Antimicrobial use and prescribing practices by equine veterinarians in Australia: Insights into reproduction, dentistry, compounding and use for nonbactericidal effects
Authors: L. Hardefeldt, K. Thomas, L. Begg
Journal: Australian Veterinary Journal
Summary
# Editorial Summary Antimicrobial resistance poses a genuine threat to equine medicine, yet prescribing practices among Australian equine veterinarians have received limited scrutiny—particularly in areas prone to variable application such as dentistry, reproduction and off-label use. Between 2023 and 2024, Hardefeldt and colleagues surveyed 134 equine practitioners across Australia to evaluate their antimicrobial selection rationale in these grey-zone clinical situations, alongside enquiries into compounding practices and use of antimicrobials for their non-bactericidal properties. Whilst most respondents favoured established agents (trimethoprim sulphonamide, penicillin and gentamicin), concerning patterns emerged: seventy percent routinely prescribed compounded antimicrobials, high-importance WHO-classified agents appeared in dental and reproductive protocols despite limited bactericidal justification, and antimicrobials were commonly employed for matrix metalloprotease inhibition, anti-inflammatory and endotoxic effects in conditions such as contracted tendons. The findings underscore substantial variation in prescribing philosophy across the profession and highlight instances where evidence-based justification appears tenuous, suggesting that formalised antimicrobial stewardship guidelines—rather than ad hoc decision-making—would help align practice standards, preserve drug efficacy for future generations and ultimately improve therapeutic outcomes in equine medicine.
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Practical Takeaways
- •Antimicrobial guidelines specific to equine practice are needed to standardize prescribing, particularly for dental, reproductive, and off-label uses
- •Compounding of antimicrobials is widespread in Australian equine practice (70%); consider whether formulations are evidence-based or based on tradition
- •Be aware that many practitioners use antimicrobials for non-bacterial purposes (inflammation, endotoxemia, tendon protection); evaluate whether these uses are justified by evidence or driven by habit
Key Findings
- •70% of surveyed equine veterinarians reported prescribing compounded antimicrobials
- •Most respondents used common antimicrobials (TMS, penicillin, gentamicin) but some reported using high-importance agents not registered for equine use
- •Antimicrobials were commonly prescribed for nonbactericidal effects including anti-inflammatory, antiendotoxic, and matrix metalloprotease inhibition
- •Wide variation in prescribing practices existed across dental and reproductive applications, indicating lack of standardized guidelines