Antimicrobial prescribing practice in UK equine veterinary practice.
Authors: Hughes L A, Pinchbeck G, Callaby R, Dawson S, Clegg P, Williams N
Journal: Equine veterinary journal
Summary
# Antimicrobial Prescribing in UK Equine Practice: A Call for Standardisation Antimicrobial resistance represents a genuine threat to therapeutic efficacy across both human and veterinary medicine, making prudent prescribing essential. Hughes and colleagues surveyed 740 UK equine practitioners using clinical scenarios to characterise prescribing patterns and identify factors influencing drug selection, dosing, and licensing status. The findings are sobering: fewer than 1% of practices operated under antimicrobial guidelines; 11% of prescriptions involved off-licence drugs; and critically, 56% of prescriptions for licensed antimicrobials exceeded recommended dose rates whilst 5% fell below them—discrepancies that persisted even when practitioners had access to horse bodyweight data. Referral practitioners showed greater willingness to use reserved antimicrobials (fluoroquinolones, 3rd and 4th generation cephalosporins), whilst first-opinion vets favoured potentiated sulphonamides, suggesting that practice type and information sources significantly influenced prescribing behaviour. For equine professionals, these results underscore the urgent need for industry-wide antimicrobial stewardship guidelines: implementing evidence-based protocols at practice level could substantially reduce inappropriate dosing, off-licence use, and unnecessary reliance on critically important antimicrobials—protecting both individual patient outcomes and the broader therapeutic arsenal available to the equine industry.
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Practical Takeaways
- •Establish written antimicrobial prescribing guidelines in your practice to standardize dosing and drug selection, as less than 1% of UK equine practices currently have them
- •Verify accurate animal weight before prescribing and use weight-based dosing tables to avoid the common problem of over-dosing (56% of prescriptions) or under-dosing (5% of prescriptions)
- •Consider your information sources about antimicrobial use and whether they support evidence-based, prudent prescribing to combat antimicrobial resistance
Key Findings
- •38% response rate to postal questionnaire of 740 UK equine veterinarians; 11% of prescriptions were off-licence antimicrobials
- •56% of licensed antimicrobial prescriptions exceeded recommended dose rates while 5% were under-dosed, despite animal weight being provided
- •Less than 1% of equine practices had antimicrobial use guidelines; referral practices more likely to prescribe 3rd/4th generation cephalosporins and fluoroquinolones than first-opinion practices
- •Trimethoprim-sulphonamides were the most commonly prescribed antimicrobials across all clinical scenarios