Antimicrobial prescribing practice in UK equine veterinary practice.

The research article examines the patterns and factors associated with antimicrobial prescriptions in UK horse veterinary practice. The study uncovers the frequent prescribing of potentiated sulphonamides, off-licence drugs, and incorrect doses. It further identifies a dearth of antimicrobial use guidelines, suggesting the need for such frameworks to foster prudent antimicrobial use.

Study Design and Methodology

• The researchers sent postal questionnaires to 740 veterinary surgeons that operate within the equine field.
• The questionnaire contained four hypothetical clinical scenarios along with requests for information relating to the clinician, their practice, and their sources of advice regarding the use of antimicrobials.
• The team employed multivariable logistic regression analysis to investigate the factors linked with five outcomes: prescribing off-licence drugs, incorrect dosages, 3rd or 4th generation cephalosporins, fluoroquinolones, and potentiated sulphonamides.

Key Findings of the Study

• The response rate was 38%. The most common antimicrobial prescribed in response to each scenario was Trimethoprim-sulphonamides.
• Only less than 1% of veterinary practices had established antimicrobial use guidelines.
• Off-licence drugs accounted for 11% of total prescriptions. ‘Off-licence’ implies that these drugs are not licensed for use in equines within the UK.
• Five percent of licensed antimicrobial prescriptions fell below the recommended dosage, while a startling 56% exceeded it.
• Prescriptions for fluoroquinolones and 3rd and 4th generation cephalosporins were limited, accounting for 1% and 3% of all prescriptions respectively.
• Veterinary surgeons in referral practices were more likely to prescribe fluoroquinolones, 3rd and 4th generation cephalosporins, and off-licence drugs, while those in first-opinion practices leaned more towards potentiated sulphonamides.

Conclusion and Implications

• The study determined that it was common for veterinarians to prescribe antimicrobials at incorrect doses, even when informed of the animal’s weight.
• Moreover, most UK equine veterinary practices lack guidelines on antibiotic use. The authors suggest that implementing these could encourage more responsible use of these potentially life-saving drugs.
• The findings highlight an urgent need for education and regulation to ensure the longevity of these essential medicines and to lessen the chances of antimicrobial resistance.