Veterinary training for antimicrobial stewardship is critical to promote responsible use of antimicrobials and to prevent the development of antimicrobial resistance. Veterinary students receive this training in the preclinical and clinical curriculum. The aim of this presentation was to investigate antimicrobial stewardship in the clinical curriculum. Clinical data was investigated to determine the antimicrobials prescribed for various conditions. Antimicrobials prescribed for the treatment of canine allergic dermatitis and dog-to-dog bite wounds were further explored.
In 2018, there were 349 prescriptions for cats, 435 for avian, exotic or wildlife species, 610 for cattle, 1,465 for horses and 2,146 for dogs. In cats, the most commonly prescribed antimicrobials were amoxicillin clavulanic acid (AMC) (39%), ceftiofur (15%) and first generation cephalosporins (8%). Ceftiofur was prescribed most commonly to treat abscesses or wounds. In cattle, tetracycline (41%) was the most common antimicrobial prescribed, followed by ceftiofur (14%), macrolides (8%) and penicillin (6%). Ceftiofur was most commonly prescribed to treat septic calves and respiratory disease. In horses, penicillin (34%), aminoglycosides (35%) and trimethoprim sulphonamides (11%) were most frequently prescribed. Imipenem was used once for septic arthritis. Ceftiofur (3%) was most commonly used to treat sepsis and colic. Fluoroquinolones (3%) for orthopedics, colic and respiratory disease. In dogs, the most commonly prescribed drugs included AMC (36%), first generation cephalosporins (21%), metronidazole (5%) and fluoroquinolones (5%). Ceftiofur (0.5%) was prescribed most commonly for wound infections. Meropenem was prescribed twice to one dog that had a cholecystoduodenostomy. Few cultures were performed with the diagnostic laboratory only receiving 629 samples.
The antimicrobials used in dogs and cats at the veterinary teaching hospital were similar to other Australian studies. The use of critically important drugs was low, though a high use of ceftiofur was noted in cattle and cats. Veterinary teaching hospitals often receive referral cases and this may account for the use of critically important antimicrobials. In the majority of cases antimicrobials were prescribed in accordance with best practice.