To mark World Antimicrobial Awareness Week, the Royal Veterinary College (RVC) has released new research using real-world antimicrobial prescription data to investigate the use of systemic antimicrobials in UK equine practice.
The research, which is the first of its kind, reveals the extent to which antimicrobials are prescribed to equines and uncovers the lack of routine culture and sensitivity testing.
This is particularly prior to the prescription of the “last resort” Category B antimicrobials, whose efficacy needs to be preserved for the treatment of serious illnesses in human medicine.
Concerns have been raised regarding the potential inappropriate and overuse of antimicrobials in veterinary species, which is known to contribute to the development of resistant bacterial populations.
Once antimicrobial resistance develops, it can result in treatment failure in veterinary patients, and due to the proximity in which animals and their owners often live, the potential transfer of resistant bacteria to people.
While the investigation of antimicrobial use is vital, to date, little work has been done to monitor equine antimicrobial use in the UK. Therefore, this study, conducted by the RVC’s VetCompass programme and funded by Veterinary Medicines Directorate, set out to do so.
The team used anonymised electronic health record data from 64,322 horses, ponies and donkeys in the year 2018, supplied by 39 veterinary practices participating in the UK VetCompass programme.
The team analysed both the prescription data and clinical notes documented within these records.
The findings of the study highlighted that in 2018, approximately 20 percent of equines attended by the participating veterinary practices were prescribed an antimicrobial licensed for systemic administration.
Nearly 9 percent of those equines received a Category B antimicrobial, an antibiotic that is of highest priority critical importance for human medicine which should be used cautiously in animals to mitigate the risk to public health.
Bacteriological culture and sensitivity testing was found to be rarely employed, despite its importance in protecting against antimicrobial resistance, by identifying the most appropriate antimicrobial for prescription.
The study found limited compliance with antimicrobial stewardship guidelines, with fewer than one in five antimicrobial courses that included a Category B antimicrobial supported by culture and sensitivity testing.
The study also identified several important risk factors for increased antimicrobial usage.
They found that the highest usage groups of Category B antimicrobials were equines under one year old, Thoroughbreds and racehorses.
The most common disorders that were treated with antimicrobials were urogenital (urinary and genital tracts), integumentary (skin and gland organs) and respiratory (airways, lungs and blood vessels).
