Keynote Message

• Effective antimicrobials are the core of modern medicine and treatment of bacterial diseases. Without effective antimicrobials, e.g., chemotherapy, surgery and treatment of patients on the ICU, but also treatment of simple infections would not be possible anymore.
• Animal health and welfare rely on effective antimicrobials as well.
• Antimicrobial resistance is increasing, while new antimicrobials are hardly developed.
• Besides infection control and prevention strategies and stimulation of research and development of new treatment options, the efficacy of the existing antimicrobial treatment options needs to be secured to preserve antimicrobials as resources for future generations.
• Data on antimicrobial use (AMU) in companion animals are scarce; however, available data show that there is room for improvement, especially with regard to the types of antimicrobials used in companion animal clinics.
• Antimicrobial use in companion animal clinics appears to be influenced by many factors and seasonal differences in systemic AMU are found.
• In veterinary medicine, antimicrobial stewardship encompasses numerous elements of improved AMU and it is often associated with countrywide surveillance of AMU and development of (inter)national guidelines on AMU, all focussed to secure the efficacy of the existing antimicrobial treatment options.
• A multifaceted intervention programme (an Antimicrobial Stewardship Programme (ASP)) was developed based upon previous qualitative and quantitative research on current prescribing behaviour in Dutch companion animal clinics. This ASP was introduced and evaluated in 44 Dutch companion animal clinics (March 2016–March 2018).
• Although AMU in Dutch companion animal clinics was already decreasing and changing, systemic AMU could be further optimised by participation in an ASP.
• There is no “one size fits all” strategy to optimise AMU. Everyone who is, in one way or another, involved in antimicrobial prescribing in companion animals should be kept involved to stimulate a joint and comprehensive effort to make sustainable optimisation of AMU in companion animal clinics possible.

Key References

1.  Hopman NEM, Portengen J, Hulscher MEJL, et al. Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: a stepped-wedge design intervention study. PLoS One. 2019;14(11):e0225124. DOI: 10.1371/journal.pone.0225124. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225124

2.  Hopman NEM, Portengen L, Heederik DJJ, et al. Time trends, seasonal differences and determinants of systemic antimicrobial use in companion animal clinics (2012–2015). Vet Microbiol. 2019;235:289–294. DOI: 10.1016/j.vetmic.2019.07.016. www.sciencedirect.com/science/article/pii/S0378113519305814?via%3Dihub (VIN editor: original link is only accessible to University of Utrecht affiliates, so it is modified on 6/29/20).

3.  Hopman NEM, Hulscher MEJL, Graveland H, et al. Factors influencing antimicrobial prescribing by Dutch companion animal veterinarians: a qualitative study. Prev Vet Med. 2018;158:106–113. DOI: 10.1016/j.prevetmed.2018.07.013. www.sciencedirect.com/science/article/pii/S0167587718302939?via%3Dihub (VIN editor: original link is only accessible to University of Utrecht affiliates, so it is modified on 6/29/20).

4.  Guardabassi L, Prescott JF. Antimicrobial stewardship in small animal veterinary practice: from theory to practice. Vet Clin North Am Small Anim Pract. 2015;45(2):361–376. DOI: 10.1016/j.cvsm.2014.11.005. www.sciencedirect.com/science/article/abs/pii/S0195561614001831?via%3Dihub (VIN editor: original link is only accessible to University of Utrecht affiliates, so it is modified on 6/29/20).