Dataset Information

Antimicrobial Prescriptions for Dogs in the Capital of Spain.

ABSTRACT: Objective: To characterize antimicrobial prescription patterns for dogs in veterinary practices in Spain using the city of Madrid as a model. Design: Retrospective survey. Settings: Dogs attending veterinary practices in the city of Madrid in 2017 were enrolled. Subjects: Three hundred dogs from 30 veterinary practices randomly selected from a set of 388 practices grouped by zip code. The inclusion criterion for dogs was treatment with antibiotics within a few days of the data collection day. Results: For the 300 dogs enrolled, 374 treatments with antimicrobials were recorded, 62.8% (235/374) were veterinary medicinal products and 37.2% (139/374) human medicinal products. The main route of administration was oral (209/374; 55.9%) followed by parenteral (100/374; 26.7%) and topical (65/374; 17.4%). Sixty-five dogs (21.7%) received a perioperative antimicrobial treatment, mainly associated with female obstetrical surgery (19/65; 29%), while 78.3% (235/300) received a pharmaceutical treatment mainly for skin (72/235; 30.6%), respiratory (47/235; 20%), or digestive (41/235; 17.4%) diseases. The most frequently used antimicrobials were beta-lactams for oral (119/209) and parenteral (79/100) administration, especially the combination amoxicillin with clavulanic acid (83/209; oral), amoxicillin alone (42/100; parenteral), and aminoglycosides (32/65) for topical use. Diagnostic confirmation with culture was carried out on only 13 out of 235 dogs receiving therapeutic treatment and nine underwent an antimicrobial susceptibility test. In addition, cytology was performed in 15 dogs. Conclusions: The pattern of antimicrobial prescriptions for dogs in our study was quite similar to that previously described in several European countries, and encompassed the same two highly interconnected key features: major use of amoxicillin with clavulanic acid and a very low level of antimicrobial susceptibility testing before prescription. Consequently, we recommend that the measures for rationalizing antimicrobial prescription for dogs in Spain should follow those implemented in other countries, especially confirming the diagnosis and promoting the use of hygiene measures by owners.

SUBMITTER: Gomez-Poveda B

PROVIDER: S-EPMC6288439 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Antimicrobial Prescriptions for Dogs in the Capital of Spain.

Gómez-Poveda Bárbara B Moreno Miguel A MA

Frontiers in veterinary science 20181204

Objective: To characterize antimicrobial prescription patterns for dogs in veterinary practices in Spain using the city of Madrid as a model. Design: Retrospective survey. Settings: Dogs attending veterinary practices in the city of Madrid in 2017 were enrolled. Subjects: Three hundred dogs from 30 veterinary practices randomly selected from a set of 388 practices grouped by zip code. The inclusion criterion for dogs was treatment with antibiotics within a few days of ...[more]

PMID: 30564586

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Project description:BackgroundAntimicrobial stewardship activities are essential to improve prudent antimicrobial use. The aim of the present study was to evaluate changes in antimicrobial prescriptions in cats after the introduction of prudent use guidelines promoted by an online antimicrobial stewardship tool (AntibioticScout.ch) in Switzerland. Data from 792 cats presented to two university hospitals and 14 private practices in 2018 were included and compared to 776 cases from 2016. Cats were diagnosed with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses. Clinical history, diagnostic work-up and antimicrobial prescriptions (class, dosage, duration) were assessed. Type and proportions [95% confidence intervals] of antimicrobial prescriptions were compared between the two evaluation periods and a mixed effects logistic regression model was applied to evaluate compliance with Swiss prudent use guidelines.ResultsFrom 2016 to 2018, the proportion of antimicrobial prescription in all included cases decreased from 75.0% [71.8-78.0] to 66.7% [63.3-69.9]; this decrease was most pronounced for treatments at university hospitals (67.1% [59.5-74.0] to 49.3% [40.9-57.8]) and for cats with FLUTD (60.1% [54.6-65.4] to 48.8% [43.2-54.4]). Use of 3rd generation cephalosporins in private practices declined from 30.7% [26.5-35.1] to 22.1% [18.4-26.2], while overall use of non-potentiated aminopenicillins increased from 19.6% [16.4-23.0] to 27.8% [24.1-31.9]. In cases where antimicrobial therapy was indicated, compliance with guidelines did not increase (33.3% [26.6-40.6] to 33.5% [27.2-40.2]), neither at universities nor in private practices. On the other hand, antimicrobial treatment was more often withheld in cases with no indication for antimicrobial therapy (35.6% [30.1-41.4] to 54.0% [47.6-60.4]); this was found for private practices (26.7% [20.8-33.4] to 46.0% [38.4-53.7]) and for aURTD cases (35.0% [26.5-44.2] to 55.4% [44.7-65.8]).ConclusionsOverall proportions of antimicrobial prescription, unjustified antimicrobial therapy and, in private practices, use of 3rd generation cephalosporins decreased from 2016 to 2018 for the investigated feline diseases. However, overall compliance with Swiss prudent use guidelines was still low, implying that further efforts are required to foster prudent antimicrobial use in cats.

