FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Antimicrobial prescribing and antimicrobial resistance surve...
Equine veterinary journal2022; 55(3); 494-505; doi: 10.1111/evj.13587

Antimicrobial prescribing and antimicrobial resistance surveillance in equine practice.

Abstract: Antimicrobial resistance (AMR) is an increasingly serious threat to human and animal health, therefore responsible use of antimicrobials in equine practice is vital. There is a need to have accurate, up to date data on antimicrobial prescribing in equine practice in the UK. Objective: To characterise current antimicrobial prescribing practices by equine veterinarians and to describe surveillance, audit processes and identification of AMR. Methods: Online cross-sectional, questionnaire-based survey. Methods: An online questionnaire targeting veterinarians who treat horses in the UK and Europe was distributed. The questionnaire collected data on participants' country of origin, practice policies, prescribing practices including use of high priority critical antimicrobials. Four common clinical case-based scenarios were included to further explore prescribing practice. Responses were compared using both descriptive statistics and multivariable logistic regression models. Results: Questionnaires were completed by 264 veterinarians from Europe (n = 33/264) and the UK (n = 231/264); 87% respondents worked only with horses and 67% worked at premises with hospitalisation facilities. Approximately half of respondents (54.4%) had a written antimicrobial use or stewardship policy within their practice. Over half of respondents did not perform any environmental surveillance (54.2%), audit of clinical infections (53.1%) or audit of infection control (57.1%). Potentiated sulphonamides were cited as the most used antimicrobial, although 44% reported using enrofloxacin in the last year and 66% used 3rd or 4th generation cephalosporins. Prophylactic antimicrobials before clean surgery were frequently/always prescribed by 48% respondents and 24% respondents frequently/always prescribed antimicrobials post-operatively in clean surgery. Conclusions: Potential selection bias of respondents, given individuals volunteered to take part in the survey. Conclusions: Compared with a previous similar study conducted in 2009, overall antimicrobial usage appeared to be declining in clinical scenarios and a greater proportion of practices now have stewardship policies. However, the use of high priority critical antimicrobials is still relatively common in equine practice in the UK and Europe.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Get Full Text
Publication Date: 2022-06-19 PubMed ID: 35575046DOI: 10.1111/evj.13587Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research examines the use of antimicrobials in horse veterinary practice across the UK and Europe, and its impact on antimicrobial resistance (AMR). The study concludes the overall use of antimicrobials appears to be decreasing, but the use of high-priority critical antimicrobials remains common.

Methodology

  • The research process involved an online cross-sectional survey with a questionnaire targeting veterinarians treating horses in the UK and Europe.
  • The questionnaire gathered information on the participants’ country of origin, their practice policies, and their antimicrobial prescribing practices.
  • The questionnaire also included usage of high-priority critical antimicrobials, and had four common clinical case-based scenarios to further understand prescribing practices.
  • Statistical methods such as descriptive statistics and multivariable logistic regression models were employed to compare responses.

Results

  • The survey recorded responses from 264 veterinarians across Europe and the UK, with a majority being sole equine practitioners and practicing in facilities with hospitalization capacities.
  • About 54.4% of respondents reported having a written antimicrobial use or stewardship policy in their practices.
  • A significant percentage of respondents did not undertake environmental surveillance (54.2%), audit of clinical infections (53.1%), or audit of infection control (57.1%).
  • Responses revealed potentiated sulphonamides were the most commonly used antimicrobial, but 44% admitted to using enrofloxacin in the last year and 66% used 3rd or 4th generation cephalosporins.
  • About 48% of respondents usually prescribed prophylactic antimicrobials before clean surgery and 24% frequently prescribed antimicrobials post-operatively in clean surgery.

Conclusion

  • The study posits a potential selection bias as respondents volunteered their participation.
  • Comparatively, the study found that overall antimicrobial usage seemed to be lowering from a similar study conducted in 2009, and more practices now have stewardship policies in place for antimicrobial usage.
  • However, the study also emphasized that the use of high-priority critical antimicrobials remains prevalent within equine practice in the UK and Europe, highlighting a concern for the development and spread of AMR.

Cite This Article

APA
Wilson A, Mair T, Williams N, McGowan C, Pinchbeck G. (2022). Antimicrobial prescribing and antimicrobial resistance surveillance in equine practice. Equine Vet J, 55(3), 494-505. https://doi.org/10.1111/evj.13587

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 3
Pages: 494-505

Researcher Affiliations

Wilson, Amie
  • Department of Equine Clinical Science, Institute of Veterinary and Ecological Sciences, University of Liverpool, Neston, UK.
Mair, Tim
  • Bell Equine Veterinary Clinic, Kent, UK.
Williams, Nicola
  • Department of Equine Clinical Science, Institute of Veterinary and Ecological Sciences, University of Liverpool, Neston, UK.
McGowan, Catherine
  • Department of Equine Clinical Science, Institute of Veterinary and Ecological Sciences, University of Liverpool, Neston, UK.
Pinchbeck, Gina
  • Department of Equine Clinical Science, Institute of Veterinary and Ecological Sciences, University of Liverpool, Neston, UK.

