Overview and Evaluation of Existing Guidelines for Rational Antimicrobial Use in Small-Animal Veterinary Practice in Europe
Fergus Allerton,
Cameron Prior,
Arzu Funda Bagcigil,
Els Broens,
Bénédicte Callens,
Peter Damborg,
Jeroen Dewulf,
Maria-Eleni Filippitzi,
Luís Pedro Carmo,
Jonathan Gómez-Raja,
Erez Harpaz,
Ana Mateus,
Mirja Nolff,
Clare J. Phythian,
Dorina Timofte,
Flavia Zendri,
Lisbeth Rem Jessen
Affiliations
Fergus Allerton
Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
Cameron Prior
Veterinary Specialists Scotland, 1 Deer Park Road Livingston, Scotland EH54 8AG, UK
Arzu Funda Bagcigil
Department of Microbiology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Turkey
Els Broens
Faculty of Veterinary Medicine, Department of Biomolecular Health Sciences, Utrecht University, Yalelaan 1, 3584 CL Utrecht, The Netherlands
Bénédicte Callens
Centre of Knowledge on Antimicrobial Use and Resistance, Galileelaan 5/02, 1210 Brussels, Belgium
Peter Damborg
Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 4, 1870 Frederiksberg, Denmark
Jeroen Dewulf
Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
Maria-Eleni Filippitzi
Veterinary Epidemiology Unit, Sciensano, 1050 Brussels, Belgium
Luís Pedro Carmo
Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Schwarzenburgstrasse 161, 3097 Liebefeld, Bern, Switzerland
Jonathan Gómez-Raja
FundeSalud, Government of Extremadura, Pio Baroja 10, 06800 Mérida, Spain
Erez Harpaz
Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway
Ana Mateus
Hawkshead Campus, Royal Veterinary College, University of London, Hawkshead Lane, Hatfield AL9 7TA, Hertfordshire, UK
Mirja Nolff
Clinic for Small Animal Surgery Tierspital Zürich, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland
Clare J. Phythian
Faculty of Veterinary Medicine, Institute for Production Animal Clinical Science, Norwegian University of Life Sciences, Small Ruminant Research and Herd Health, Høyland, 4325 Sandnes, Norway
Dorina Timofte
Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK
Flavia Zendri
Department of Veterinary Anatomy, Leahurst Campus, Institute of Infection, Veterinary and Ecological Sciences, Physiology and Pathology, University of Liverpool, Neston CH64 7TE, UK
Lisbeth Rem Jessen
Department of Veterinary Clinical Sciences, Faculty of Health Sciences, University of Copenhagen, Dyrlægevej 16, 1870 Frederiksberg C, Denmark
Antimicrobial stewardship guidelines (ASGs) represent an important tool to help veterinarians optimize their antimicrobial use with the objective of decreasing antimicrobial resistance. The aim of this study was to map and qualitatively assess the ASGs for antimicrobial use in cats and dogs in Europe. Country representatives of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT) were asked to identify ASGs published in their countries. All collated ASGs updated since January 2010 containing recommendations on antimicrobial therapy for at least three conditions affecting different organ systems in cats and dogs underwent detailed review including AGREE II analysis. Out of forty countries investigated, fifteen ASGs from eleven countries met the inclusion criteria. Several critical principles of antimicrobial use were identified, providing a framework that should assist development of stewardship guidance. The AGREE II analysis highlighted several methodological limitations of the currently available ASGs. This study sheds light on the lack of national ASGs for dogs and cats in multiple European countries and should encourage national bodies to prioritize guideline development in small animals. A greater awareness of the need to use a structured approach to guideline development could improve the quality of ASGs in the future.
