to December 2019. Moreover, their antibiotic resistance profiles were evaluated, highlighting an increasing spread of multi-drug-resistant strains. It is worth noting that this spread may also concern humans because of their close contact with pets. Thus, it not only is of veterinary significance but also has zoonotic importance, with pets acting as reservoirs for humans, especially pet owners and veterinarians. Abstract A 4-year retrospective study (2016–2019) of selected routine bacteriological examinations of the veterinary microbiology laboratory of the University Veterinary Teaching Hospital of Naples (Italy) was carried out. A total of 189 bacteriological samples were collected from 171 dogs and 18 cats suffering from skin infections. In dogs, the most common cutaneous infection was otitis externa, while pyoderma was found to be prevalent in cats. The number of recorded Gram-positive strains over the study period did not vary considerably from year to year and was always significantly higher (p-value = 0.0007) in comparison with Gram-negative bacterial isolations. In dogs, Staphylococcus pseudintermedius was the most common identified Gram-positive bacterium (65%), while Pseudomonas aeruginosa (36%) was the one among the isolated Gram-negative bacteria. In cats, coagulase-negative staphylococci were the most predominant isolated bacteria (47%). The phenotypic profiles of antibiotic resistance showed that most of the strains were resistant to amoxicillin–clavulanate, penicillin, clindamycin, and trimethoprim–sulfamethoxazole. Several multi-drug-resistant strains (35%) were detected in canine isolates. An updating of antibiotic resistance profiles of the main Gram-positive and Gram-negative bacteria principally associated with skin infections of pet animals is necessary to improve stewardship programs of veterinary hospitals and clinics.
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Affiliation(s)
| | | | | | - Laura Cortese
- Correspondence: (L.C.); (L.D.M.); Tel.: +39-081-253-6005 (L.C.); +39-081-253-6180 (L.D.M.)
| | - Luisa De Martino
- Correspondence: (L.C.); (L.D.M.); Tel.: +39-081-253-6005 (L.C.); +39-081-253-6180 (L.D.M.)
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Mouiche MMM, Mpouam SE, Moffo F, Nkassa CMN, Mbah CK, Mapiefou NP, Awah-Ndukum J. Prescription Pattern of Antimicrobial Use in Small Animal Veterinary Practice in Cameroon. Top Companion Anim Med 2021; 44:100540. [PMID: 33984558 DOI: 10.1016/j.tcam.2021.100540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/28/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
Retrospective data on antimicrobial use (AMU) within the period ranging from January 2012-December 2015 was collected to assess the antimicrobial prescription patterns in pets (cats and dogs) treated by 16 veterinary private practitioners in the 2 main urban cities of Cameroon (Douala and Yaounde). The vet practitioners were interviewed in order to analyze prescribing behavior and factors influencing antimicrobial prescription. Out of a total of 3928 antimicrobial prescriptions, 3673(93.5%) were recorded in dogs and 255 (6.5%) in cats during the study period in 7 veterinary clinics. The most prescribed antimicrobials were sulfamethoxypyridazine-trimethoprim (dog: 31.2%; cat: 28.6%), benzylpenicillin-streptomycin (dogs:19.0%; cat:21.9%) and marbofloxacin (dogs:18.3%; cats:16.1%). Almost, 64.6% of antimicrobial prescription in dogs was categorized as highly important antimicrobials and 34.9% as critically important antimicrobial agents. In cats, 77.9% of antimicrobial prescription was categorized as highly important antimicrobials and 22.1% as critically important antimicrobial agents. Antimicrobials were mostly used for gastro-intestinal disorders (31.9%) and skin diseases (24. 1%) in dogs while they were mostly applied for surgical problems (29.8%), musculo-skeletal disease (20.4%) and gastro-intestinal tract diseases (19.6%) in cats. Fluoroquinolones were administered as first option instead of third option. Antimicrobials were associated with other veterinary drugs (anti-inflammatory, internal and external parasite therapy) in 75.3% of cases. The prescription of antimicrobials was based on clinical diagnosis (symptom-based), ease of drug administration, owner's purchasing power and antibiogram. This study highlights the necessity to promote antimicrobial stewardship in pet medicine in Cameroon. Confirmatory diagnosis and antibiotic susceptibility testing before antibiotic prescription should be encouraged. The uncontrolled use of critically important antimicrobials for human medicine and especially their indiscriminate use may favor the occurrence of AMR public health issues.
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Affiliation(s)
- Mohamed Moctar Mouliom Mouiche
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon.
| | - Serge Eugene Mpouam
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Claire Murielle Nno Nkassa
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Cleophas Kahtita Mbah
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Nabilah Pemi Mapiefou
- Department of Pharmacy, Pharmacology and Toxicology, School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
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21
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Goggs R, Menard JM, Altier C, Cummings KJ, Jacob ME, Lalonde-Paul DF, Papich MG, Norman KN, Fajt VR, Scott HM, Lawhon SD. Patterns of antimicrobial drug use in veterinary primary care and specialty practice: A 6-year multi-institution study. J Vet Intern Med 2021; 35:1496-1508. [PMID: 33942943 PMCID: PMC8163138 DOI: 10.1111/jvim.16136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Combatting antimicrobial resistance requires a One Health approach to antimicrobial stewardship including antimicrobial drug (AMD) use evaluation. Current veterinary AMD prescribing data are limited. OBJECTIVES To quantify companion animal AMD prescribing in primary care and specialty practice across 3 academic veterinary hospitals with particular focus on third-generation cephalosporins, fluoroquinolones, and carbapenems. ANIMALS Dogs and cats presented to 3 academic veterinary hospitals from 2012 to 2017. METHODS In this retrospective study, AMD prescribing data from 2012 to 2017 were extracted from electronic medical records at each hospital and prescriptions classified by service type: primary care, specialty practice or Emergency/Critical Care (ECC). Hospital-level AMD prescribing data were summarized by species, service type, AMD class, and drug. Multivariable logistic full-factorial regression models were used to estimate hospital, year, species, and service-type effects on AMD prescribing. Estimated marginal means and confidence intervals were plotted over time. RESULTS The probability of systemic AMD prescribing for any indication ranged between 0.15 and 0.28 and was higher for dogs than cats (P < .05) apart from 2017 at hospital 1. Animals presented to primary care were least likely to receive AMDs (dogs 0.03-0.15, cats 0.03-0.18). The most commonly prescribed AMD classes were aminopenicillins/β-lactamase inhibitors (0.02-0.15), first-generation cephalosporins (0.00-0.09), fluoroquinolones (0.00-0.04), nitroimidazoles (0.01-0.06), and tetracyclines (0.00-0.03). Among the highest priority classes, fluoroquinolones (dogs 0.00-0.09, cats 0.00-0.08) and third-generation cephalosporins (dogs 0.00-0.04, cats 0.00-0.05) were most frequently prescribed. CONCLUSIONS AND CLINICAL IMPORTANCE Antimicrobial drug prescribing frequencies were comparable to previous studies. Additional stewardship efforts might focus on fluoroquinolones and third-generation cephalosporins.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Julie M Menard
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Craig Altier
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Kevin J Cummings
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Megan E Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Denise F Lalonde-Paul
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Mark G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Keri N Norman
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Virginia R Fajt
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - H Morgan Scott
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
| | - Sara D Lawhon
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, Texas, USA
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22
