Pattern of prescriptions and prudent use of antimicrobial in horse practice at a Veterinary Teaching Hospital.

This research focuses on the patterns of antimicrobial prescriptions at the University of Pisa’s Veterinary Teaching Hospital over the course of 11 years. It investigates how these prescriptions comply with recommendations for prudent use, specifically the use of such medication in horses.

Prescription Patterns and Usage

This study looked at the following patterns in antimicrobial prescription:

• It was found that at least one antimicrobial was prescribed in every case of surgical prophylaxis used for stitching wounds.
• One-third of horses showing signs of body system disease were prescribed antimicrobials.
• Antimicrobials were administered either as a single treatment (48% of cases), in fixed-dose combinations (21%), or empirical combinations (31%).
• Most prescriptions (63%) were administered via injection, while oral and topical antimicrobials made up 14% and 23% of prescriptions, respectively.
• The most commonly prescribed antimicrobials were gentamicin, benzylpenicillin, and ceftiofur, which constitute a majority of penicillin, aminoglycosides, and cephalosporin classes of antimicrobials.
• Protected antimicrobials, aligning with WHO HPCIA guidelines and rifampicin, accounted for 24% of all dispensed antimicrobials.
• There was a huge range in the classes of prescribed antimicrobials based on the body system being treated, with up to eight different pharmaceutical classes used.
• A high diversity in prescription was confirmed by measuring the prescription diversity index.

Compliance with Prudent Use Recommendations

Furthermore, the researchers analysed how these prescription patterns adhered to recommended guidelines for prudent antimicrobial use:

• Prescriptions were found to be in compliance with recommendations in terms of availability of diagnosis, respect for the recommended dose range, and appropriate duration of treatment.
• However, areas of concern were identified in relation to off-label use, the use of antimicrobials in empirical combinations, the use of antimicrobial susceptibility tests, and the use of protected antimicrobials.
• These findings suggest that while some aspects of prescription align with prudent use recommendations, more needs to be done to fully meet these standards and ensure responsible antimicrobial use in horse treatment.