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Equine veterinary journal2022; 55(5); 808-819; doi: 10.1111/evj.13878

Use of antimicrobials licensed for systemic administration in UK equine practice.

Abstract: Judicious antimicrobial use (AMU) is important for preserving therapeutic effectiveness. Large-scale studies of antimicrobial prescribing can provide clinical benchmarks and help identify opportunities for improved stewardship. Objective: To describe systemic AMU in UK equine practice and identify factors associated with systemic and Category B (third and fourth generation cephalosporins, quinolones and polymixins) AMU. Methods: Retrospective cohort. Methods: Anonymised electronic patient records (EPRs) for all equids attended by 39 UK veterinary practices between 1 January and 31 December 2018 were collected via the VetCompass programme. Systemic antimicrobial prescriptions were identified using electronic keyword searches. Indications for AMU were determined through manual review of a randomly selected subset of EPRs. The types and frequency of systemic antimicrobials prescribed and indications were summarised using descriptive statistics. Mixed-effects logistic regression was used to evaluate practice- and horse-related risk factors. Results: Systemic antimicrobials were prescribed to 12 538 (19.5%, 95% confidence interval [CI]: 19.2%-19.8%) of 64 322 equids attended in 2018. Category B antimicrobials were prescribed to 1.9% (95% CI: 1.8%-2.0%) of attended equids and in 8.9% (95% CI: 8.5%-9.4%) of antimicrobial courses. Bacteriological culture was performed in 19.1% (95% CI: 17.1%-21.3%) of Category B antimicrobial courses. The most commonly prescribed antimicrobial classes were potentiated sulphonamides (50.2% of equids receiving antimicrobials) and tetracyclines (33.5% of equids receiving antimicrobials). Integumentary disorders were the most common reason for systemic AMU (40.5% of courses). Urogenital disorders were the most common reason for Category B AMU (31.1% of courses). Increased odds of systemic and Category B AMU were observed in equids <1 year compared with those aged 5-14 years. Breed was associated with AMU, with odds of systemic and Category B AMU highest in Thoroughbreds and Thoroughbred crosses. Conclusions: Convenience sample of practices may limit generalisability. Conclusions: Empirical use of Category B antimicrobials remains commonplace. Unassigned: Ein umsichtiger Umgang mit antimikrobiellen Medikamenten (AMU) ist wichtig für die Erhaltung der therapeutischen Wirksamkeit. Gross angelegte Studien über die Verschreibung antimikrobieller Medikamente können klinische Vergleichswerte liefern und dazu beitragen Möglichkeiten für eine verbesserte Anwendung zu ermitteln. Unassigned: Beschreibung der systemischen AMU in der britischen Pferdepraxis und Ermittlung von Faktoren, di mit systemischer AMU und AMU der Kategorie B (Cephalosporine der dritten und vierten Generation, Chinolone und Polymyxine) in Verbindung stehen. Methods: Retrospektive Kohorte. Methods: Anonymisierte elektronische Patientenakten (EPRs) für alle Equiden, die zwischen dem 1. Januar und dem 31. Dezember 2018 in 39 britischen Tierarztpraxen behandelt wurden, wurden über das Programm VetCompass™ erfasst. Systemische Verschreibungen von antimikrobiellen Medikamenten wurden durch elektronische Stichwortsuche identifiziert. Die Indikationen für AMU wurden durch manuelle Überprüfung einer zufällig ausgewählten Teilmenge von EPRs ermittelt. Die Arten und die Häufigkeit der verschriebenen systemischen antimikrobiellen Medikamente sowie die Indikationen wurden anhand von deskriptiven Statistiken zusammengefasst. Eine logistische Regression mit gemischten Effekten wurde verwendet, um praxis- und pferdebezogene Risikofaktoren zu bewerten. Results: Systemische antimikrobielle Medikamente wurden 12 538 (19.5%, 95% CI 19.2-19.8%) von 64 322 im Jahr 2018 behandelten Equiden verschrieben. Antimikrobielle Medikamente der Kategorie B wurden bei 1.9% (95% KI 1.8-2.0%) der behandelten Equiden und in 8.9% (95% KI 8.5-9.4%) der antimikrobiellen Medikamente verschrieben. Bei 19.1% (95% KI 17.1-21.3%) der antimikrobiellen Medikamente der Kategorie B wurde eine bakteriologische Kultur angelegt. Die am häufigsten verschriebenen antimikrobiellen Klassen waren potenzierte Sulfonamide (50.2% der mit antimikrobiellen Medikamenten behandelten Equiden) und Tetracycline (33.5% der mit antimikrobiellen Medikamenten behandelten Equiden). Dermatologische Erkrankungen waren der häufigste Grund für systemische AMU (40.5% der Behandlungen). Urogenitale Erkrankungen waren der häufigste Grund für AMU der Kategorie B (31.1% der Behandlungen). Eine erhöhte Wahrscheinlichkeit für systemische AMU und AMU der Kategorie B wurde bei Equiden unter 1 Jahr im Vergleich zu Equiden im Alter von 5-14 Jahren beobachtet. Die Rasse wurde mit AMU in Verbindung gebracht, wobei die Wahrscheinlichkeit einer systemischen AMU und einer AMU der Kategorie B bei Vollblütern und Vollblutkreuzungen am höchsten war. WICHTIGSTE EINSCHRÄNKUNGEN: Die Verallgemeinerung der Ergebnisse ist möglicherweise durch eine Zufallsstichprobe von Praxen beeinträchtigt. Unassigned: Der empirische Einsatz von antimikrobiellen Medikamenten der Kategorie B ist nach wie vor weit verbreitet.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2022-11-02 PubMed ID: 36199158DOI: 10.1111/evj.13878Google Scholar: Lookup
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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.