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Antibiotic prescription practices and opinions regarding antimicrobial resistance among veterinarians in Kentucky, USA. PLoS One 2021; 16:e0249653. [PMID: 33857198 PMCID: PMC8049335 DOI: 10.1371/journal.pone.0249653] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background Inappropriate antimicrobial use (AMU) is a global concern. Opinions of veterinarians regarding AMU and its role in the development of antimicrobial resistance (AMR) may influence their prescription practices. It is important to understand these opinions, prescription practices and their potential impact on the development of AMR in order to guide efforts to curb the problem. Therefore, the objective of this study was to investigate the antimicrobial prescription practices and opinions of veterinarians in Kentucky regarding AMU and AMR. Methods This cross-sectional study used a 30-question survey questionnaire administered to veterinarians who were members of the Kentucky Veterinary Medical Association. Survey responses from 101 participants were included in the study. Descriptive statistics were computed and associations between categorical variables assessed using Chi-square or Fisher’s exact tests. Firth logistic models were used to investigate predictors of “Compliance with prescription policies” and “Cost of antimicrobial affects prescription decisions”. Results Almost all (93%) respondents indicated that improper AMU contributed to selection for AMR. A total of 52% of the respondents believed that antimicrobials were appropriately prescribed, while the remaining 48% believed that antimicrobials were inappropriately prescribed. Significant predictors of compliance with prescription policies were availability of prescription policy at the veterinary facility (Odds Ratio (OR) = 4.2; p<0.001) and over-prescription (OR = 0.35; p = 0.025). Similarly, significant predictors of cost of antimicrobials affecting prescription decisions were lack of post-graduate training (OR = 8.3; p = 0.008) and practice type, with large animal practices having significantly lower odds of the outcome (OR = 0.09; p = 0.004) than small animal practices. Conclusion Most veterinarians indicated that improper AMU contributed to selection for AMR. Since the odds of compliance with prescription policies were 4-times higher among veterinarians working at facilities that had prescription policies compared to those at facilities that didn’t, more veterinary facilities should be encouraged to adopt prescription policies to help improve compliance and reduce AMR. Veterinarians would also benefit from continued professional education to help improve prescription practices, antimicrobial stewardship and curb AMR.
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23
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Allerton F, Prior C, Bagcigil AF, Broens E, Callens B, Damborg P, Dewulf J, Filippitzi ME, Carmo LP, Gómez-Raja J, Harpaz E, Mateus A, Nolff M, Phythian CJ, Timofte D, Zendri F, Jessen LR. Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe. Antibiotics (Basel) 2021; 10:antibiotics10040409. [PMID: 33918617 PMCID: PMC8069046 DOI: 10.3390/antibiotics10040409] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
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Affiliation(s)
- Fergus Allerton
- Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
- Correspondence:
| | - Cameron Prior
- Veterinary Specialists Scotland, 1 Deer Park Road Livingston, Scotland EH54 8AG, UK;
| | - Arzu Funda Bagcigil
- Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Turkey;
| | - Els Broens
- Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Bénédicte Callens
- Centre of Knowledge on Antimicrobial Use and Resistance, Galileelaan 5/02, 1210 Brussels, Belgium;
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark;
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium;
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Schwarzenburgstrasse 161, 3097 Liebefeld, Bern, Switzerland;
| | | | - Erez Harpaz
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Ana Mateus
- Hawkshead Campus, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK;
| | - Mirja Nolff
- Clinic for Small Animal Surgery Tierspital Zürich, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland;
| | - Clare J. Phythian
- Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway; (E.H.); (C.J.P.)
| | - Dorina Timofte
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Flavia Zendri
- Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK; (D.T.); (F.Z.)
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, Faculty of Health Sciences, University of Copenhagen, Dyrlægevej 16, 1870 Frederiksberg C, Denmark;
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24
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Chirollo C, Nocera FP, Piantedosi D, Fatone G, Della Valle G, De Martino L, Cortese L. Data on before and after the Traceability System of Veterinary Antimicrobial Prescriptions in Small Animals at the University Veterinary Teaching Hospital of Naples. Animals (Basel) 2021; 11:ani11030913. [PMID: 33806745 PMCID: PMC8005210 DOI: 10.3390/ani11030913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Veterinary electronic prescription (VEP) is mandatory by law, dated 20 November 2017, No. 167 (European Law 2017) Article 3, and has been implemented in Italy since April 2019. In this study, the consumption of antimicrobials before and after the mandatory use of VEP was analyzed at the Italian University Veterinary Teaching Hospital of Naples in order to understand how the traceability of antimicrobials influences veterinary prescriptions. The applicability and utility of VEP may present an effective surveillance strategy able to limit both the improper use of antimicrobials and the spread of multidrug-resistant pathogens, which have become a worrying threat both in veterinary and human medicine. Abstract Over recent decades, antimicrobial resistance has been considered one of the most relevant issues of public health. The aim of our study was to evaluate the differences related to the prescription of antimicrobials at the University Veterinary Teaching Hospital, before and after the mandatory use of veterinary electronic prescription (VEP). In particular, the consumption of antimicrobials was examined, especially taking into consideration the recommendations of prudent use. A comparison of data collected before and after the use of electronic prescription highlighted that during the period chosen for the study, the choice of antimicrobial molecules was appropriate, favoring those of “first” and “second line.” However, prescription and the use of some molecules not registered for veterinary medicine were observed in the period before VEP. Broad-spectrum antimicrobials, including penicillins with β-lactamase inhibitors, as well as first-generation cephalosporins and fluoroquinolones, were the most frequently prescribed compounds. There are few studies conducted in Italy aimed at investigating the use of antimicrobials in companion animals under field conditions and with particular regard to prudent use recommendations. This type of study underlines the importance of electronic medical recording in veterinary practice and, above all, its usefulness in monitoring the use of certain antimicrobial agents classified as of critical importance in human medicine.
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25
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Alcantara GLC, Pinello KC, Severo M, Niza-Ribeiro J. Antimicrobial resistance in companion animals - Veterinarians' attitudes and prescription drivers in Portugal. Comp Immunol Microbiol Infect Dis 2021; 76:101640. [PMID: 33684640 DOI: 10.1016/j.cimid.2021.101640] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 11/25/2022]
Abstract
Antimicrobial resistance transmitted from companion animals is a threat to public health increased by the pet's relationship with humans. This study aims to understand the attitude and drivers of antimicrobial (AM) prescription among companion animal veterinarians in Portugal and identify actions to combat antimicrobial resistance (AMR). This cross-sectional study is based on a questionnaire with 417 respondents representing the Portuguese veterinary population. The results allowed grouping the respondents according to the attitude of prescription. Two types of veterinarians were identified: those who prefer to prescribe treatments based on the animals' signs and their own experience - empirical-oriented type - and those who refer to a guidance protocol to assist the prescription decision - protocol-oriented type. Respondents working in hospitals displayed a positive association with the use of guidance protocols. Efficacy was the main driver of prescription for both groups, suggesting that no matter the attitude in prescribing, the veterinarian's aim is achieving positive clinical results. Most respondents prefer empirical-oriented prescriptions, declare the absence of protocols for the prudent use of AM at the workplace and do not refer to AMR issues nor the need for hygiene reinforcement measures with owners. Owners are less likely to request AMs from veterinarians aged over 43 years old. It was discovered that communication between owners and veterinarians about risks associated with AMR was poor and must be improved and the adoption of a national guideline for the adequate use of AM directed for companion animals would be beneficial.