MeSH Terms

  • Humans
  • Animals
  • Horses
  • Anti-Bacterial Agents / therapeutic use
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial
  • Anti-Infective Agents / therapeutic use
  • Surveys and Questionnaires
  • Veterinarians

References

This article includes 48 references
  1. Isgren C. Antimicrobial resistance in horses.. Vet Rec 2018;183:316-8.
  2. Panzuti P, Rocafort Ferrer G, Mosca M, Pin D. Equine pastern vasculitis in a horse associated with a multidrug-resistant Pseudomonas aeruginosa isolate.. Vet Dermatol 2020;31:247.
  3. Spijk JN, Schmitt S, Schoster A. Infections caused by multidrug-resistant bacteria in an equine hospital (2012-2015).. 12th ed. Great Britain: John Wiley & Sons Ltd; 2019.
  4. Gilbertie JM, Schnabel LV, Stefanovski D, Kelly DJ, Jacob ME, Schaer TP. Gram-negative multi-drug resistant bacteria influence survival to discharge for horses with septic synovial structures: 206 cases (2010-2015).. Vet Microbiol 2018;226:64-73.
  5. Johns IC, Adams EL. Trends in antimicrobial resistance in equine bacterial isolates: 1999-2012.. Vet Rec 2015;176:334.
  6. Theelen MJP, Wilson WD, Edman JM, Magdesian KG, Kass PH. Temporal trends in in vitro antimicrobial susceptibility patterns of bacteria isolated from foals with sepsis: 1979-2010.. Equine Vet J 2014;46:161-8.
  7. Department of Health. Tackling antimicrobial resistance 2019-2024-The UK's 5 year national action plan.. 2019.
  8. British Veterinary Association. BVA-Responsible use of antimicrobials.. 2020.
  9. British Small Animal Veterinary Association. BSAVA-Protect Me.. 2020.
  10. British Equine Veterinary Association. BEVA-Protect Me Toolkit.. 2020.
  11. World Health Organisation. Critically Important Antimicrobials for Human Medicine-6th Revision.. 2018.
  12. European Medicines Agency. Categorisation of antibiotics used in animals promotes responsible use to protect public and animal health.. 2020.
  13. UK-VARSS. Veterinary Antibiotic Resistance and Sales Surveillance Report (UK-VARSS 2019).. 2020.
  14. Allen S, Brodbelt D, Slater J, Verheyen K. Use of protected antimicrobials in UK equine practice.. Equine Vet J 2020;52(S54):13-3.
  15. Dunkel B, Corley KTT. Pathophysiology, diagnosis and treatment of neonatal sepsis.. Equine Vet Educ 2015;27:92-8.
  16. Theelen MJP, Wilson WD, Byrne BA, Edman JM, Kass PH, Mughini-Gras L. Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization.. J Vet Intern Med 2020;34:955-63.
  17. Toombs-Ruane LJ, Riley CB, Kendall AT, Hill KE, Benschop J, Rosanowski SM. Antimicrobial susceptibility of bacteria isolated from neonatal foal samples submitted to a New Zealand veterinary pathology laboratory (2004 to 2013).. N Z Vet J 2016;64:107-11.
  18. Welsh CE, Parkin TDH, Marshall JF. Use of large-scale veterinary data for the investigation of antimicrobial prescribing practices in equine medicine.. Equine Vet J 2017;49:425-32.
  19. Atherton RP, Furr M. Endotoxin release after antimicrobial treatment in sick foals is mediated by antimicrobial class.. J Equine Vet 2006;26:356-63.
  20. Ross SE, Duz M, Rendle DI. Antimicrobial selection and dosing in the treatment of wounds in the United Kingdom.. Equine Vet J 2016;48:676-80.
  21. Bowen M. Antimicrobial stewardship: time for change.. Equine Vet J 2013;45:127-9.
  22. Mair TS, Parkin TD. Audit of antimicrobial use in eleven equine practices over a five-year period (2014-2018).. Equine Vet Educ 2020.
    doi: 10.1111/eve.13438google scholar: lookup
  23. Borg H, Carmalt JL. Postoperative septic arthritis after elective equine arthroscopy without antimicrobial prophylaxis.. Vet Surg 2013;42:262-6.
  24. Southwood LL. Perioperative antimicrobials: should we be concerned about antimicrobial drug use in equine surgical patients?. Equine Vet J 2014;46:267-9.
  25. Toia F, D'Arpa S, Massenti MF, Amodio E, Pirrello R, Moschella F. Perioperative antibiotic prophylaxis in plastic surgery: a prospective study of 1,100 adult patients.. J Plast Reconstr Aesthet Surg 2012;65:601-9.
  26. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK. Clinical practice guidelines for antimicrobial prophylaxis in surgery.. Am J Health Syst Pharm 2013;70:195-283.
  27. Aiken MJ, Hughes TK, Abercromby RH, Holmes MA, Anderson AA. Prospective, randomized comparison of the effect of two antimicrobial regimes on surgical site infection rate in dogs undergoing orthopedic implant surgery.. Vet Surg 2015;44:661-7.
