Use of a point prevalence survey to measure antimicrobial use and antimicrobial resistance in equine veterinary hospitals.
Authors: Leus E K, Collins N, Gruyaert M, Kennedy R N, McConnell E, McGorum B C, Luethy D, Sanz M, Versporten A, Viljoen A, Lyle C H
Journal: Equine veterinary journal
Summary
# Editorial Summary Antimicrobial resistance poses an escalating threat to equine medicine, yet little standardised data exists on prescribing patterns across veterinary hospitals. This pilot point prevalence survey adapted the human hospital Global-PPS methodology to eight equine facilities across five countries, capturing antibiotic use on four snapshot days throughout 2022 and evaluating 742 patients (310 surgical, 432 nonsurgical). Whilst surgical patients were substantially more likely to receive antibiotics (58.7%) than medical cases (25.9%), the study revealed concerning gaps in stewardship: prophylactic use accounted for 45.2% of all prescriptions, yet only 48.8% of therapeutic treatments were guided by biomarkers, and critically, 59.5% of prescriptions lacked a documented stop or review date. Of the 260 therapeutic cases where culture was indicated, samples were submitted in just 56.9%, though antibiograms were available for 90.4% of positive results, suggesting that when culture is performed, sensitivities are appropriately used. For practitioners, these findings highlight specific intervention targets—particularly the need to establish routine stop/review protocols, increase biomarker-guided therapy, and reduce unnecessary prophylaxis—whilst the survey itself offers a repeatable framework for monitoring stewardship improvements within individual hospitals over time.
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Practical Takeaways
- •Implement documented stop/review dates for all antibiotic courses to reduce unnecessary prolonged use and support antimicrobial stewardship in your hospital
- •Establish protocols requiring biomarker testing (e.g., clinical signs, blood work) before initiating therapeutic antibiotics, particularly for surgical prophylaxis decisions
- •Submit bacterial culture samples routinely before starting therapeutic antibiotics and use antibiogram results to guide empiric antibiotic selection rather than defaulting to broad-spectrum options
Key Findings
- •58.7% of surgical and 25.9% of nonsurgical hospitalized equine patients were prescribed antibiotics
- •45.2% of antibiotic prescriptions were prophylactic rather than therapeutic
- •Only 48.8% of therapeutic antibiotic use was guided by biomarker testing, and 59.5% of prescriptions lacked a documented stop/review date
- •Penicillin, gentamicin, and trimethoprim-sulfonamides were the most commonly prescribed antibiotics across the eight hospitals studied