Antimicrobial use drives the development of antimicrobial resistance. With resistant bacteria able to transfer between humans and animals, veterinary antimicrobial use is coming under increased scrutiny. Much of the focus so far on veterinary antimicrobial use has been in food animals, but attention is shifting to use in other species, particularly those that have close contact with humans, such as dogs and cats. Methods of measuring antimicrobial usage in small animal veterinary practice have been largely reliant on surveys or analysis of clinical records. Surveys provide information on self-reporting of prescribing intentions in hypothetical clinical scenarios, but may not accurately reflect actual usage. In contrast, analysis of veterinary medical records provides valuable data on actual usage. However, with relevant details largely in free text fields, analysis of electronic records has been performed manually, thus limiting the number of records that can be assessed. Additionally, assessing antimicrobial usage in cohorts restricted to those attending veterinary practices, does not assess the rate of antimicrobial prescribing in a population of animals independent of their need for veterinary attention. This may overestimate usage per animal if extrapolated to the wider population.
To overcome these limitations, analysis of pet insurance claim data provided an opportunity to investigate the exposure of companion animals to antimicrobials at a population level, independent of their need for veterinary intervention. This demonstrated exposure to antimicrobials in this cohort of animals was much lower than community antimicrobial use in humans in Australia.
Additionally, access to big data via VetCompass (181 Australian veterinary clinics contributing medical records) and the use of natural language processing to analyse unstructured free text in over 3 million records is enabling characterisation of veterinary antimicrobial usage patterns on a larger scale.
These data sets provide a unique opportunity to establish baseline antimicrobial usage data in dogs and cats, identify targets for antimicrobial stewardship interventions and monitor the impact of these interventions on veterinary antimicrobial prescribing in Australia.