Antimicrobial selection and dosing in the treatment of wounds in the United Kingdom.

This research paper explores the standards of antimicrobial usage within the equine veterinary profession in the United Kingdom, analysing specifically the levels of protected drugs used and the accuracy with which doses are administered. The study finds suboptimal levels of both these key parameters recommending better adherence to established guidelines and accurate bodyweight measurement for dose determination.

Study Objective

• The main goal of this research was to evaluate the extent of protected antimicrobial usage and the accurateness of their dosing in relation to the treatment of limb wounds in horses, a common scenario in equine practice.

Methods

• The researchers used a retrospective cohort study design, reviewing the cases of 113 horses treated for limb wounds pre-referral to a single referral hospital over a period of 20 months.
• The type of antimicrobial administered—first-line, alternative, or protected—was categorized according to the British Equine Veterinary Association guidelines, which also provided the recommended dosing rates for reference.

Results

• Out of 113 horses, 94 (83.2%) had been treated with systemic antimicrobials prior to their referral.
• 8 (8.5%) of these 94 horses were administered the protected antimicrobials—third or fourth generation cephalosporins or fluoroquinolones.
• It was found that 48 out of 87 horses (55.2%) for which full dosing data was available, received antimicrobials at less than or equal to 90% of the recommended dose.
• The study results demonstrated that practitioners’ choice to use protected antimicrobials or their likelihood of administering inadequate doses did not significantly vary based on factors such as possession of a postgraduate clinical qualification or working in a purely equine practice.
• The study revealed that more experienced veterinary surgeons were less inclined to use protected antimicrobials—a finding to be taken cautiously due to a limited case number.
• Concerning dosage, it was found that heavier horses were more likely subjected to under-dosing.

Conclusions

• The paper reveals inappropriate administration of crucial categories of antimicrobials where their use would probably not be justified.
• Concluding this study, it has been suggested that if past findings reflect the broader attitudes and behavior of the equine practitioners, there is evidently a need for increased awareness and adherence to the recommendations for responsible use of antimicrobials in the field.
• To ensure accurate dosing, the authors advocate measuring or using validated techniques to estimate the bodyweight of horses before administering systemic medications.