What criteria do veterinarians use to prescribe antimicrobials to pets?

A study from the Instituto de Saúde Pública da Universidade do Porto (ISPUP) found that most Portuguese veterinarians do not use specific protocols to prescribe antimicrobials to pets. The prescription is made empirically, through analysis of the animal’s symptoms and without resorting to any kind of examination that proves the need for these drugs.

It was concluded that the preference for empirical prescription happens because 80% of veterinarians do not have a protocol that guides prescription in their workplace. For this reason, researchers stress the urgency of creating a Portuguese protocol, which would help veterinarians make a more prudent and responsible use of these substances, while also highlighting the role of these professionals in combating antimicrobial resistance.

Antimicrobial resistance – which includes, for example, antibiotics and antifungals – represents a growing threat to Public Health worldwide and is associated with significant economic losses.

This resistance can spread between animals, humans, and the environment.

As explained by Gisélia Alcântara, first author of the study, coordinated by ISPUP researcher Niza Ribeiro, “antimicrobial-resistant bacteria can pass on from pets to people and vice versa. This transmission occurs through the environment. This is where the logic of One Health comes in, recognising the interconnection between human, animal, and ecosystem health”.

“For this reason, the misuse and overuse of antimicrobials in pets increases the risk of antimicrobial resistance in both animals and humans, endangering the health and welfare of people and animals,” she adds.

Given this framework, the ISPUP researchers sought to understand the motivations and criteria used for the prescription of antimicrobials by Portuguese veterinarians, as well as understand whether they followed a prescription protocol or prescribed empirically.

To this end, they applied a self-answered questionnaire to 417 veterinarians, a representative sample of this professional class in the country, between October 2019 and January 2020, in order to assess which prescription method was used, their reasons for prescribing antimicrobials, the recommendations given to the pet’s guardian, among other relevant aspects.

Protocols are more used among those working in hospitals

The authors of the study, published in the Journal of Comparative Immunology, Microbiology and Infectious Diseases, identified two distinct profiles of veterinarians: those who prescribe antimicrobial drugs following the guidelines from a protocol in their workplace, and those who do so empirically.

It was concluded that veterinarians who work in hospitals use a protocol for prescribing antimicrobials to pets more often. These professionals also revealed a more prudent attitude towards the prescription of these substances.

Likewise, it was found that a high percentage of veterinarians prefer empirical prescription, which can be explained by the fact that 82% do not have a protocol at their workplace.

When asked about the main factors influencing the prescription of antimicrobials to pets, the majority mentioned the efficacy of these drugs. “Vets want, above all, for animals to be cured,” says Gisélia Alcântara.

And does the animal’s guardian influence the veterinarian’s decision regarding the prescription? The answer is yes. “59% of veterinarians mentioned that guardians sometimes ask for antibiotics for their animals when they go to a consultation, and 18% even stated that guardians always ask for these drugs,” stresses the ISPUP researcher.

Communication as a weapon to raise awareness on the proper use of antimicrobials

Another result that deserves particular attention relates to the fact that Portuguese veterinarians are not aware of their role as disseminators of antimicrobial resistance, especially among the guardians who visit their clinic.

The research showed that a large number of veterinarians do not talk to guardians about the problems associated with antimicrobial resistance, nor indicate the need to reinforce hygiene and sanitary measures during the timeframe in which the animal is taking the drug.

This issue is worrying because, as Gisélia Alcântara says, “strengthening hygiene measures during antimicrobial treatment is essential to prevent the transmission of resistant bacteria from animals to humans”.

Thus, communication between veterinarians and guardians about the risks associated with the use of these drugs needs to be improved.

“The education of guardians on the proper use of antimicrobials is a crucial issue, especially because they influence veterinarians’ decisions when prescribing drugs” she stresses.

The importance of creating a Portuguese protocol for pets

Taking the results found into account, the researchers highlight the urgency of creating a Portuguese protocol to guide veterinarians at the time of prescription.

This protocol would help professionals make a more appropriate use of antimicrobials and in turn helping to combat antimicrobial resistance.

The research, named Antimicrobial resistance in companion animals – Veterinarians’ attitudes and prescription drivers in Portugal, also involved researchers Katia Pinello and Milton Severo.

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