Antimicrobial prescribing and antimicrobial resistance surveillance in equine practice.
Authors: Wilson Amie, Mair Tim, Williams Nicola, McGowan Catherine, Pinchbeck Gina
Journal: Equine veterinary journal
Summary
# Antimicrobial Prescribing in Equine Practice: Current UK and European Trends Wilson and colleagues surveyed 264 equine veterinarians across the UK and Europe to establish baseline data on antimicrobial prescribing patterns, stewardship policies, and surveillance practices—information critical for combating the rising threat of antimicrobial resistance in equine medicine. Respondents completed questionnaires detailing their practice policies, prescribing habits across various clinical scenarios, and their use of high-priority critically important antimicrobials (CIAs), with additional case-based scenarios used to probe decision-making. Encouragingly, antimicrobial usage appears to have declined since 2009, and a larger proportion of practices now implement formal stewardship policies; however, significant gaps remain, with over half of respondents conducting no environmental surveillance, no audit of clinical infections, and only 46% operating written antimicrobial use policies. Third- and fourth-generation cephalosporins were used by 66% of practitioners and enrofloxacin by 44%, whilst prophylactic antimicrobials were frequently or always prescribed before clean surgery in 48% of cases and post-operatively in 24%—all concerning patterns given the designation of these drugs as high-priority CIAs. For equine professionals, these findings underscore the need for more widespread adoption of structured antimicrobial stewardship protocols and surveillance systems within practices, and should prompt reflection on whether current prescribing habits in routine scenarios—particularly prophylaxis in clean surgery—align with evidence-based, resistance-conscious practice.
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Practical Takeaways
- •Evaluate whether your practice has a written antimicrobial stewardship policy and implement one if absent, as this is becoming standard practice
- •Review your surgical prophylaxis protocols—consider whether post-operative antimicrobials are truly necessary for clean surgeries, as this may contribute to unnecessary resistance development
- •Establish basic surveillance and audit processes for clinical infections and infection control to identify resistance patterns and inform prescribing decisions
Key Findings
- •54.4% of equine practices have written antimicrobial stewardship policies, up from previous surveys
- •44% of respondents reported using enrofloxacin and 66% used 3rd or 4th generation cephalosporins in the past year
- •Over half of practices do not perform environmental surveillance (54.2%), audit clinical infections (53.1%), or audit infection control (57.1%)
- •48% of respondents frequently/always prescribe prophylactic antimicrobials before clean surgery, with 24% continuing post-operatively