Project description:IntroductionThe Italian antimicrobial prescription rate is one of the highest in Europe, and antibiotic resistance has become a serious problem with high costs and severe consequences, including prolonged illnesses, the increased period of hospitalization and mortality. Inadequate antibiotic prescriptions have been frequently reported, especially for lower respiratory tract infections (LRTI); many patients receive antibiotics for viral pneumonia or bronchiolitis or broad-spectrum antibiotics for not complicated community-acquired pneumonia. For this reason, healthcare organizations need to implement strategies to raise physicians' awareness about this kind of drug and their overall effect on the population. The implementation of antibiotic stewardship programs and the use of Clinical Pathways (CPs) are excellent solutions because they have proven to be effective tools at diagnostic and therapeutic levels.AimsThis study evaluates the impact of CPs implementation in a Pediatric Emergency Department (PED), analyzing antibiotic prescriptions before and after the publication in 2015 and 2019. The CP developed in 2019 represents an update of the previous one with the introduction of serum procalcitonin. The study aims to evaluate the antibiotic prescriptions in patients with community-acquired pneumonia (CAP) before and after both CPs (2015 and 2019).MethodsThe periods analyzed are seven semesters (one before CP-2015 called PRE period, five post CP-2015 called POST 1-5 and 1 post CP-2019 called POST6). The patients have been split into two groups: (i) children admitted to the Pediatric Acute Care Unit (INPATIENTS), and (ii) patients evaluated in the PED and sent back home (OUTPATIENTS). We have analyzed all descriptive diagnosis of CAP (the assessment of episodes with a descriptive diagnosis were conducted independently by two pediatricians) and CAP with ICD9 classification. All antibiotic prescriptions for pediatric patients with CAP were analyzed.ResultsA drastic reduction of broad-spectrum antibiotics prescription for inpatients has been noticed; from 100.0% in the PRE-period to 66.7% in POST1, and up to 38.5% in POST6. Simultaneously, an increase in amoxicillin use from 33.3% in the PRE-period to 76.1% in POST1 (p-value 0.078 and 0.018) has been seen. The outpatients' group's broad-spectrum antibiotics prescriptions decreased from 54.6% PRE to 17.4% in POST6. Both for outpatients and inpatients, there was a decrease of macrolides. The inpatient group's antibiotic therapy duration decreased from 13.5 days (PRE-period) to 7.0 days in the POST6. Antibiotic therapy duration in the outpatient group decreased from 9.0 days (PRE) to 7.0 days (POST1), maintaining the same value in subsequent periods. Overlapping results were seen in the ICD9 group for both inpatients and outpatients.ConclusionsThis study shows that CPs are effective tools for an antibiotic stewardship program. Indeed, broad-spectrum antibiotics usage has dropped and amoxicillin prescriptions have increased after implementing the CAP CP-2015 and the 2019 update.

Dataset Information

Antimicrobial Prescriptions for Dogs in the Capital of Spain.

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Antimicrobial Prescriptions for Dogs in the Capital of Spain.

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