What's Happening?
A recent study published in the Journal of Veterinary Internal Medicine found that nearly one in three pets (30.4%) treated at U.S. and Canadian veterinary teaching hospitals received at least one antibiotic prescription. The research, which reviewed
medical records from 1,800 dogs and cats in August 2022 across 31 institutions, highlighted areas for improved antimicrobial stewardship. While overall antibiotic prescribing rates have seen a decline from 36.5% in 2020 to 30.4% in 2022, the study identified concerns regarding surgical prophylaxis, the management of urinary tract infections, and the frequent use of broad-spectrum antibiotics, particularly fluoroquinolones. For instance, 64.3% of animals undergoing surgery received antibiotics, with 55.5% for elective surgeries and 26.3% for spay/neuter procedures. The study also noted that first-line antibiotic recommendations were not consistently followed for sporadic bacterial cystitis, and diagnostic testing, such as bacterial culture and susceptibility testing, was only performed in 27.9% of antibiotic-prescribed cases.
Why It's Important?
The findings are significant because veterinary teaching hospitals play a crucial role in shaping the prescribing habits of future veterinarians. The overuse or inappropriate use of antibiotics in animals contributes to antimicrobial resistance, a 'One Health' concern where resistant bacteria can transfer between animals, humans, and the environment. The study's revelation that critically important antibiotics like fluoroquinolones are frequently prescribed (14.7% of systemic antibiotic prescriptions) is particularly concerning, as these are vital for treating serious bacterial infections in humans. Inappropriate antibiotic use can limit future treatment options for both animals and people. By improving stewardship in these educational settings, there is an opportunity to model responsible prescribing, ensuring that antibiotics remain effective for medically necessary cases and reducing the development of resistance. This impacts public health by mitigating the spread of resistant pathogens across species.
What's Next?
The study suggests that veterinary teaching hospitals have an immediate opportunity to implement and reinforce antimicrobial stewardship programs. This includes reviewing surgical antibiotic protocols to reduce unnecessary prophylaxis, prioritizing appropriate first-line treatments for conditions like sporadic bacterial cystitis, and increasing the use of diagnostic testing to guide antibiotic selection. Educational initiatives for veterinary students, interns, and residents will be crucial to instill systematic approaches to antibiotic use. Furthermore, the development of prescribing benchmarks and regular monitoring of antibiotic use can help institutions evaluate the effectiveness of stewardship interventions. These efforts are expected to lead to more targeted and responsible antibiotic prescribing, ultimately preserving the efficacy of these essential medications for both animal and human health.
Beyond the Headlines
The implications of this study extend beyond veterinary practice, touching upon the broader societal challenge of antimicrobial resistance. The 'One Health' concept underscores the interconnectedness of human, animal, and environmental health. The routine prescribing habits formed in veterinary teaching hospitals can influence practices in general veterinary settings, potentially exacerbating the global issue of antibiotic resistance. This highlights an ethical imperative for veterinary institutions to lead by example, not only in treating individual patients but also in safeguarding public health. The study implicitly calls for a cultural shift towards more judicious antibiotic use, emphasizing that while antibiotics are indispensable, their effectiveness is contingent on responsible application, informed by diagnostics and evidence-based guidelines. This proactive approach is vital to prevent a future where common infections become untreatable.
