Antimicrobial use practices among companion animal veterinarians in Hong Kong

Adopting international guidelines on the prudent use of antimicrobials in companion animal practices has been debated in Hong Kong. This study was conducted to assess antimicrobial use (AMU) practices among companion animal veterinarians in Hong Kong and highlight the areas for targeted interventions. Data on demographics, antimicrobial prescribing behaviors, and administered antibiotic classes were collected using an online questionnaire targeting all registered companion animal veterinarians in Hong Kong (estimated at 800-900). Of all invited veterinarians, 112 submitted the survey and 74 finished the questionnaire. Most respondents worked in primary care practices (76.4 %) and were women (67.4 %); 85 % reported the absence of a formal, written AMU policy in their clinics. Veterinary drug handbooks were the main source of information used for AMU (76 %), followed by courses or workshops (64.6 %) and clinicians' professional experience and judgment (59.5 %). Owner compliance issues regarding the dosage and duration of AMU were never-rarely observed by 63 %, and 21.5 % reported they never-rarely requested culture and antimicrobial susceptibility testing to guide their AMU. The majority (71 %) prescribed antimicrobials empirically in > 30 % of cases. Most frequent barriers to ordering and conducting the susceptibility test were the financial burden on animal owners (82 %), delay in starting treatments (56 %), and time constraints (24 %). Most respondents never or rarely used preoperative (81 %) or postoperative (86 %) antimicrobials in clean surgical procedures. We highlighted key gaps in antimicrobial stewardship which can be addressed through locally tailored guidelines informed by our findings, education for veterinarians and pet owners, and improved enforcement of antimicrobial regulations.