  28. Freeman KD, Southwood LL, Lane J, Lindborg S, Aceto HW. Post operative infection, pyrexia and perioperative antimicrobial drug use in surgical colic patients.. Equine Vet J 2012;44:476-81.
  29. Hardefeldt LY, Browning GF, Thursky K, Gilkerson JR, Billman-Jacobe H, Stevenson MA. Antimicrobials used for surgical prophylaxis by equine veterinary practitioners in Australia.. Equine Vet J 2018;50:65-72.
  30. Hammersley E, Marshall JF, Parkin TDH, Duz M, Welsh CE. Retrospective study of the use of reserved antimicrobials in first-opinion UK equine veterinary practice.. Equine Vet J 2016;48:22-2.
  31. Isgren CM, Williams NJ, Fletcher OD, Timofte D, Maddox TW, Clegg PD. Antimicrobial resistance surveillance from clinical submissions in UK horses.. Equine Vet J 2019;51(S53):26.
  32. Isgren CM, Williams NJ, Fletcher OD, Timofte D, Newton JR, Maddox TW. Antimicrobial resistance in clinical bacterial isolates from horses in the UK.. Equine Vet J 2022;54(2):390-414.
  33. van Spijk JN, Schmitt S, Schoster A. Infections caused by multidrug-resistant bacteria in an equine hospital (2012-2015).. Equine Vet Educ 2019;31:653-8.
  34. Ruple-Czerniak AA, Aceto HW, Bender JB, Paradis MR, Shaw SP, Van Metre DC. Syndromic surveillance for evaluating the occurrence of healthcare-associated infections in equine hospitals.. Equine Vet J 2014;46:435-40.
  35. Dziubinski N, Mählmann K, Lübke-Becker A, Lischer C. Retrospective identification of bacterial isolates from emergency laparotomy surgical site infections in horses.. J Equine Vet Sci 2020;87:102927.
  36. Bortolami A, Williams NJ, McGowan CM, Kelly PG, Archer DC, Corrò M. Environmental surveillance identifies multiple introductions of MRSA CC398 in an equine veterinary hospital in the UK, 2011-2016.. Sci Rep 2017;7:5499.
  37. Allen JL, Bushell RN, Browning GF, Marenda MS. Routine environmental surveillance and rep-PCR fingerprinting for the management of a complex salmonella outbreak in a veterinary equine teaching hospital.. J Equine Vet 2016;39:S2.
  38. van Balen J, Mowery J, Piraino-Sandoval M, Nava-Hoet RC, Kohn C, Hoet AE. Molecular epidemiology of environmental MRSA at an equine teaching hospital: introduction, circulation and maintenance.. Vet Res 2014;45:31.
  39. Pandya M, Wittum T, Tadesse DA, Gebreyes W, Hoet A. Environmental salmonella surveillance in the Ohio State University veterinary teaching hospital.. Vector-Borne Zoonotic Dis 2009;9(6):649-54.
  40. Leon IM, Lawhon SD, Norman KN, Threadgill DS, Ohta N, Vinasco J. Serotype diversity and antimicrobial resistance among salmonella enterica isolates from patients at an equine referral hospital.. Appl Environ Microbiol 2018;84(13):e02829-17.
  41. Ward MP, Brady TH, Couëtil LL, Liljebjelke K, Maurer JJ, Wu CC. Investigation and control of an outbreak of salmonellosis caused by multidrug-resistant salmonella typhimurium in a population of hospitalized horses.. Vet Microbiol 2005;107:233-40.
  42. van Duijkeren E, Moleman M, Sloet van Oldruitenborgh-Oosterbaan MM, Multem J, Troelstra A, Fluit AC. Methicillin-resistant Staphylococcus aureus in horses and horse personnel: an investigation of several outbreaks.. Vet Microbiol 2010;141:96-102.
  43. Prescott JF. Outpacing the resistance tsunami: antimicrobial stewardship in equine medicine, an overview.. Equine Vet Educ 2020;33:539-45.
  44. McKenzie KE, Mayorga ME, Miller KE, Singh N, Arnold RC, Romero-Brufau S. Notice to comply: a systematic review of clinician compliance with guidelines surrounding acute hospital-based infection management.. Am J Infect Control 2020;48:940-7.
  45. Bergström K, Nyman G, Widgren S, Johnston C, Grönlund-Andersson U, Ransjö U. Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden.. Acta Vet Scand 2012;54:14.
  46. Cummings KJ, Rodriguez-Rivera LD, Mitchell KJ, Hoelzer K, Wiedmann M, McDonough PL. Salmonella enterica serovar Oranienburg outbreak in a veterinary medical teaching hospital with evidence of nosocomial and on-farm transmission.. Vector Borne Zoonotic Dis 2014;14:496-502.
  47. Royal College of Veterinary Surgeons. Practice Standards Scheme.. 2021.
  48. Hughes LA, Pinchbeck G, Callaby R, Dawson S, Clegg P, Williams N. Antimicrobial prescribing practice in UK equine veterinary practice.. Equine Vet J 2013;45:141-7.