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Affiliation(s)
| | - K C Pinello
- Public Health Institute, University of Porto, Portugal; Department of Population Studies, Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal
| | - M Severo
- EPIUnit, Institute of Public Health, ISPUP, University of Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - J Niza-Ribeiro
- Public Health Institute, University of Porto, Portugal; Department of Population Studies, Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal; EPIUnit, Institute of Public Health, ISPUP, University of Porto, Portugal.
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26
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Miranda C, Silva V, Igrejas G, Poeta P. Impact of European pet antibiotic use on enterococci and staphylococci antimicrobial resistance and human health. Future Microbiol 2021; 16:185-201. [PMID: 33491483 DOI: 10.2217/fmb-2020-0119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Due to the inappropriate use of antibiotics described in both human and veterinary medicine, there is emerging evidence of antimicrobial-resistant organisms isolated from humans and pets, forming a multifaceted problem. Although the true magnitude of antimicrobial resistance in pets and other animals, as well as humans, are not fully known; pets, in particular dogs and cats, can contribute to the spread of antimicrobial resistance due to close contact with humans and their status as a family member in urban households. This review summarizes and highlights the current data concerning the antibiotic use on pets, and the European distribution of the increasing prevalence of multiresistant bacterial pathogens, such as enterococci and methicillin-resistant staphylococci on pets, as well as its implications for public health.
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Affiliation(s)
- Carla Miranda
- Microbiology & Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes & Alto Douro, Vila Real 5001-801, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, 2829-516, Portugal
| | - Vanessa Silva
- Microbiology & Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes & Alto Douro, Vila Real 5001-801, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, 2829-516, Portugal.,Department of Genetics & Biotechnology, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal.,Functional Genomics & Proteomics Unit, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal
| | - Gilberto Igrejas
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, 2829-516, Portugal.,Department of Genetics & Biotechnology, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal.,Functional Genomics & Proteomics Unit, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal
| | - Patrícia Poeta
- Microbiology & Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes & Alto Douro, Vila Real 5001-801, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes & Alto Douro, Vila Real, 5001-801, Portugal.,Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, Caparica, Lisboa, 2829-516, Portugal
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Méndez M, Moreno MA. Quantifying Antimicrobial Exposure in Dogs From a Longitudinal Study. Front Vet Sci 2020; 7:545. [PMID: 33282922 PMCID: PMC7691241 DOI: 10.3389/fvets.2020.00545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
Bacterial resistance to antimicrobials (AMR) is a growing public health threat, and exposure to antimicrobials (AMs) is, on the whole, a major risk factor for the occurrence of AMR. During the past decade, a limited number of studies about AM exposure in dogs have been published, showing a noticeable diversity regarding numerators (AMU), denominators (population at risk), and indicators. The aim of this study is to show that metrics based on the most easily recorded data about treatments and a follow-up design are a promising method for a preliminary assessment of AM exposure in companion animals when more detailed data are not available. To quantify AM exposure, two simple indicators were used: the number of treatments (Ts) per 100 dogs and the number of treatments per 10 dog-years. Overall figures of AM exposure were 194 Ts/100_dogs (480 treatments and 248 dogs) and 18.4 Ts/10_dog-years (480 treatments and 95,171 dog-days), respectively. According to the administration route, AM exposure figures were 126 Ts/100 dogs (305 treatments and 242 dogs) and 12.1 Ts/10_dog-years (305 treatments and 92,059 dog-days) for systemic use and 66 Ts/100 dogs (160 treatments and 242 dogs) and 6.3 Ts/10_dog-years (160 treatments in 92,059 dog-days) for topical use. Since there is no current agreement regarding an indicator for quantifying AM exposure in dogs, in addition to other measures, the simplest indicators based on the most frequently available information should also be reported as a preliminary compromise for permitting a comparative analysis of the different scenarios.
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Affiliation(s)
- María Méndez
- Department of Animal Health, Veterinary Faculty, Complutense University, Madrid, Spain
| | - Miguel A Moreno
- Department of Animal Health, Veterinary Faculty, Complutense University, Madrid, Spain.,VISAVET Center, Complutense University, Madrid, Spain
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28
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Piccolo FL, Belas A, Foti M, Fisichella V, Marques C, Pomba C. Detection of multidrug resistance and extended-spectrum/plasmid-mediated AmpC beta-lactamase genes in Enterobacteriaceae isolates from diseased cats in Italy. J Feline Med Surg 2020; 22:613-622. [PMID: 31524037 PMCID: PMC10814436 DOI: 10.1177/1098612x19868029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the antimicrobial susceptibility of Enterobacteriaceae isolated from cats affected by diseases commonly encountered in practice, and to characterise the third-generation cephalosporin (3GC)-resistance molecular mechanisms involved. METHODS Clinical samples (n = 100) included 58 rectal swabs from cats with diarrhoea, 31 nasal swabs from cats with clinical signs of upper respiratory tract disease, four ear swabs from cats with otitis, three conjunctival swabs from cats with conjunctivitis, two oral swabs from cats with stomatitis, one swab from a skin abscess and one urine sample from a cat with cystitis. A total of 125 Enterobacteriaceae were isolated from 90 cats. Escherichia coli was the most frequently isolated species (n = 65), followed by Enterobacter species (n = 20), Proteus species (n = 13), Citrobacter species (n = 12) and others (n = 15). Bacterial susceptibility testing was performed with respect to eight antimicrobial classes. Beta (β)-lactamase genes were identified by PCR and nucleotide sequencing. RESULTS Overall, the higher frequency of resistance was to amoxicillin-clavulanate (61.3%), trimethoprim/sulfamethoxazole (33.6%) and cefotaxime (32.8%). Thirty-six percent of the isolates (n = 45) were resistant to 3GCs. Of these isolates, 34 were tested by PCR and nucleotide sequencing and 23 were confirmed as encoding β-lactamase genes. Fourteen 3GC-resistant isolates harboured extended-spectrum β-lactamases (ESBLs) belonging to groups CTX-M-1 (n = 12, two of which were CTX-M-79), CTX-M-2 (n = 1) and CTX-M-9 (n = 1), as well as SHV-12 (n = 1) and TEM-92 (n = 1). Nine isolates had CMY-2 plasmid-mediated AmpC β-lactamases (pAmpC). Thirty-one percent (n = 39) of the isolates were multidrug resistant (MDR) and were isolated from 34% (n = 31/90) of the cats. CONCLUSIONS AND RELEVANCE A high frequency of MDR and ESBL/pAmpC β-lactamase-producing Enterobacteriaceae were detected among bacteria isolated from a feline population in southern Italy with a variety of common clinical conditions, which poses limitations on therapeutic options for companion animals. We describe the first detection of CTX-M-79 and TEM-92 ESBL genes in isolates from cats.
