Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Bérénice Lutz; Claudia Lehner; Kira Schmitt; Barbara Willi; Gertraud Schüpbach; Meike Mevissen; Ruth Peter; Cedric Müntener; Hanspeter Naegeli; Simone Schuller

doi:10.1136/vetreco-2019-000370

Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016

Vet Rec Open. 2020 Mar 9;7(1):e000370. doi: 10.1136/vetreco-2019-000370. eCollection 2020.

Authors

Affiliations

¹ Department Clinical Veterinary Medicine, Division Small Animal Internal Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland.
² Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
³ Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
⁴ Division of Pharmacology and Toxicology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
⁵ Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Abstract

Background: Antimicrobial resistance is an increasing problem in human and veterinary medicine and is closely linked to the use of antimicrobials. The objective of this study was to describe antimicrobial prescriptions for selected canine diseases in Switzerland during 2016.

Methods: Dogs presented to two university hospitals and 14 private practices for acute diarrhoea (AD; n=371), suspected or confirmed urinary tract infections (UTIs; n=245), respiratory tract infections (RTIs; n=274) or wound infections (WIs; n=175) were included. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage and duration) were retrospectively assessed. A justification score was applied to evaluate appropriateness of antimicrobial therapy based on available national and international consensus guidelines.

Results: Antimicrobials were prescribed in 65 per cent of dogs with AD, 88 per cent with UTI, 62 per cent with RTI and 90 per cent with WI. The most prescribed antimicrobial classes (monotherapy and combination therapy) were potentiated aminopenicillins (59 per cent), nitroimidazoles (22 per cent), non-potentiated aminopenicillins (16 per cent) and fluoroquinolones (13 per cent). Overall, 38 per cent (95 per cent CI 0.35 to 0.41) of the prescriptions were in accordance with consensus guidelines. In dogs with AD, antimicrobial therapy was associated with the presence of haemorrhagic diarrhoea (P<0.05) and complied in 32 per cent with consensus guidelines, which recommend antimicrobial treatment only when sepsis is suspected. A bacterial aetiology was confirmed via culture and/or sediment examination in 36 per cent of dogs with suspected UTI.

Conclusions: Overall, adherence to consensus guidelines was poor both, at university hospitals and private practices. Antimicrobial stewardship measures are therefore needed to improve prudent use.

Keywords: antimicrobial resistance; antimicrobial stewardship; dogs; prescribing habits.