Preliminary results, which recorded a decline in the quantities of antimicrobials prescribed from 2014 to 2018, were published in 2022.
A further audit has now been undertaken in all 22 of the company's first opinion practices to investigate the age, breed and estimated weight of each horse, the clinical indication for antibiotic use, the drugs prescribed, their dose rates, the route of administration and whether culture and sensitivity were used to guide antimicrobial selection.
Data collection was completed in August 2022.
This secondary audit was conducted using a ‘point prevalence’ survey, in which each CVS Equine first opinion Quality Improvement Lead gathered information about all systemic antibiotics prescribed by each of their practices on one day a month for 12 consecutive months.
The project yielded information on 331 cases where systemic antimicrobials were prescribed.
Complete data about the first line-drug selection were available for 261 prescriptions.
The commonest prescribed antimicrobial was sulfadiazine/trimethoprim (41%), followed by oxytetracycline (23%), procaine penicillin (16%), doxycycline (13%), gentamicin (4%), metronidazole (1%), ceftiofur (1%) and enrofloxacin (1%).
Highest priority critically important antimicrobials (ceftiofur and enrofloxacin) were only prescribed in four horses (clinical indications for these included possible sepsis, skin infection, lower respiratory tract infection and a wound complication – in none of these cases was the first-line drug selection based on the results of culture and sensitivity.
Overall, the clinical indications for antimicrobial use were recorded in 246 cases; the commonest indications were cellulitis/lymphangitis (27%), uncomplicated wounds (19%), surgical prophylaxis (15%), respiratory infections (11%) and skin infections (8%).
Hattie Lawrence, Director of CVS Equine, said: “Though the impact of this work is yet to be documented, there is anecdotal evidence that it has raised awareness amongst our veterinarians of the importance of antimicrobial stewardship.
"Taken together, the results of both pieces of work will be used to help develop and inform clinical audits and clinical guidelines of antimicrobial use in horses.”
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