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Affiliation(s)
- Francesco Lo Piccolo
- Section of Microbiology and Infectious Diseases, Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Adriana Belas
- CIISA, Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Maria Foti
- Section of Microbiology and Infectious Diseases, Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Vittorio Fisichella
- Section of Microbiology and Infectious Diseases, Department of Veterinary Sciences, University of Messina, Messina, Italy
| | - Cátia Marques
- CIISA, Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Constança Pomba
- CIISA, Centre of Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
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29
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Lutz B, Lehner C, Schmitt K, Willi B, Schüpbach G, Mevissen M, Peter R, Müntener C, Naegeli H, Schuller S. Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016. Vet Rec Open 2020; 7:e000370. [PMID: 32201578 PMCID: PMC7064144 DOI: 10.1136/vetreco-2019-000370] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/28/2020] [Accepted: 02/07/2020] [Indexed: 12/28/2022] Open
Abstract
Background Antimicrobial resistance is an increasing problem in human and veterinary medicine and is closely linked to the use of antimicrobials. The objective of this study was to describe antimicrobial prescriptions for selected canine diseases in Switzerland during 2016. Methods Dogs presented to two university hospitals and 14 private practices for acute diarrhoea (AD; n=371), suspected or confirmed urinary tract infections (UTIs; n=245), respiratory tract infections (RTIs; n=274) or wound infections (WIs; n=175) were included. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage and duration) were retrospectively assessed. A justification score was applied to evaluate appropriateness of antimicrobial therapy based on available national and international consensus guidelines. Results Antimicrobials were prescribed in 65 per cent of dogs with AD, 88 per cent with UTI, 62 per cent with RTI and 90 per cent with WI. The most prescribed antimicrobial classes (monotherapy and combination therapy) were potentiated aminopenicillins (59 per cent), nitroimidazoles (22 per cent), non-potentiated aminopenicillins (16 per cent) and fluoroquinolones (13 per cent). Overall, 38 per cent (95 per cent CI 0.35 to 0.41) of the prescriptions were in accordance with consensus guidelines. In dogs with AD, antimicrobial therapy was associated with the presence of haemorrhagic diarrhoea (P<0.05) and complied in 32 per cent with consensus guidelines, which recommend antimicrobial treatment only when sepsis is suspected. A bacterial aetiology was confirmed via culture and/or sediment examination in 36 per cent of dogs with suspected UTI. Conclusions Overall, adherence to consensus guidelines was poor both, at university hospitals and private practices. Antimicrobial stewardship measures are therefore needed to improve prudent use.
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Affiliation(s)
- Bérénice Lutz
- Department Clinical Veterinary Medicine, Division Small Animal Internal Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Claudia Lehner
- Department Clinical Veterinary Medicine, Division Small Animal Internal Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Kira Schmitt
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Barbara Willi
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Gertraud Schüpbach
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Meike Mevissen
- Division of Pharmacology and Toxicology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ruth Peter
- Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Cedric Müntener
- Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Hanspeter Naegeli
- Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Simone Schuller
- Department Clinical Veterinary Medicine, Division Small Animal Internal Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
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30
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Robbins SN, Goggs R, Lhermie G, Lalonde-Paul DF, Menard J. Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care. Front Vet Sci 2020; 7:110. [PMID: 32258067 PMCID: PMC7093014 DOI: 10.3389/fvets.2020.00110] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/13/2020] [Indexed: 01/30/2023] Open
Abstract
Background: Antimicrobial use contributes to emergence of antimicrobial resistance. It was hypothesized that antimicrobial prescribing behavior varies between the emergency (ER) and critical care (CC) services in a veterinary teaching hospital. This study aimed to: (i) describe antimicrobial prescribing patterns in the ER and CC services; (ii) assess adherence to stewardship principles; (iii) evaluate the prevalence of multidrug resistant (MDR) bacterial isolates. Methods: Institution electronic medical records were queried for all antimicrobial prescriptions from the ER and CC services between 1/1/2017 and 12/31/2017. Prescriptions were manually reviewed, and the following data recorded: drug, dosage, duration, diagnosis, outcome, hospitalization duration, culture submission, and susceptibility results. Results: There were 5,091 ER visits, of which 3,125 were not transferred to another service. Of these emergency visits, 516 (16.5%) resulted in 613 antimicrobial drug prescriptions. The most commonly prescribed drugs for the ER were amoxicillin/clavulanate (n = 243, 39.6%), metronidazole (n = 146, 23.8%), and ampicillin/sulbactam (n = 55, 9.0%). The most common reasons for antimicrobial prescriptions were skin disease (n = 227, 37.0%), gastrointestinal disease (n = 173, 28.2%), and respiratory disease (n = 50, 8.2%). For ER patients 18 cultures were submitted, equivalent to a 3.5% submission rate. The CC service managed 311 case visits for 822 patient days. Of these, 133 case visits (42.7%) resulted in 340 prescriptions. The most commonly prescribed drugs for the CC service were ampicillin/sulbactam (n = 103, 30.3%), enrofloxacin (n = 75, 22.1%), and metronidazole (n = 59, 17.4%). The most common reasons for antimicrobial prescriptions were gastrointestinal disease (n = 106, 31.2%), respiratory disease (n = 71, 20.9%), and sepsis (n = 61, 17.9%). On the CC service, 46 patients had ≥1 culture submitted, equivalent to a 34.6% submission rate. Of patients prescribed antimicrobials, 13/38 (34%) with urinary tract disease, 2/28 (7%) with pneumonia, 1/11 (9%) with canine infectious respiratory disease complex and 2/8 (25%) with feline upper respiratory infection were compliant with published guidelines. Conclusions: Antimicrobial prescription was common in both ER and CC services and followed similar patterns. Adherence to published guidelines for urinary and respiratory infections was poor.
