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Short Communication
Short Communication Antimicrobial prescribing practices by Swiss, German and Austrian equine practitioners J. Schwechler, R. van den Hoven, A. Schoster ANTIMICROBIAL use contributes to the emerging concern of antimicrobial resistance (Traub-Dargatz and Dargatz 2009, Guardabassi 2012). In equine medicine, antimicrobials are prescribed for the treatment of diseases with an unlikely bacterial aetiology (Weese and Sabino 2005, Hughes and others 2013). Recent data from a European-wide survey indicated that veterinarians prescribe critically important antimicrobials (CIAs) in 13–30 per cent of cases depending on species, country and disease (De Briyne and others 2013). Less than 1 per cent of veterinarians from Austria and Switzerland responded in the above survey; therefore, there are currently little data for these countries. Veterinarians are encouraged to use antimicrobial products according to the product license; however, originally licensed dosages are often no longer adequate (Burton and others 2013, Weese and others 2015). Subtherapeutic doses of antimicrobials could contribute to the development of antimicrobial resistance, and it is currently unknown whether veterinarians rather adhere to licensing regulations or scientifically published data. The objective of this study was to survey the antimicrobial prescribing practices of equine practitioners in Germany, Austria and Switzerland. Target audiences of the online cross-sectional survey were the members of the Swiss Equine Veterinary Association (n=252), Association of German Equine Practitioners (n=740) and the Association of Austrian Equine Practitioners (n=235). The questionnaire used was similar to the one of a previous study in England (Hughes and others 2013). It was distributed to the practitioners via the software www.surveymonkey.com (see online Supplementary Item 1). Aside from demographic questions and resources on antimicrobials, six hypothetical clinical scenarios were presented. Respondents were asked to state if and which antimicrobial class they would use, as well as brand name, dose and duration of therapy. Licensed dosages for antimicrobials were retrieved from each country’s licensing body (Swissmedic—Switzerland, Federal
Veterinary Record (2016) J. Schwechler, med.vet., A. Schoster, Dr.med.vet, PhD, DVSc, Dip. ACVIM, Dip. ECEIM, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland R. van den Hoven, DVM, PhD, Dip. ECEIM, Dip ECVPT (ret),
doi: 10.1136/vr.103438 Section Internal Medicine, University of Veterinary Medicine Vienna, Equine University Clinic, Vienna 1210, Austria E-mail for correspondence: [email protected] Provenance: Not commissioned; externally peer reviewed Accepted January 24, 2016
ministry for Health—Germany, and Austrian Agency for Health and Food Safety—Austria). The British Equine Veterinary Association (BEVA) guidance for antimicrobial use was selected as a representative for current scientific recommendations (www.beva.org.uk/protectme, based on Haggett and Wilson 2008). Dosages prescribed by veterinarians were compared with the above to determine underdosing (±10 per cent). The χ2 test with a Bonferroni correction for multiple comparisons (significance set at P10 (0.04) NR NR
Fluoroquinolones
Use of a non-licensed anti-microbial
Underdosing according to licensed dosage
Underdosing according to BEVA guidance
Extended use of preoperative antimicrobials
NR NR
NR A+B+C/D+E (0.04)
Ger+Swi/Aus (0.01) NR
NR NR
Ger/Aus+Swi (0.004) NR
NR 1/2−3+4−5+6−10 +>10 (0.02)
NR NR
AP+H/U (0.06)
NR
H+AP/U (0.049)
NR
A:
Short Communication
Short Communication Antimicrobial prescribing practices by Swiss, German and Austrian equine practitioners J. Schwechler, R. van den Hoven, A. Schoster ANTIMICROBIAL use contributes to the emerging concern of antimicrobial resistance (Traub-Dargatz and Dargatz 2009, Guardabassi 2012). In equine medicine, antimicrobials are prescribed for the treatment of diseases with an unlikely bacterial aetiology (Weese and Sabino 2005, Hughes and others 2013). Recent data from a European-wide survey indicated that veterinarians prescribe critically important antimicrobials (CIAs) in 13–30 per cent of cases depending on species, country and disease (De Briyne and others 2013). Less than 1 per cent of veterinarians from Austria and Switzerland responded in the above survey; therefore, there are currently little data for these countries. Veterinarians are encouraged to use antimicrobial products according to the product license; however, originally licensed dosages are often no longer adequate (Burton and others 2013, Weese and others 2015). Subtherapeutic doses of antimicrobials could contribute to the development of antimicrobial resistance, and it is currently unknown whether veterinarians rather adhere to licensing regulations or scientifically published data. The objective of this study was to survey the antimicrobial prescribing practices of equine practitioners in Germany, Austria and Switzerland. Target audiences of the online cross-sectional survey were the members of the Swiss Equine Veterinary Association (n=252), Association of German Equine Practitioners (n=740) and the Association of Austrian Equine Practitioners (n=235). The questionnaire used was similar to the one of a previous study in England (Hughes and others 2013). It was distributed to the practitioners via the software www.surveymonkey.com (see online Supplementary Item 1). Aside from demographic questions and resources on antimicrobials, six hypothetical clinical scenarios were presented. Respondents were asked to state if and which antimicrobial class they would use, as well as brand name, dose and duration of therapy. Licensed dosages for antimicrobials were retrieved from each country’s licensing body (Swissmedic—Switzerland, Federal
Veterinary Record (2016) J. Schwechler, med.vet., A. Schoster, Dr.med.vet, PhD, DVSc, Dip. ACVIM, Dip. ECEIM, Vetsuisse Faculty, Equine Department, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland R. van den Hoven, DVM, PhD, Dip. ECEIM, Dip ECVPT (ret),
doi: 10.1136/vr.103438 Section Internal Medicine, University of Veterinary Medicine Vienna, Equine University Clinic, Vienna 1210, Austria E-mail for correspondence: [email protected] Provenance: Not commissioned; externally peer reviewed Accepted January 24, 2016
ministry for Health—Germany, and Austrian Agency for Health and Food Safety—Austria). The British Equine Veterinary Association (BEVA) guidance for antimicrobial use was selected as a representative for current scientific recommendations (www.beva.org.uk/protectme, based on Haggett and Wilson 2008). Dosages prescribed by veterinarians were compared with the above to determine underdosing (±10 per cent). The χ2 test with a Bonferroni correction for multiple comparisons (significance set at P10 (0.04) NR NR
Fluoroquinolones
Use of a non-licensed anti-microbial
Underdosing according to licensed dosage
Underdosing according to BEVA guidance
Extended use of preoperative antimicrobials
NR NR
NR A+B+C/D+E (0.04)
Ger+Swi/Aus (0.01) NR
NR NR
Ger/Aus+Swi (0.004) NR
NR 1/2−3+4−5+6−10 +>10 (0.02)
NR NR
AP+H/U (0.06)
NR
H+AP/U (0.049)
NR
A:
