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May 15, 2021

Studies aim to improve antimicrobial prescribing in pets

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A Minnesota-based research group will collect data from across the country on how often and why antimicrobials are administered to pets.

The project team sees the potential for the point-prevalence survey to be the first in a long-term series that could aid antimicrobial stewardship efforts in veterinary medicine.

In a separate project, researchers in the United Kingdom found that a series of educational interventions and reviews for practitioners reduced prescriptions of antimicrobials critical for use in human medicine, and organizations plan to apply the results in more veterinary hospitals.

Drs. Bollig, Beaudoin, and Granick
A national survey could help show how often and why antimicrobials are used in veterinary clinics. The leaders of the project team are, from left, Drs. Emma Bollig, Amanda Beaudoin, and Jennifer Granick. (Courtesy of the University of Minnesota)

Minnesota initiative

Dr. Amanda Beaudoin, one of the two principal investigators on the Minnesota-based project funded by the Food and Drug Administration, is an epidemiologist and director of the One Health Antibiotic Stewardship program within the Minnesota Department of Health. Her state government work includes helping officials with the Centers for Disease Control and Prevention gather data on antimicrobial use and hospital-acquired infections in human health care, and she said the team saw an opportunity to replicate that effort in small animal veterinary care.

UMN Antimicrobial Resistance and Stewardship Initiative

Dr. Jennifer Granick, associate professor in the Department of Veterinary Clinical Sciences at the University of Minnesota College of Veterinary Medicine and co-principal investigator, said the research team wants data that can show the national scope of antimicrobial prescribing in companion animal medicine, encompassing what antimicrobial drugs veterinarians prescribe and which diseases they treat with each of those drugs.

Dr. Beaudoin, who is also an adjunct assistant professor at Minnesota’s veterinary college, said existing prescribing guidelines in veterinary medicine cover some specific conditions, such as upper respiratory disease and urinary tract infection. The data from the survey could show how closely prescribing follows guidelines, as well as provide indications whether guidelines are needed for additional diseases common in veterinary medicine, such as acute gastrointestinal disease.

Dr. Emma Bollig, program manager and epidemiologist at the University of Minnesota, said the group plans to recruit veterinary clinics through July and hopes to secure participation from at least 100 total, with at least 25 from each of four regions. Every clinic contributing to the survey will select one day from a two-week period in August and provide data on antimicrobial administration and prescribing from that day. A trained facility coordinator will collect retrospective data on-site using existing health records. Data from all study sites will be compiled to summarize patient characteristics and presenting complaints, antimicrobial prescribing rates, rates of diagnostic testing, and more.

Dr. Granick said the small amount of time volunteered by each veterinary clinic helps ensure the data are more representative of the profession’s antimicrobial use, and she’s excited for the potential for collaboration by veterinarians across the country.

“Each individual practice could contribute data that could be really impactful,” she said.

Research in the United Kingdom

In a separate effort, researchers in the United Kingdom found that a program of education, reflection, and reviews of past practices and factors that may be connected with higher-than-average prescribing helped veterinarians reduce prescribing of antimicrobials considered critically important for human medicine. An article published March 11 in Nature Communications indicates the Royal College of Veterinary Surgeons Trust, which goes by RCVS Knowledge, plans to apply lessons from the study in developing a national antimicrobial stewardship program in collaboration with the hospital chain that hosted the study, CVS Group PLC.

The research group, from the University of Liverpool and CVS, divided veterinary practices with above-average antimicrobial prescribing into three groups: a high-intervention group, a low-intervention group, and a control group. The researchers told the intervention groups they were outliers and gave them one of two tiers of education and guidance about antimicrobial prescribing.

The study results indicate the high-intervention group had sharper overall reductions in antimicrobial prescribing over the low-intervention group, which also had lower overall administration in comparison with the control group. Eight months after the intervention began, the high-intervention group reduced prescribing of highly important antimicrobials for administration to cats by 40% and for administration to dogs by 23%, whereas the low-intervention group reduced prescribing of such drugs for administration to cats by 17% and showed no significant change in prescribing for dogs, according to the study results and a related announcement from RCVS Knowledge.