Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey.
Authors: van den Brom-Spierenburg Astrid J, Mureșan Alexandra N, Westermann Cornélie M
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Antimicrobial Prescription in Equine Asthma Despite equine asthma being a non-infectious inflammatory condition, a significant proportion of veterinarians use antimicrobials to manage affected horses, raising concerns about appropriate stewardship. Between December 2020 and January 2022, an international survey gathered responses from 249 equine veterinarians across 25 countries, including 79 specialists, to establish current prescription patterns and the drivers behind treatment decisions. Of those surveyed, 131 (53%) reported using antimicrobials at least sometimes in asthma cases, with trimethoprim-sulfa combinations being most frequently prescribed, followed by penicillins and tetracyclines; notably, those practising without national antimicrobial regulations were significantly more likely to prescribe tetracyclines and cephalosporins. Decision-making centred on three key factors: tracheal wash culture results (62%), concurrent disease in other barn horses (60%), and response to non-antimicrobial therapies (53%). These findings highlight a disconnect between current practice and evidence-based asthma management, particularly among mixed-practice veterinarians and those in regions lacking regulatory frameworks; targeted education emphasising the revised ACVIM consensus statement definitions and the non-infectious nature of equine asthma is essential to reduce unnecessary antimicrobial use and support global stewardship efforts.
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Practical Takeaways
- •Antimicrobial use in equine asthma cases is inconsistent globally, suggesting opportunity to align practice with non-infectious nature of the condition and improve stewardship
- •Tracheal wash culture results should guide antimicrobial use rather than presumptive treatment; consider whether clinical presentation truly indicates bacterial infection before prescribing
- •Ensure your antimicrobial prescribing in asthma cases aligns with current ACVIM consensus definitions and your country's regulations to avoid unnecessary use of critical antimicrobial classes
Key Findings
- •249 veterinarians across 25 countries responded to an international survey on antimicrobial use in equine asthma cases
- •131 respondents (53%) reported using antimicrobials at least sometimes in asthma cases, with trimethoprim-sulfa combinations most common (105 veterinarians), followed by penicillins (53) and tetracyclines (38)
- •Veterinarians treating >95% equine patients demonstrated greater knowledge of ACVIM asthma consensus definitions (median 7 correct answers vs 4 for mixed practitioners, p<0.001)
- •Tracheal wash culture (62%), presence of similar complaints in barn mates (60%), and response to other therapies (53%) were the most influential factors in antimicrobial prescription decisions