RESEARCH COMMUNICATIONS OF THE 28th ECVIM-CA CONGRESS

Antimicrobial resistance is an emerging problem in human and veterinary medicine. Antibiotic use is the main driver for resistance development. The goal of this study was to evaluate antimicrobial prescription in cats in Switzerland with acute upper respiratory tract disease (aURTD) and feline lower urinary tract disease (FLUTD). Cases presented to two University hospitals and eight private veterinary practices during 2016 were retrospectively evaluated. Clinical history, diagnostic work‐up and antimicrobial therapy (class, dosage, duration) were assessed. A justification score (JS) was used to assess the agreement of antimicrobial prescription with current guidelines (1=appropriate, 2=incorrect dosage/duration, 3=inappropriate antimicrobial, 4=overall wrong treatment decision). Of 142 cats with aURTD, 107 (75%) received antibiotic therapy of the following classes: potentiated aminopenicillins (51%), third generation cephalosporins (22%), aminopenicillins (21%), tetracyclines (17%), fluoroquinolones (5%), amphenicoles (2%), first generation cephalosporins and macrolides (1% each); 16% received combination or serial therapy. The cases were treated for 4 to 37 (median 10) days. When assessment of prudent use was possible (120/142), antimicrobial therapy was judged appropriate (JS‐1) in 35 (29%) and inappropriate in 85 (71%) cases (JS‐2=2; JS‐3=38; JS‐4=45). Antibiotic therapy was significantly associated with the presence of lethargy, anorexia or fever (p=0.003). Of 252 cats with FLUTD, 150 cases (60%; 50 with bacterial cystitis, 100 with other/unknown diagnosis) received antibiotic therapy of the following classes: potentiated aminopenicillins (67%), third generation cephalosporins (18%), fluoroquinolones (13%), aminopenicillins (7%), first generation cephalosporins (4%), amphenicoles (1%) and tetracyclines (1%); 10% received combination or serial therapy. The cats were treated for 1 to 56 (median 11) days. When assessment of prudent use was possible (152/252), antimicrobial therapy was judged appropriate (JS‐1) in 76 (50%) and inappropriate in 76 (50%) cases (JS‐2=1; JS‐3=28; JS‐4=47); inadequate diagnostic work‐up (97/100) was the main reason to preclude judgment. Bacteriuria was significantly associated with antibiotic therapy (p<0.001). Overall, frequency of antimicrobial therapy was not significantly different between university hospitals and private practices, but critically important antibiotics (third generation cephalosporins and fluoroquinolones) were significantly more often used in private practices (aURTD, p=0.009; FLUTD, p<0.001). Our results suggest that overprescription of antibiotics in cats with aURTD and FLUTD is common. Third generation cephalosporins are frequently used. The study highlights the need to promote antimicrobial stewardship in small animal medicine. To support this, an online tool (www.antibioticscout.ch) based on current veterinary guidelines was launched in 2017. The impact of this tool on prescribing habits will be assessed in the future.