Abstract
Background
Antimicrobial resistance (AMR) is increasingly recognised in equine medicine. Antimicrobial use (AMU) is a key driver of AMR.
Objectives
To pilot a point prevalence survey (PPS), based on the Global-PPS used in human hospitals, to obtain data on antibiotic prescribing and AMR in equine hospitals and to identify targets for improvement in AMU.
Study Design
Point prevalence survey.
Methods
Eight equine hospitals located in Australia, Belgium, South Africa, the United Kingdom and the United States were recruited. Data on AMU were collected from all in-patients on antibiotic treatment at 08h00 on four selected study days throughout the study year (2022).
Results
In total, 742 patients, 310 (41.8%) surgical and 432 (58.2%) nonsurgical cases, were evaluated and 58.7% (182/310) surgical and 25.9% (112/432) nonsurgical patients were on antibiotics. The most prescribed antibiotics were penicillin, gentamicin and trimethoprim sulfonamides. In 45.2% (215/476) of prescriptions, use was prophylactic. Therapeutic use was based on a biomarker in 48.8% (127/260) of treatments. A sample was submitted for culture in 56.9% (148/260) of therapeutic treatments. A positive culture result was reported from 49.3% (73/148) of samples, with an antibiogram available for 90.4% (66/73) of the positive cultures. An antibiotic use stop/review date was not recorded in 59.5% (283/476) of uses.
Main Limitations
This PPS was a pilot study with a relatively small sample size and likely does not reflect AMU in all types of equine hospitals in all geographic locations.
Conclusions and Clinical Relevance
The PPS identified multiple ways in which antibiotic prescribing could be improved. Targets identified for stewardship interventions included empiric use of European Medicines Agency Category A and B antibiotics, the high prevalence of prophylaxis and the lack of use of a stop/review date. The survey could be used as a repeatable tool to assess stewardship interventions in equine hospitals.
