Effect of antimicrobial stewardship on antimicrobial prescriptions for selected diseases of dogs in Switzerland. (28th October 2020)

• Record Type: Journal Article
• Authors: Lehner, Claudia; Hubbuch, Alina; Schmitt, Kira; Schuepbach‐Regula, Gertraud; Willi, Barbara; Mevissen, Meike; Peter, Ruth; Muentener, Cedric R.; Naegeli, Hanspeter; Schuller, Simone
• Is Part Of: Journal of veterinary internal medicine. Volume 34:Number 6(2020)
• Page Start: 2418
• Page End: 2431
• Publication Date: 2020-10-28
• Subjects: antibiotic -- antimicrobial resistance -- dog -- guidelines -- prescribing habits; Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.15906
• Languages: English
• ISSNs: 0891-6640

Abstract

Abstract: Background: Antimicrobial stewardship programs (ASPs) are important tools to foster prudent antimicrobial use. Objective: To evaluate antimicrobial prescriptions by Swiss veterinarians before and after introduction of the online ASP AntibioticScout.ch in December 2016. Animals: Dogs presented to 2 university hospitals and 14 private practices in 2016 or 2018 for acute diarrhea (AD; n = 779), urinary tract infection (UTI; n = 505), respiratory tract infection (RTI; n = 580), or wound infection (WI; n = 341). Methods: Retrospective study. Prescriptions of antimicrobials in 2016 and 2018 were compared and their appropriateness assessed by a justification score. Results: The proportion of dogs prescribed antimicrobials decreased significantly between 2016 and 2018 (74% vs 59%; P < .001). The proportion of prescriptions in complete agreement with guidelines increased significantly (48% vs 60%; P < .001) and those in complete disagreement significantly decreased (38% vs 24%; P < .001) during this time. Antimicrobial prescriptions for dogs with AD were significantly correlated with the presence of hemorrhagic diarrhea in both years, but a significantly lower proportion of dogs with hemorrhagic diarrhea were unnecessarily prescribed antimicrobials in 2018 (65% vs 36%; P < .001). In private practices, in 2018 a bacterial etiology of UTI was confirmed in 16% of dogs. Prescriptions for fluoroquinolones significantly decreased (29% vs 14%; P = .002). Prescriptions for antimicrobials decreased significantly in private practices for RTI (54% vs 31%; P < .001). Conclusion: Antimicrobials were used more prudently for the examined indications in 2018 compared to 2016. The study highlights the continued need for ASPs in veterinary medicine.