Use of antimicrobials licensed for systemic administration in UK equine practice.
Authors: Allen Sarah E, Verheyen Kristien L P, O'Neill Dan G, Brodbelt Dave C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Systemic Antimicrobial Use in UK Equine Practice Nearly one in five equids (19.5%) attending 39 UK veterinary practices in 2018 received systemic antimicrobials, with potentiated sulphonamides and tetracyclines dominating prescribing patterns. This large-scale retrospective analysis of over 64,000 equine patient records revealed that Category B antimicrobials—reserved for serious infections due to resistance concerns—were administered in 8.9% of all antimicrobial courses, yet bacterial cultures preceded only 19.1% of these Category B prescriptions, indicating substantial empirical use without diagnostic confirmation. Integumentary conditions drove the majority of systemic prescribing (40.5%), whilst urogenital disorders accounted for most Category B use (31.1%), with young animals (under one year) and Thoroughbreds showing significantly elevated odds of receiving both systemic and Category B drugs compared to older horses and other breeds. The findings highlight persistent gaps in stewardship practices—particularly the routine empirical deployment of higher-tier antimicrobials when culture-guided therapy could preserve their efficacy—suggesting that UK equine practitioners have meaningful opportunities to refine prescribing protocols, especially for integumentary and urogenital conditions where diagnostic support could reduce reliance on Category B agents.
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Practical Takeaways
- •Nearly 1 in 5 horses seen in practice receives systemic antimicrobials annually; integumentary conditions are the primary driver, suggesting opportunities for non-antimicrobial wound management strategies
- •Reserve antimicrobials (Category B) are being used empirically in most cases without culture confirmation; implementing routine bacteriological culture before prescribing these drugs would strengthen antimicrobial stewardship
- •Young foals and Thoroughbreds receive antimicrobials at higher rates; veterinary teams should review protocols for these populations to ensure prescribing is truly justified and not routine practice
Key Findings
- •19.5% of equids attended UK veterinary practices in 2018 received systemic antimicrobials, with potentiated sulphonamides (50.2%) and tetracyclines (33.5%) being most commonly prescribed
- •Category B antimicrobials (3rd/4th generation cephalosporins, quinolones, polymixins) were prescribed to 1.9% of equids overall but comprised 8.9% of all antimicrobial courses
- •Bacteriological culture was performed in only 19.1% of Category B antimicrobial courses, indicating predominantly empirical use of reserve antimicrobials
- •Equids under 1 year and Thoroughbreds/Thoroughbred crosses had significantly higher odds of receiving systemic and Category B antimicrobials compared to older horses and other breeds