A survey of antimicrobial usage patterns by veterinarians treating dogs and cats in South Africa

Abstract

The emergence of antimicrobial resistant bacteria in animal health that may affect humans directly or transfer resistant genes to human pathogens is a cause for major concern. As a result both the human and veterinary use of antimicrobials has come under increased scrutiny. The aim of this research project was to characterise antimicrobial usage patterns in dogs and cats in South Africa and to confirm whether South African veterinarians treating companion animals were making use of the proper selection guidelines in optimizing their antimicrobial use. To meet this objective, a survey was undertaken through an online questionnaire sent to 2880 registered South African veterinarians. The questionnaire covered general use principles; scope of extra-label use of antimicrobials; Section 21 applications for unregistered antimicrobials; use of antibiograms; adverse drug reactions; owner compliance; disposal of expired stock and length of use of multi-dose vials. Questionnaires were completed by 181 veterinarians representing a response of 16% from the 1120 small animal veterinarians to which the questionnaire was sent. Use of antimicrobials without laboratory diagnosis, off label prescriptions and compounding of antimicrobials by small animal veterinarians in South Africa was reported. When presented with first time cases, 91.16% (n=165) of the respondents selected their antimicrobial empirically before undertaking laboratory testing. Antimicrobial compounding was practiced by 13.26% (n=24) of the respondents, with the following preparations being compounded; enrofloxacin (baytril) + saline + silver sulfadiazine (flamazine); gentamicin + dimethyl sulfoxide (DMSO); enrofloxacin + DMSO; enrofloxacin (baytril) + ear preparations. A high proportion of respondents also used antimicrobials off label (86.19%; n=156). All the major classes of antimicrobials were in use by small animal veterinarians. This descriptive study is an important first stage in investigating small animal antimicrobial usage patterns in South Africa. The descriptive information gained from this study will play a major role in the development of appropriate hypotheses that can be tested in future studies linked with the emergence of antimicrobial resistant bacteria. It is also envisaged that this project will help in the review of antimicrobial prudent usage guidelines and facilitate better veterinary antimicrobial stewardship.