Effect of antimicrobial stewardship on antimicrobial prescriptions for selected diseases of dogs in Switzerland.

Abstract

BACKGROUND: Antimicrobial stewardship programs (ASPs) are important tools to foster prudent antimicrobial use. OBJECTIVE: To evaluate antimicrobial prescriptions by Swiss veterinarians before and after introduction of the online ASP AntibioticScout.ch in December 2016. ANIMALS: Dogs presented to 2 university hospitals and 14 private practices in 2016 or 2018 for acute diarrhea (AD; n = 779), urinary tract infection (UTI; n = 505), respiratory tract infection (RTI; n = 580), or wound infection (WI; n = 341). METHODS: Retrospective study. Prescriptions of antimicrobials in 2016 and 2018 were compared and their appropriateness assessed by a justification score. RESULTS: The proportion of dogs prescribed antimicrobials decreased significantly between 2016 and 2018 (74% vs 59%; P&#x2009;<&#x2009;.001). The proportion of prescriptions in complete agreement with guidelines increased significantly (48% vs 60%; P&#x2009;<&#x2009;.001) and those in complete disagreement significantly decreased (38% vs 24%; P&#x2009;<&#x2009;.001) during this time. Antimicrobial prescriptions for dogs with AD were significantly correlated with the presence of hemorrhagic diarrhea in both years, but a significantly lower proportion of dogs with hemorrhagic diarrhea were unnecessarily prescribed antimicrobials in 2018 (65% vs 36%; P&#x2009;<&#x2009;.001). In private practices, in 2018 a bacterial etiology of UTI was confirmed in 16% of dogs. Prescriptions for fluoroquinolones significantly decreased (29% vs 14%; P = .002). Prescriptions for antimicrobials decreased significantly in private practices for RTI (54% vs 31%; P&#x2009;<&#x2009;.001). CONCLUSION: Antimicrobials were used more prudently for the examined indications in 2018 compared to 2016. The study highlights the continued need for ASPs in veterinary medicine.