Cross-sectional survey on the use and impact of the Danish national antibiotic use guidelines for companion animal practice

Background

The Danish antibiotic use guidelines for companion animal practice were published by the Danish Veterinary Association in 2012. Since then, national surveillance data indicate a 10% reduction in the total use of antibiotics for companion animals, particularly a marked reduction in the use of third generation cephalosporins. The aim of the study was to assess if and how the guidelines have impacted diagnostic and antibiotic prescription habits of the users, and to identify user perceived barriers to implementation.

Results

An online questionnaire was sent to all 882 members of the Danish Small Animal Veterinary Association in October 2015. The survey was completed by 151 veterinarians. Respondents most frequently consulted the recommendations on skin and urinary tract infections (UTI), and users generally reported a high degree of adherence to the recommendations. Sixty-five per cent indicated that the guidelines had influenced their habits in one or more of the areas being investigated, i.e. perioperative use of antibiotics, use of first line antibiotics for the treatment of pyoderma or UTI, and/or use of microbiological diagnostics. Perioperative use of antibiotics for clean surgeries was uncommon, irrespective of whether respondents had consulted the relevant recommendations or not. On the contrary, significant differences in the prescribing habits between guideline users and non-users were observed for pyoderma and UTI, suggesting an impact of the guidelines towards more prudent antimicrobial use. The diagnostic habits were examined in a subgroup of 63 guideline users. Of those, 19 and 39% reported frequent use of culture and susceptibility (C&S) testing prior to treating pyoderma and UTI respectively, whereas 68–84% reported C&S testing in the event of poor response to treatment or recurrence of infections. The main barriers for implementation of therapeutic recommendations were confidence in old prescribing practices and unavailability of recommended drugs. The main barriers for C&S testing were good experience with empiric treatment, and the owners’ financial situation.

Conclusions

The findings suggest a positive influence of the national antibiotic guidelines on prescription patterns among companion animal practitioners in Denmark. Sustained campaign activity is encouraged and should include promotion of bacteriological testing.

Electronic supplementary material

The online version of this article (10.1186/s13028-017-0350-8) contains supplementary material, which is available to authorized users.

Antimicrobial stewardship in small animal veterinary practice: from theory to practice

Despite the increasing recognition of the critical role for antimicrobial stewardship in preventing the spread of multidrug-resistant bacteria, examples of effective antimicrobial stewardship programs are rare in small animal veterinary practice. This article highlights the basic requirements for establishing stewardship programs at the clinic level. The authors provide suggestions and approaches to overcome constraints and to move from theoretic concepts toward implementation of effective antimicrobial stewardship programs in small animal clinics.

A Critical Evaluation and Comparison of Antimicrobial Prophylaxis in Elective Surgeries Across three Hospitals

OBJECTIVES

1. To evaluate and compare the pattern and rationality of prophylactic antimicrobial therapy in elective surgeries. 2. To evaluate and compare the adherence of hospitals to the standard guidelines on prophylactic antimicrobial therapy.

METHODOLOGY

A total of 150 patients each from a government hospital (group I), medical college teaching hospital (group II), and corporate hospital attached to the institution (group III) who had undergone elective, non-complicated surgery were included. The number & types of antimicrobials used along with duration were noted. Rationality was assessed on the basis of Kunin's criteria, ASHP guidelines & SIGN guidelines. Statistical analysis was done using appropriate tests.

RESULTS

Cephalosporins were the most commonly used antimicrobials in all three groups (52.6%,85.7% & 84.8% respectively) followed by nitroimidazoles. Antimicrobial prophylaxis was appropriate in only 14.1%, 23.3% & 32.9% cases in the three groups respectively (p<0.01).The most common problem was prolonged duration of administration in 50.3%,58% & 45% respectively. The implementation of prophylaxis with respect to regimen & duration was erroneous in 20.1%, 12.7% & 4.7% respectively (p<0.01).

CONCLUSION

The rationality & regimen of antimicrobial prophylaxis was comparatively better in the corporate hospital followed by medical college hospital and the government hospital. The present study calls for an urgent review on rational use of antimicrobials for prophylaxis in all the 3 hospitals.