Citations

This article has been cited 11 times.
  1. Pereira AF, de Rago L, Pinho JO, Plácido AI, Figueiras A, Roque F, Herdeiro MT, Coelho AC, Oliveira PA. Veterinarians' attitudes, knowledge, and practices about antibiotic use in animals: questionnaire design and reliability. Front Vet Sci 2025;12:1754010.
    doi: 10.3389/fvets.2025.1754010pubmed: 41647437google scholar: lookup
  2. Sousa A, de Rago L, Pinho JO, Estrela M, Coelho AC, Oliveira PA, Figueiras A, Roque F, Herdeiro MT. Understanding how veterinarians' knowledge, attitudes, and practices influence antibiotic prescription: a systematic review of survey studies. BMC Vet Res 2025 Sep 24;21(1):543.
    doi: 10.1186/s12917-025-05001-6pubmed: 40993662google scholar: lookup
  3. Graham AE, Colgate VA, Floyd EF. Antibiograms of Bacterial Cultures From Equine Neonates at a United Kingdom Hospital: 381 Samples (2018-2023). J Vet Intern Med 2025 Sep-Oct;39(5):e70198.
    doi: 10.1111/jvim.70198pubmed: 40802493google scholar: lookup
  4. Stuart RB, Miles-Farrier F, Bard AM, Rees G. Understanding antimicrobial use by equine owners in Wales: Using cross-sectional survey and semi-structured interviews. Equine Vet J 2026 Mar;58(2):564-579.
    doi: 10.1111/evj.14522pubmed: 40394995google scholar: lookup
  5. Gao T, Liu X, Qiu D, Li Y, Qiu Z, Qi J, Li S, Guo X, Zhang Y, Wang Z, Gao X, Ma Y, Ma T. Ex Vivo Pharmacokinetic/Pharmacodynamic Integration Model of Cefquinome Against Escherichia coli in Foals. Vet Sci 2025 Mar 22;12(4).
    doi: 10.3390/vetsci12040294pubmed: 40284796google scholar: lookup
  6. Sjöberg I, Horn I, Ljungvall K, Andersen PH, Sternberg-Lewerin S. Influence of antimicrobial prophylaxis in horses undergoing sutured castrations. Vet Surg 2025 Jul;54(5):872-878.
    doi: 10.1111/vsu.14256pubmed: 40159848google scholar: lookup
  7. Hepworth-Warren KL, Love K. Survey of the approach to the diagnosis and management of bacterial pneumonia in adult horses by equine veterinarians. Front Vet Sci 2024;11:1484970.
    doi: 10.3389/fvets.2024.1484970pubmed: 39764370google scholar: lookup
  8. Hallowell KL, Hepworth-Warren KL, Dembek K. An updated description of bacterial pneumonia in adult horses and factors associated with death. J Vet Intern Med 2024 Sep-Oct;38(5):2766-2775.
    doi: 10.1111/jvim.17141pubmed: 39005215google scholar: lookup
  9. Yang B, Liu S, Cheng J, Qu H, Guo Y, Ji C, Wang Y, Zhao S, Huang S, Zhao L, Ma Q. Pharmacokinetics of Enrofloxacin in Plasma, Urine, and Feces of Donkey (Equus asinus) after a Single Intragastric Administration. Antibiotics (Basel) 2024 Apr 12;13(4).
    doi: 10.3390/antibiotics13040355pubmed: 38667031google scholar: lookup
  10. van den Brom-Spierenburg AJ, Mureșan AN, Westermann CM. Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey. Animals (Basel) 2024 Jan 30;14(3).
    doi: 10.3390/ani14030457pubmed: 38338101google scholar: lookup
  11. Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008-2021. Animals (Basel) 2023 Nov 19;13(22).
    doi: 10.3390/ani13223573pubmed: 38003189google scholar: lookup
Subscribe to our newsletter
Join 99,316 horse owners like you who receive our email updates on horse health and nutrition.