Antimicrobial prescribing patterns in equine ambulatory practice.

This research aims to analyze the antimicrobial prescription patterns in equine ambulatory services through a retrospective study of billing and medical records. In doing so, the researchers hope to help address the pressing issue of antimicrobial resistance, understand the associated risks, and guide the establishment of antimicrobial stewardship guidelines.

Research Method

• The research has been carried out using a retrospective analysis of billing and electronic medical records. This means that the researchers looked at historical records of cases where antimicrobials were prescribed in an out-of-hospital care environment (ambulatory) for horses.
• The data for prescription frequency, duration, drug class, the prescribing clinician, and the animal’s affected body system were recorded.
• The study further analyzed various factors affecting antimicrobial prescription, including the nature of the visit, whether a culture was submitted for testing, the body system affected, and the prescribing clinician.

Findings

• The study found that antimicrobials were prescribed in 8.5% of visits.
• The median number of Animal-defined daily doses (ADD) – which refers to the quantity of all antimicrobials prescribed in a single visit – was 3.5.
• Aminoglycosides were the most commonly prescribed class of antimicrobials, and trimethoprim-sulfamethoxazole was the most prescribed drug overall.
• Amikacin, a particular type of aminoglycoside, was used primarily for patients showing musculoskeletal signs. The median of ADD here was 1.
• Interestingly, statistically significant differences in antimicrobial use patterns were observed across different clinicians, months, years, and affected body systems.
• Antimicrobial prescription was most common for horses with ocular and integumentary (related to the skin) signs. The chances of antibiotics being prescribed was higher during emergency visits and when a bacterial culture was submitted.

Significance

• Resistance to antimicrobials is a crucial concern for public health globally. This study, which is the first to quantify antimicrobial use in equine ambulatory practice in the US, will help to understand the patterns of antimicrobial use better and identify areas to focus on for curbing unnecessary use.
• By recognizing the factors associated with increase in the likelihood of antimicrobial prescription, the study can help design guidelines to promote better antimicrobial stewardship in equine health care. This is crucial in limiting antimicrobial resistance.