Page 47 - WSAVA2017
P. 47

L.R. Jessen1,2
1Department of Veterinary Clinical Sciences, University of Copenhagen, Denmark
2European Study Group of Veterinary Microbiology
Antibiotic usage has long been recognized as the main driver for the selection of antibiotic resistant pathogens. Strategies to enhance rational antibiotic prescribing are therefore of uppermost importance in the combat against antibiotic resistance. Guidelines on rational antibiotic use aim at improving patient outcome while minimizing the selection for antimicrobial resistance, and are considered a cornerstone in antibiotic stewardship. Such guidelines are written as clinical practice guidelines (CPG) indicating diagnostic criteria for - and recommended therapy (drug, dose, duration) of – infectious diseases of bacterial origin. When implemented at practice or hospital level, CPGs hold a huge potential to impact prescribing habits of veterinary clinicians and promote prudent use of antibiotics (1).
The effect of national CPGs is much more difficult to assess. In Sweden, national antibiotic use guidelines
for companion animals (2) were first published in 2002 and later revised in 2009 by the Swedish Small Animal Association. In 2010 national guidelines where launched by the Swedish Medical Agencies, and from January 2014 Sweden implemented legal measures to restrict the use of third /fourth generation cephalosporins and fluoroquinolones.
The first set of guidelines did not receive much attention and had no apparent effect on consumption data.
From 2006 the overall consumption of antibiotics
started decreasing (fig 1), and by 2015 the sale of antibiotics for oral use in dogs had dropped by 53 % as compared to 2006 (3). In a survey conducted in 2012 on antibiotic use and prescribing habits among veterinary practitioners from seven European countries, Swedish small animal practitioners reported a very low use of critically important antibiotics (4) and, as the sole country, indicated antibiotic guidelines as the most important factor influencing their prescription habits(5)
Fig 1. Companion animal AB consumption from 2005-2010, Sweden. Courtesy of Dr. Ulrika Grønlund
In Denmark the first national antibiotic use guidelines for companion animals were published in late 2012 (6) and are due for revision in 2017. National data indicate a 10 % reduction in the total antimicrobial consumption for companion animals from 2012 to 2016 with the lowest consumption being in 2015 (- 14 %) (7). With regard to critical and/or broad spectrum drugs, a marked reduction in the use of third/fourth generation cephalosporins (cefovecin) was been observed, whereas fluoroquinolone consumption remained at a steady level except from a minor transitory decrease
in 2013 (fig 2). A minor transitory decrease was also observed for amoxicillin clavulanate in 2013 followed by a steady increase from 2014.
An Urban Experience
    Fig 2. Consumption of critical antibiotics for companion animals in Denmark 2007 – 2016. Courtesy Dr. Vibeke Frøkjær

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