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Affiliation(s)
- Sarah N Robbins
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Guillaume Lhermie
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.,IHAP, Université de Toulouse, INRA, ENVT, Toulouse, France
| | - Denise F Lalonde-Paul
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Julie Menard
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
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31
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Joosten P, Ceccarelli D, Odent E, Sarrazin S, Graveland H, Van Gompel L, Battisti A, Caprioli A, Franco A, Wagenaar JA, Mevius D, Dewulf J. Antimicrobial Usage and Resistance in Companion Animals: A Cross-Sectional Study in Three European Countries. Antibiotics (Basel) 2020; 9:E87. [PMID: 32079072 PMCID: PMC7175148 DOI: 10.3390/antibiotics9020087] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022] Open
Abstract
Companion animals have been described as potential reservoirs of antimicrobial resistance (AMR), however data remain scarce. Therefore, the objectives were to describe antimicrobial usage (AMU) in dogs and cats in three European countries (Belgium, Italy, and The Netherlands) and to investigate phenotypic AMR. A questionnaire and one fecal sample per animal (n = 303) were collected over one year and AMU was quantified using treatment incidence (TI). Phenotypic resistance profiles of 282 Escherichia coli isolates were determined. Nineteen percent of the animals received at least one antimicrobial treatment six months preceding sampling. On average, cats and dogs were treated with a standard daily dose of antimicrobials for 1.8 and 3.3 days over one year, respectively. The most frequently used antimicrobial was amoxicillin-clavulanate (27%). Broad-spectrum antimicrobials and critically important antimicrobials for human medicine represented 83% and 71% of the total number of treatments, respectively. Resistance of E. coli to at least one antimicrobial agent was found in 27% of the isolates. The most common resistance was to ampicillin (18%). Thirteen percent was identified as multidrug resistant isolates. No association between AMU and AMR was found in the investigated samples. The issue to address, regarding AMU in companion animal, lies within the quality of use, not the quantity. Especially from a One-Health perspective, companion animals might be a source of transmission of resistance genes and/or resistant bacteria to humans.
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Affiliation(s)
- Philip Joosten
- Veterinary Epidemiology Unit, Department of Obstetrics, Reproduction and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (E.O.); (S.S.); (J.D.)
| | - Daniela Ceccarelli
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Houtribweg 39, 8221 RA Lelystad, The Netherlands; (D.C.); (J.A.W.); (D.M.)
| | - Evelien Odent
- Veterinary Epidemiology Unit, Department of Obstetrics, Reproduction and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (E.O.); (S.S.); (J.D.)
| | - Steven Sarrazin
- Veterinary Epidemiology Unit, Department of Obstetrics, Reproduction and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (E.O.); (S.S.); (J.D.)
| | - Haitske Graveland
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Liese Van Gompel
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands;
| | - Antonio Battisti
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Department of General Diagnostics, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova, 1411, 00178 Rome, Italy; (A.B.); (A.F.)
| | - Andrea Caprioli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Department of General Diagnostics, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova, 1411, 00178 Rome, Italy; (A.B.); (A.F.)
| | - Alessia Franco
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Department of General Diagnostics, National Reference Laboratory for Antimicrobial Resistance, Via Appia Nuova, 1411, 00178 Rome, Italy; (A.B.); (A.F.)
| | - Jaap A. Wagenaar
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Houtribweg 39, 8221 RA Lelystad, The Netherlands; (D.C.); (J.A.W.); (D.M.)
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Dik Mevius
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Houtribweg 39, 8221 RA Lelystad, The Netherlands; (D.C.); (J.A.W.); (D.M.)
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands;
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Department of Obstetrics, Reproduction and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (E.O.); (S.S.); (J.D.)
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Hopman NEM, van Dijk MAM, Broens EM, Wagenaar JA, Heederik DJJ, van Geijlswijk IM. Quantifying Antimicrobial Use in Dutch Companion Animals. Front Vet Sci 2019; 6:158. [PMID: 31192236 PMCID: PMC6546947 DOI: 10.3389/fvets.2019.00158] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/08/2019] [Indexed: 02/01/2023] Open
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.
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Affiliation(s)
- Nonke E. M. Hopman
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Marloes A. M. van Dijk
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Els M. Broens
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Jaap A. Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, Netherlands
- Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Dick J. J. Heederik
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, Netherlands
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ingeborg M. van Geijlswijk
- The Netherlands Veterinary Medicines Institute (SDa), Utrecht, Netherlands
- Pharmacy Department, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
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Hartmann FA, Fox L, Fox B, Viviano K. Diagnostic and therapeutic challenges for dogs with urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli. J Am Vet Med Assoc 2019; 253:850-856. [PMID: 30211649 DOI: 10.2460/javma.253.7.850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Antimicrobial use for selected diseases in cats in Switzerland. BMC Vet Res 2019; 15:94. [PMID: 30871537 PMCID: PMC6417182 DOI: 10.1186/s12917-019-1821-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/25/2019] [Indexed: 02/08/2023] Open
Abstract
Background Antibiotic use in human and veterinary medicine is considered a main driver of antimicrobial resistance. Although guidelines to promote appropriate use of antimicrobials in veterinary patients have been developed, antibiotic overprescription is assumed to be a common problem. The goal of this study was to investigate antimicrobial use in cats in Switzerland with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses, and to assess compliance of prescription with consensus guidelines. A total of 776 cases (aURTD, n = 227; FLUTD, n = 333; abscesses, n = 216) presented to two university hospitals and 14 private veterinary practices in Switzerland during 2016 were retrospectively evaluated. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage, duration) were assessed. Results A total of 77% (aURTD), 60% (FLUTD) and 96% (abscesses) of the cases received antibiotic therapy; 13–24% received combination or serial therapy. The cats were treated for a median of 7 (abscesses) and 10 days (aURTD, FLUTD). Treatments with potentiated aminopenicillins (40–64%), third generation cephalosporins (25–28%), aminopenicillins (12–24%) and fluoroquinolones (3–13%) were most common. Prescriptions were judged in complete accordance with consensus guidelines in 22% (aURTD), 24% (FLUTD) and 17% (abscesses) of the cases. Antibiotics were prescribed although not indicated in 34% (aURTD), 14% (FLUTD) and 29% (abscesses) of the cases. The presence of lethargy, anorexia or fever in cats with aURTD, and the detection of bacteriuria in cats with FLUTD were significantly associated with antibiotic therapy. Although diagnostic work-up was significantly more common (aURTD: university hospitals, 58%; private practices, 1%; FLUTD: university hospitals, 92%; private practices, 27%) and the use of critically important antibiotics significantly less common at the university hospitals (aURTD, 10%; FLUTD, 14%) compared to private practices (aURTD, 38%; FLUTD, 54%), the frequency of antibiotic treatment was not different between the university hospitals and private practices. Conclusions Our results indicate that overprescription of antibiotics in cats in Switzerland is common and accordance with guidelines is poor. The study highlights the need to promote antimicrobial stewardship in small animal medicine.
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Redding LE, Cole SD. Pet owners’ knowledge of and attitudes toward the judicious use of antimicrobials for companion animals. J Am Vet Med Assoc 2019; 254:626-635. [DOI: 10.2460/javma.254.5.626] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Optimization of antimicrobial treatment is a cornerstone in the fight against antimicrobial resistance. Various national and international authorities and professional veterinary and farming associations have released generic guidelines on prudent antimicrobial use in animals. However, these generic guidelines need to be translated into a set of animal species- and disease-specific practice recommendations. This article focuses on prevention of antimicrobial resistance and its complex relationship with treatment efficacy, highlighting key situations where the current antimicrobial drug products, treatment recommendations, and practices may be insufficient to minimize antimicrobial selection. The authors address this topic using a multidisciplinary approach involving microbiology, pharmacology, clinical medicine, and animal husbandry. In the first part of the article, we define four key targets for implementing the concept of optimal antimicrobial treatment in veterinary practice: (i) reduction of overall antimicrobial consumption, (ii) improved use of diagnostic testing, (iii) prudent use of second-line, critically important antimicrobials, and (iv) optimization of dosage regimens. In the second part, we provided practice recommendations for achieving these four targets, with reference to specific conditions that account for most antimicrobial use in pigs (intestinal and respiratory disease), cattle (respiratory disease and mastitis), dogs and cats (skin, intestinal, genitourinary, and respiratory disease), and horses (upper respiratory disease, neonatal foal care, and surgical infections). Lastly, we present perspectives on the education and research needs for improving antimicrobial use in the future.
