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Antimicrobial prescribing patterns in equine ambulatory practice.

Emily K Rule1, Ashley G Boyle1, Laurel E Redding1

  • 1Department of Clinical Studies, New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA, 19348, USA.

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|June 20, 2021
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Summary

Antimicrobials are prescribed in 8.5% of equine visits, with aminoglycosides and trimethoprim sulfamethoxazole being common. Ocular and integumentary signs, emergency visits, and culture submissions increased antimicrobial likelihood.

Keywords:
AmbulatoryAntimicrobial prescriptionEquineResistanceVeterinary

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Area of Science:

  • Veterinary Medicine
  • Antimicrobial Stewardship
  • Equine Health

Background:

  • Antimicrobial resistance poses a significant global public health risk.
  • Limited data exists on antimicrobial prescription patterns in equine veterinary practice.
  • Understanding current usage is crucial for developing effective antimicrobial stewardship.

Purpose of the Study:

  • To investigate antimicrobial prescription patterns in equine ambulatory settings.
  • To identify risk factors associated with antimicrobial use in horses.
  • To provide quantitative data for antimicrobial stewardship guideline development.

Main Methods:

  • Retrospective analysis of billing and electronic medical records from equine ambulatory practice.
  • Assessment of prescription frequency, duration, drug class, clinician, and affected body system.
  • Multivariable regression used to evaluate risk factors for antimicrobial prescription.

Main Results:

  • Antimicrobials were prescribed in 8.5% of visits, with a median of 3.5 animal-defined daily doses (ADD).
  • Aminoglycosides were the most common class; trimethoprim sulfamethoxazole was the most frequent drug.
  • Ocular/integumentary signs, emergency visits, and bacterial culture submission were associated with higher antimicrobial likelihood.

Conclusions:

  • This study provides the first quantitative characterization of antimicrobial use in US equine ambulatory practice.
  • Significant variations in antimicrobial use were observed across clinicians, time, and affected body systems.
  • Findings are essential for assessing antimicrobial use appropriateness and developing targeted stewardship strategies.