Antimicrobial Prescribing Practices Among Sri Lankan Veterinarians for Common Medical Conditions in Companion Animals

Veterinarians are essential in antimicrobial stewardship. Companion animal (CA) practitioners have recently received more attention. There are few relevant studies on CA antimicrobial prescribing practices in South Asia. A cross-sectional survey on the antimicrobial prescribing practices of Sri Lankan veterinarians associated with six common CA infections and factors associated with bacterial culture and antimicrobial susceptibility testing (AST) was conducted. A survey of antimicrobial prescribing practices was distributed via email or professional events among veterinarians treating CAs. There were 127 respondents. Most were from CA-only practices (63%); the remainder worked in government, mixed, or other practices. Based on the World Health Organization's criteria, 1.7% (13/783) of cases were treated with drugs authorized for human use only; 23.9% (187/783) were treated with highest-priority critically important antimicrobials; 4.7% (37/783) were treated with critically important antimicrobials, and 66.8% (523/783) were treated with highly important antimicrobials. The antimicrobial treatment of abscesses, skin, urinary, and ear infections was usually empirical, with only 12.4% (72/579) of cases utilizing AST to guide diagnosis and treatment. The use of AST was significantly associated with the type of antibiotic prescribed, the medical condition, the practice type, and continuing professional development, with the latter recognized as a pathway toward improved veterinary antimicrobial stewardship and the implementation of a One Health approach.