On the record: Gathering data to safeguard crucial antibiotics

A recent study led by researchers from the University of Minnesota College of Veterinary Medicine found that 36.5% of dogs and cats in veterinary teaching hospitals (VTHs)  were prescribed antibiotics—and nearly a third of those (31.8%) were prescribed two or more antibiotics. The study, which was funded by the US Food and Drug Administration, demonstrates a sustainable methodology for filling major gaps in knowledge around veterinary prescribing practices. Ultimately, such data collection will help to improve prescribing practices and safeguard against the growing threat of antibiotic resistance.

Antibiotic use, overuse, and misuse are primary drivers of antimicrobial resistance, which the World Health Organization has identified as one of the greatest global public health threats. Microbes such as bacteria can adapt over time developing resistance to medicines and rendering treatment ineffective, so that even common infections and minor injuries can become deadly. Use of antibiotics in veterinary medicine contributes to the problem—and must be a part of the solution.

However, outside of food-animal drug sales data collected by the U.S. Food and Drug Administration (FDA) and other special studies, there are few sources of data that track antibiotic use for animals within the U.S. In 2020, there were 83.7 million dogs and 60.2 million cats in the U.S., with 45% and 26% of households owning dogs and cats, respectively. This amounts to more dogs and cats than the combined human population in the United Kingdom and Australia. Despite this, antibiotic prescribing practices by veterinarians for dogs and cats remain poorly described.

For this study, the researchers, led by Dr. Jennifer Granick, Associate Professor of Internal Medicine in the Department of Veterinary Clinical Sciences, used data from VTH medical records of dogs and cats examined by primary care, urgent care, emergency and critical care, internal medicine, and surgery services on a single day during August 13–September 3, 2020. Fourteen of the 28 academic VTHs in the US participated.

The study identified not only the numbers of prescriptions, but also the classes of medications, their intended use, the clinical conditions for which they were prescribed, and any associated diagnostic testing.

The results suggest some areas of immediate need for improvement in antibiotic stewardship, as well as areas where more targeted data collection is needed to understand the context for certain prescribing practices. “The data shows that there continues to be overprescribing of antibiotics for diarrhea in dogs and cats, highlighting an area for immediate prescriber education,” said Granick. “Just over a quarter of antibiotics prescribed were for the prevention, rather than the treatment, of infection, often given during and after surgical procedures. This is an area where more research is needed to understand if using or withholding antibiotics in these circumstances changes patient outcomes.”

Perhaps most importantly, the study demonstrates that this method for data collection via electronic medical records is viable as a means to estimate population-level antibiotic use and prescribing practices. Collaborative efforts for ongoing tracking will be crucial for informing future actions to ensure adequate antibiotic stewardship in veterinary practice.

Read the full study in the Journal of Veterinary Internal Medicine.