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Gómez-Poveda B, Moreno MA. Antimicrobial Prescriptions for Dogs in the Capital of Spain. Front Vet Sci 2018; 5:309. [PMID: 30564586 PMCID: PMC6288439 DOI: 10.3389/fvets.2018.00309] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/22/2018] [Indexed: 11/23/2022] Open
Abstract
Objective: To characterize antimicrobial prescription patterns for dogs in veterinary practices in Spain using the city of Madrid as a model. Design: Retrospective survey. Settings: Dogs attending veterinary practices in the city of Madrid in 2017 were enrolled. Subjects: Three hundred dogs from 30 veterinary practices randomly selected from a set of 388 practices grouped by zip code. The inclusion criterion for dogs was treatment with antibiotics within a few days of the data collection day. Results: For the 300 dogs enrolled, 374 treatments with antimicrobials were recorded, 62.8% (235/374) were veterinary medicinal products and 37.2% (139/374) human medicinal products. The main route of administration was oral (209/374; 55.9%) followed by parenteral (100/374; 26.7%) and topical (65/374; 17.4%). Sixty-five dogs (21.7%) received a perioperative antimicrobial treatment, mainly associated with female obstetrical surgery (19/65; 29%), while 78.3% (235/300) received a pharmaceutical treatment mainly for skin (72/235; 30.6%), respiratory (47/235; 20%), or digestive (41/235; 17.4%) diseases. The most frequently used antimicrobials were beta-lactams for oral (119/209) and parenteral (79/100) administration, especially the combination amoxicillin with clavulanic acid (83/209; oral), amoxicillin alone (42/100; parenteral), and aminoglycosides (32/65) for topical use. Diagnostic confirmation with culture was carried out on only 13 out of 235 dogs receiving therapeutic treatment and nine underwent an antimicrobial susceptibility test. In addition, cytology was performed in 15 dogs. Conclusions: The pattern of antimicrobial prescriptions for dogs in our study was quite similar to that previously described in several European countries, and encompassed the same two highly interconnected key features: major use of amoxicillin with clavulanic acid and a very low level of antimicrobial susceptibility testing before prescription. Consequently, we recommend that the measures for rationalizing antimicrobial prescription for dogs in Spain should follow those implemented in other countries, especially confirming the diagnosis and promoting the use of hygiene measures by owners.
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Affiliation(s)
- Bárbara Gómez-Poveda
- Department of Animal Health, Faculty of Veterinary, Complutense University, Madrid, Spain
| | - Miguel A Moreno
- Department of Animal Health, Faculty of Veterinary, Complutense University, Madrid, Spain.,VISAVET Center, Complutense University, Madrid, Spain
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King C, Smith M, Currie K, Dickson A, Smith F, Davis M, Flowers P. Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK. BMC Vet Res 2018; 14:332. [PMID: 30404649 PMCID: PMC6223057 DOI: 10.1186/s12917-018-1646-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 10/11/2018] [Indexed: 11/30/2022] Open
Abstract
Background Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice. This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N = 16). The objective of the research was to explore the drivers of companion animal veterinary surgeons’ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n = 4), Scotland (n = 11), Northern Ireland (n = 1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours. Results Five components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors. Conclusion This paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeons’ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR.
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Affiliation(s)
- C King
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - M Smith
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - K Currie
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - A Dickson
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - F Smith
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - M Davis
- School of Social Sciences, Monash University, Melbourne, Australia
| | - P Flowers
- Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
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Bisson JL, Argyle DJ, Argyle SA. Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations. Vet Comp Oncol 2018; 16:301-310. [PMID: 29892997 DOI: 10.1111/vco.12406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/21/2018] [Accepted: 04/29/2018] [Indexed: 12/22/2022]
Abstract
Bacterial infection following cancer chemotherapy-induced neutropenia is a serious cause of morbidity and mortality in human and veterinary patients. Antimicrobial prophylaxis is controversial in the human oncology field, as any decreased incidence in bacterial infections is countered by patient adverse effects and increased antimicrobial resistance. Comprehensive guidelines exist to aid human oncologists in prescribing antimicrobial prophylaxis but similar recommendations are not available in veterinary literature. As the veterinarian's role in antimicrobial stewardship is increasingly emphasized, it is vital that veterinary oncologists implement appropriate antimicrobial use. By considering the available human and veterinary literature we present an overview of current clinical practices and are able to suggest recommendations for prophylactic antimicrobial use in veterinary cancer chemotherapy patients.
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Affiliation(s)
- J L Bisson
- The Royal (Dick) School of Veterinary Studies and the Roslin Insitute, University of Edinburgh, Edinburgh, UK
| | - D J Argyle
- The Royal (Dick) School of Veterinary Studies and the Roslin Insitute, University of Edinburgh, Edinburgh, UK
| | - S A Argyle
- The Royal (Dick) School of Veterinary Studies and the Roslin Insitute, University of Edinburgh, Edinburgh, UK
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Larsen RF, Boysen L, Jessen LR, Guardabassi L, Damborg P. Diversity of Staphylococcus pseudintermedius in carriage sites and skin lesions of dogs with superficial bacterial folliculitis: potential implications for diagnostic testing and therapy. Vet Dermatol 2018; 29:291. [PMID: 29781542 DOI: 10.1111/vde.12549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Staphylococcus pseudintermedius is genotypically diverse within the canine population and multiple strains may colonize individual dogs at any given time. If multiple strains with distinct antimicrobial resistance profiles are present in superficial bacterial folliculitis (SBF), sampling a single skin lesion for culture and antimicrobial susceptibility testing (AST) might be inadequate to select effective therapy. HYPOTHESIS/OBJECTIVES To investigate S. pseudintermedius diversity in carriage sites and lesions of dogs with SBF. ANIMALS Fourteen dogs with SBF. METHODS Staphylococcus pseudintermedius isolates obtained from perineum, gingiva and four to six skin lesions per dog were subjected to pulsed-field gel electrophoresis (PFGE) and AST to assess diversity between lesions. For two dogs, 14-16 isolates per lesion were included in the analysis to assess diversity within lesions. RESULTS Analysis of one isolate per lesion revealed one to four strains displaying unique PFGE profiles, and up to three unique antimicrobial resistance (AMR) profiles for each dog. Multiple pustules from the same dog always harboured the same strain, whereas papules, crusts and collarettes did not. Up to four strains with distinct AMR profiles were isolated from the same lesion in two dogs. In 12 dogs, at least one carriage site strain also was represented in lesions. CONCLUSIONS AND CLINICAL IMPORTANCE Lesions of SBF may harbour multiple S. pseudintermedius strains with distinct antimicrobial resistance profiles. Pustules are the best target for bacterial culture. It remains unclear whether isolation of different strains from other lesion types is a consequence of contamination or co-infection by multiple strains.