This research article centers on the study of antimicrobial use (AMU) in UK equine veterinary practice. It specifically focuses on systemic use and Category B antimicrobials, aiming to identify factors that correlate with the use of these substances. The study also strives to pinpoint opportunities for improving antimicrobial stewardship in the equine sector.

Methods

  • The study was retrospective in nature and utilized anonymized electronic patient records (EPRs) from 39 UK veterinary practices. The EPRs, which covered all equids these practices attended to between 1 January and 31 December 2018, were collected via the VetCompass program.
  • An electronic keyword search method was employed to identify systemic antimicrobial prescriptions.
  • The indications for AMU were determined by manually reviewing a randomly selected subset of EPRs.
  • Descriptive statistics were used to summarize the types and frequency of systemic antimicrobials prescribed and their indications.
  • Mixed-effects logistic regression was used to scrutinize practice- and horse-related risk factors.

Results

  • The findings showed that systemic antimicrobials were prescribed to 12,538 (19.5%) of 64,322 equids attended in 2018.
  • The research revealed that a certain sector of these prescriptions (1.9%) covered Category B antimicrobials and accounted for 8.9% of antimicrobial courses.
  • Of these Category B antimicrobial courses, only 19.1% integrated a bacteriological culture.
  • The study discovered that the most frequently prescribed antimicrobial classes included potentiated sulphonamides (prescribed to 50.2% of equids receiving antimicrobials) and tetracyclines (prescribed to 33.5% of equids receiving antimicrobials).
  • Integumentary disorders emerged as the most common reason for systemic AMU (accounting for 40.5% of courses), whereas urogenital disorders were pinpointed as the leading cause for Category B AMU (accounting for 31.1% of courses).
  • The research revealed an increased odds of systemic and Category B AMU in equids under 1 year than those aged between 5-14 years.
  • The breed was identified as a determining factor for AMU, with Thoroughbreds and Thoroughbred crosses displaying the highest odds of systemic and Category B AMU.

Conclusions

  • The authors noted that their study’s limited sample of veterinary practices may hinder the broader applicability of these findings.
  • They also concluded that empiric use of Category B antimicrobials remains prevalent.

Cite This Article

APA
Allen SE, Verheyen KLP, O'Neill DG, Brodbelt DC. (2022). Use of antimicrobials licensed for systemic administration in UK equine practice. Equine Vet J, 55(5), 808-819. https://doi.org/10.1111/evj.13878

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 5
Pages: 808-819

Researcher Affiliations

Allen, Sarah E
  • Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK.
Verheyen, Kristien L P
  • Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK.
O'Neill, Dan G
  • Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK.
Brodbelt, Dave C
  • Department of Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, UK.

MeSH Terms

  • Horses
  • Animals
  • Retrospective Studies
  • Anti-Infective Agents
  • Anti-Bacterial Agents / therapeutic use
  • United Kingdom

Grant Funding

  • Veterinary Medicines Directorate

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Citations

This article has been cited 4 times.
  1. Merle R, Feuer L, Frenzer K, Plenio JL, Bethe A, Sarnino N, Lübke-Becker A, Bäumer W. Antibiotic Use in Horses: Analysis of 57 German Veterinary Practices (2018-2023). Antibiotics (Basel) 2025 Sep 19;14(9).
    doi: 10.3390/antibiotics14090953pubmed: 41009931google scholar: lookup
  2. 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
  3. Hardefeldt LY, Thomas K, Begg L. Antimicrobial use and prescribing practices by equine veterinarians in Australia: Insights into reproduction, dentistry, compounding and use for nonbactericidal effects. Aust Vet J 2025 Jun;103(6):307-313.
    doi: 10.1111/avj.13428pubmed: 40000246google scholar: lookup
  4. 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
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