People: Ben Walker, Dan O'Neill, Noel Kennedy, David Church, David Brodbelt

Vet Compass Project Type: Dog, Cat, Small Animal

Intro

Funded by the Petplan Charitable Trust, this project aims to identify and promote effective and practical antimicrobial stewardship interventions for widespread adoption in veterinary practice.

People

Ben Walker, Dan O’Neill, Huw Stacey, Noel Kennedy, David Church, Dave Brodbelt.

Collaborators 

Ana Mateus, Luca Guardabassi, David Lloyd, David Singleton.

Background

Antimicrobial resistance is increasingly reported in human and veterinary practice and is recognised as a global One Health concern. UK veterinary surveillance networks, including VetCompass and SAVSNET, have shown persistently high prescribing rates of antimicrobials to cats and dogs over the last ten years.1-3 The BVA, BSAVA, and FECAVA have all recognised high prescribing rates of antimicrobials as potentially promoting antimicrobial resistance in animals and have produced guidelines to define and promote responsible antimicrobial prescribing. Recent qualitative studies have sought to understand the factors influencing decisions by veterinarians in general practice to prescribe an antimicrobial by exploring attitudes to prescribing among clinicians and pet owners.4-6 These results have highlighted issues related to low awareness of formal antimicrobial prescribing guidelines; complex trade-offs between clinical, owner, and stewardship concerns; limited time among practitioners; and limited buy-in of stewardship interventions within clinics.Antimicrobial stewardship aims to promote antimicrobial prescribing behaviours that will preserve their longer-term effectiveness within the context of the individual patient, their owner, and the veterinary professional. Recent efforts to assess the influence of stewardship interventions on changing prescribing behaviours have shown that some change is possible.7,8 However, there remains a need to establish scalable and evidence-based interventions for widespread adoption, especially interventions designed around the realities of first-opinion clinical practice.

Project summary

This study aims to identify and promote effective antimicrobial stewardship interventions in UK first-opinion companion animal practice. Our objectives are to benchmark current antimicrobial usage in dogs and cats, develop an d implement a range of antimicrobial stewardship interventions, evaluate the impact of these interventions, and promote widespread adoption of the most effective interventions across the UK.

Impact

Maintaining antimicrobial effectiveness is essential to protect the long-term health and welfare of companion animals. Providing practical, affordable, evidence-based interventions will promote the uptake of antimicrobial stewardship programs within first-opinion clinics.

Timeframe

September 2021–September 2023 (2-year project).

References

1.  Mateus A, Brodbelt DC, Barber N, et al. Antimicrobial usage in dogs and cats in first opinion veterinary practices in the UK. Journal of Small Animal Practice 2011;52:515–521.

2.  Buckland EL, O'Neill D, Summers J, et al. Characterisation of antimicrobial usage in cats and dogs attending UK primary care companion animal veterinary practices. Veterinary Record 2016;179:489.

3.  Singleton DA, Sánchez-Vizcaíno F, Dawson S, et al. Patterns of antimicrobial agent prescription in a sentinel population of canine and feline veterinary practices in the United Kingdom. The Veterinary Journal 2017;224:18–24.

4.  Tompson AC, Chandler CIR, Mateus ALP, et al. What drives antimicrobial prescribing for companion animals? A mixed-methods study of UK veterinary clinics. Preventive Veterinary Medicine 2020;183:105117.

5.  King C, Smith M, Currie K, et al. Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK. BMC Vet Res 2018;14:332.

6.  Smith M, King C, Davis M, et al. Pet owner and vet interactions: exploring the drivers of AMR. Antimicrob Resist Infect Control 2018;7:46.

7.  Singleton DA, Rayner A, Brant B, et al. A randomised controlled trial to reduce highest priority critically important antimicrobial prescription in companion animals. Nat Commun 2021;12:1593.

8.  Hopman NEM, Portengen L, Hulscher MEJL, et al. Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: A stepped-wedge design intervention study. PLOS ONE 2019;14:e0225124.  

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