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Affiliation(s)
- Rikke Friis Larsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870, Frederiksberg C, Denmark
| | - Lene Boysen
- Veterinary Dermatology Clinic, Kongevejen 159, 2830, Virum, Denmark
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg C, Denmark
| | - Luca Guardabassi
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870, Frederiksberg C, Denmark
| | - Peter Damborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870, Frederiksberg C, Denmark
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Van Cleven A, Sarrazin S, de Rooster H, Paepe D, Van der Meeren S, Dewulf J. Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians. Vet Rec 2017; 182:324. [PMID: 29196488 DOI: 10.1136/vr.104316] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 07/31/2017] [Accepted: 10/29/2017] [Indexed: 11/04/2022]
Abstract
The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials.
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Affiliation(s)
- Alexia Van Cleven
- Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Steven Sarrazin
- Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Hilde de Rooster
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sofie Van der Meeren
- Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Jeroen Dewulf
- Veterinary Epidemiology Unit, Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Pomba C, Rantala M, Greko C, Baptiste KE, Catry B, van Duijkeren E, Mateus A, Moreno MA, Pyörälä S, Ružauskas M, Sanders P, Teale C, Threlfall EJ, Kunsagi Z, Torren-Edo J, Jukes H, Törneke K. Public health risk of antimicrobial resistance transfer from companion animals. J Antimicrob Chemother 2017; 72:957-968. [PMID: 27999066 DOI: 10.1093/jac/dkw481] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Antimicrobials are important tools for the therapy of infectious bacterial diseases in companion animals. Loss of efficacy of antimicrobial substances can seriously compromise animal health and welfare. A need for the development of new antimicrobials for the therapy of multiresistant infections, particularly those caused by Gram-negative bacteria, has been acknowledged in human medicine and a future corresponding need in veterinary medicine is expected. A unique aspect related to antimicrobial resistance and risk of resistance transfer in companion animals is their close contact with humans. This creates opportunities for interspecies transmission of resistant bacteria. Yet, the current knowledge of this field is limited and no risk assessment is performed when approving new veterinary antimicrobials. The objective of this review is to summarize the current knowledge on the use and indications for antimicrobials in companion animals, drug-resistant bacteria of concern among companion animals, risk factors for colonization of companion animals with resistant bacteria and transmission of antimicrobial resistance (bacteria and/or resistance determinants) between animals and humans. The major antimicrobial resistance microbiological hazards originating from companion animals that directly or indirectly may cause adverse health effects in humans are MRSA, methicillin-resistant Staphylococcus pseudintermedius, VRE, ESBL- or carbapenemase-producing Enterobacteriaceae and Gram-negative bacteria. In the face of the previously recognized microbiological hazards, a risk assessment tool could be applied in applications for marketing authorization for medicinal products for companion animals. This would allow the approval of new veterinary medicinal antimicrobials for which risk levels are estimated as acceptable for public health.
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Affiliation(s)
- Constança Pomba
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Merja Rantala
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | | | | | | | | | - Ana Mateus
- Royal Veterinary College, University of London, London, UK
| | - Miguel A Moreno
- Faculty of Veterinary Medicine, Complutense University, Madrid, Spain
| | - Satu Pyörälä
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Modestas Ružauskas
- Veterinary Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pascal Sanders
- Agence Nationale de Sécurité Sanitaire (ANSES), Fougères, France
| | | | | | | | - Jordi Torren-Edo
- European Medicines Agency, London, UK.,Facultat de Veterinària, UAB, Cerdanyola del Vallès, Spain
| | - Helen Jukes
- Veterinary Medicines Directorate, Addlestone, UK
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Barbarossa A, Rambaldi J, Miraglia V, Giunti M, Diegoli G, Zaghini A. Survey on antimicrobial prescribing patterns in small animal veterinary practice in Emilia Romagna, Italy. Vet Rec 2017; 181:69. [PMID: 28512231 DOI: 10.1136/vr.104128] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This investigation provides for the first time a general view of the prescribing patterns of
antimicrobials in small animal practice in Emilia Romagna, Italy. In the context of a project
on antimicrobial resistance managed by the Regional Veterinary Service, veterinary clinicians
were invited to voluntarily complete an online questionnaire. This was designed to gather
information on antimicrobial prescribing practices and biosecurity measures and to
understand the perception of the issue specific to this region of Italy. In total, 266
questionnaires correctly completed were collected. Although clinicians seemed to follow
different approaches when using antimicrobials, the data analysis revealed a general
awareness on resistance. Penicillins were the most commonly prescribed class, followed by
(fluoro)quinolones and cephalosporins. Among those who use laboratory testing more or
less frequently (microbiological analysis and susceptibility testing) to support their
prescribing habits, only 7 per cent make a habit of always waiting for the results before
starting the treatment. Seventy-eight per cent of the respondents declared the use of
antimicrobials licensed for human beings. Biosecurity measures were carefully taken into
account by the majority of the veterinarians. The results identified the antimicrobial classes
that are commonly prescribed and highlighted that perioperative hygiene measures and the
use of laboratory diagnosis are critical aspects that need to be emphasised in drawing up
guidelines on the prudent use of these drugs in pets.
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Affiliation(s)
- A Barbarossa
- University of Bologna, Ozzano dell'Emilia, Italy
| | - J Rambaldi
- University of Bologna, Ozzano dell'Emilia, Italy
| | - V Miraglia
- Servizio Prevenzione Collettiva e Sanità Pubblica, Bologna, Italy
| | - M Giunti
- University of Bologna, Ozzano dell'Emilia, Italy
| | - G Diegoli
- Servizio Prevenzione Collettiva e Sanità Pubblica, Bologna, Italy
| | - A Zaghini
- University of Bologna, Ozzano dell'Emilia, Italy
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Fowler H, Davis MA, Perkins A, Trufan S, Joy C, Buswell M, McElwain TF, Moore D, Worhle R, Rabinowitz PM. A survey of veterinary antimicrobial prescribing practices, Washington State 2015. Vet Rec 2016; 179:651. [PMID: 27807211 DOI: 10.1136/vr.103916] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 01/18/2023]
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.
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Affiliation(s)
- H Fowler
- Department of Occupational and Environmental Health Sciences, Center for One Health Research (COHR), University of Washington School of Public Health, Seattle, Washington, USA
| | - M A Davis
- Washington State One Health Veterinary Workgroup
| | - A Perkins
- Washington State One Health Veterinary Workgroup
| | - S Trufan
- Department of Occupational and Environmental Health Sciences, Center for One Health Research (COHR), University of Washington School of Public Health, Seattle, Washington, USA
| | - C Joy
- Washington State One Health Veterinary Workgroup
| | - M Buswell
- Washington State One Health Veterinary Workgroup
| | - T F McElwain
- Washington State One Health Veterinary Workgroup
| | - D Moore
- Washington State One Health Veterinary Workgroup
| | - R Worhle
- Washington State One Health Veterinary Workgroup
| | - P M Rabinowitz
- Department of Occupational and Environmental Health Sciences, Center for One Health Research (COHR), University of Washington School of Public Health, Seattle, Washington, USA
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Jones P, Marier E, Tranter R, Wu G, Watson E, Teale C. Factors affecting dairy farmers’ attitudes towards antimicrobial medicine usage in cattle in England and Wales. Prev Vet Med 2015; 121:30-40. [DOI: 10.1016/j.prevetmed.2015.05.010] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 05/28/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
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46
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Whitehouse W, Viviano K. Update in feline therapeutics: clinical use of 10 emerging therapies. J Feline Med Surg 2015; 17:220-34. [PMID: 25701861 PMCID: PMC11148892 DOI: 10.1177/1098612x15571879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE The field of veterinary medicine is constantly evolving. New medications are being introduced into clinical practice, and novel uses for established medications are frequently being discovered as new information comes to light. CLINICAL CHALLENGES Therapeutic options for our feline patients can be restricted based on inadequate clinical evidence, adverse effects and patient compliance concerns. Additionally, with the reduced availability of commonly used medications in some regions, clinicians are forced to utilize alternatives with which they may have limited experience. AUDIENCE This review article is directed towards primary care veterinarians working with feline patients. The selection of medications discussed is based on many of the clinical challenges commonly encountered in practice. EVIDENCE BASE The evidence for use of some of these medications is limited due to their novelty. Known mechanisms of action, pharmacokinetic and pharmacodynamics data, adverse effects and clinical uses are reviewed where possible, with clinical recommendations made based on the evidence of data available.
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Affiliation(s)
- William Whitehouse
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
| | - Katrina Viviano
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, 2015 Linden Drive, Madison, WI 53706, USA
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47
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Summers JF, Hendricks A, Brodbelt DC. Prescribing practices of primary-care veterinary practitioners in dogs diagnosed with bacterial pyoderma. BMC Vet Res 2014; 10:240. [PMID: 25293803 PMCID: PMC4193143 DOI: 10.1186/s12917-014-0240-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/23/2014] [Indexed: 11/23/2022] Open
Abstract
Background Concern has been raised regarding the potential contributions of veterinary antimicrobial use to increasing levels of resistance in bacteria critically important to human health. Canine pyoderma is a frequent, often recurrent diagnosis in pet dogs, usually attributable to secondary bacterial infection of the skin. Lesions can range in severity based on the location, total area and depth of tissue affected and antimicrobial therapy is recommended for resolution. This study aimed to describe patient signalment, disease characteristics and treatment prescribed in a large number of UK, primary-care canine pyoderma cases and to estimate pyoderma prevalence in the UK vet-visiting canine population. Results Of 54,600 dogs presented to 73 participating practices in 2010, 683 (1.3%) had a pyoderma diagnosis recorded in available electronic patient record (EPR) data. Antimicrobials were dispensed in 97% of cases and most dogs were prescribed systemic therapy (92%). Agents most frequently prescribed were amoxicillin-clavulanate, cefalexin, clindamycin and cefovecin. Systemic antimicrobials were prescribed for fewer than 14 days in around 40% of study cases reviewed in detail. Prescribed daily doses were below minimum recommended daily dose (MRDD) in 26% of 43 dogs with sufficient information for calculation of minimum dose. Conclusions Antimicrobial prescribing behaviour for treatment of canine pyoderma was variable but frequently appeared inconsistent with current recommendations. Use of clinical data from primary practice EPRs can provide valuable insight into common clinical conditions and associated prescribing. Electronic supplementary material The online version of this article (doi:10.1186/s12917-014-0240-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer F Summers
- Department of Population and Public Health (PPH), Royal Veterinary College, Hatfield, UK.
| | - Anke Hendricks
- Queen Mother Hospital for Animals (QMHA), Royal Veterinary College, Hatfield, UK.
| | - David C Brodbelt
- Department of Population and Public Health (PPH), Royal Veterinary College, Hatfield, UK.
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48
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Song CY, Nam EH, Park SH, Hwang CY. In vitroefficacy of the essential oil fromLeptospermum scoparium(manuka) on antimicrobial susceptibility and biofilm formation inStaphylococcus pseudintermediusisolates from dogs. Vet Dermatol 2013; 24:404-8, e87. [DOI: 10.1111/vde.12045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Chi-Youn Song
- The Research Institute for Veterinary Science; College of Veterinary Medicine; Seoul National University; Seoul; 151-742; Korea
| | - Eui-Hwa Nam
- The Research Institute for Veterinary Science; College of Veterinary Medicine; Seoul National University; Seoul; 151-742; Korea
| | - Seol-Hee Park
- The Research Institute for Veterinary Science; College of Veterinary Medicine; Seoul National University; Seoul; 151-742; Korea
| | - Cheol-Yong Hwang
- The Research Institute for Veterinary Science; College of Veterinary Medicine; Seoul National University; Seoul; 151-742; Korea
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49
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Valentine BK, Dew W, Yu A, Weese JS. In vitroevaluation of topical biocide and antimicrobial susceptibility ofStaphylococcus pseudintermediusfrom dogs. Vet Dermatol 2012; 23:493-e95. [DOI: 10.1111/j.1365-3164.2012.01095.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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50
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Mateus A, Brodbelt DC, Barber N, Stärk KDC. Antimicrobial usage in dogs and cats in first opinion veterinary practices in the UK. J Small Anim Pract 2011; 52:515-21. [PMID: 21824147 DOI: 10.1111/j.1748-5827.2011.01098.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To provide baseline data on patterns of antimicrobial usage in dogs and cats through the analysis of data stored in electronic practice management systems. METHODS Clinical data from 11 first opinion veterinary practices were extracted for the year 2007. Descriptive statistical analysis was performed to assess the usage of antimicrobials. RESULTS Widespread usage of systemic broad-spectrum antimicrobials was observed. Antimicrobials most frequently used in both species were potentiated amoxicillin (44·4% and 46.1% in cats and dogs, respectively) and amoxicillin (14·3% and 20·7%). Cephalexin (13·4%) and cefovecin (15·0%) were also commonly used in dogs and cats, respectively. Systemic critically important antimicrobials in human medicine were widely used in dogs (60·5%) and cats (82·7%). Topical antimicrobials used in both species included fusidic acid (48·4% and 54·8%), framycetin (20·4% and 13·4%), polymyxin B (12·6% and 9·3%) and neomycin (6·5% and 6·6%). CLINICAL SIGNIFICANCE Inappropriate usage of broad-spectrum antimicrobials may contribute to the development of antimicrobial resistance and loss of efficacy of antimicrobials in veterinary settings. Data recorded in practice management systems were demonstrated to be a practical source for monitoring antimicrobial usage in pets.
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Affiliation(s)
- A Mateus
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Campus, North Mymms, Hertfordshire AL9 7TA School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX
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