Mapping Antibiotic Use, Also for Companion Animal Veterinarians
Unnecessary or improper use of antibiotics leads to increased antibiotic resistance, which is undesirable. By being cautious and selective when prescribing antibiotics, companion animal veterinarians, like general practitioners (GPs), can help reduce unnecessary or improper antibiotic use. The Faculty of Veterinary Medicine at Utrecht University, in collaboration with partners, has received funding from ZonMw to adapt a successful program for GPs to companion animal veterinarians.
Similarities Between GPs and Veterinarians
Research shows that both GPs and veterinarians sometimes prescribe antibiotics unnecessarily or incorrectly, according to guidelines. And there are more similarities between these two professions. Primary care consultations are brief and often lack extensive diagnostic tools or tests, limiting the ability to make precise diagnoses or identify the pathogen.
Additionally, the trust-based relationship between a GP and patient is similar to that between a veterinarian and pet owner. Veterinarians want to help, and owners appreciate this effort. This personal relationship can sometimes lead veterinarians, like GPs, to err on the side of caution and prescribe antibiotics just in case, even when it might not be necessary.
From SABEL to SABEL-MedVet
The project "Spiegelinformatie AntiBiotica EersteLijn" (SABEL, or "Feedback Information on Antibiotics in Primary Care") was previously developed and implemented for GPs to reduce unnecessary or improper antibiotic prescriptions. This initiative is now being translated to the veterinary field as SABEL-MedVet. The project is spearheaded by researchers Els Broens from the Faculty of Veterinary Medicine and Alike van der Velden from the University Medical Center Utrecht, alongside numerous partners, including the Institute for Responsible Medication Use, RIVM, Rezisto (Regional AMR Care Network North Brabant), KNMvD, IVC Evidensia, IDEXX Animana, and the Dutch Veterinary Medicines Authority (SDa).
Education and Feedback
In the SABEL project for GPs, anonymous medical data from electronic patient records is used to calculate how often antibiotics are prescribed in each practice and which antibiotics are used for specific diagnoses. This information is shared in intervision meetings, where it is compared with the prescribing behavior of other practices and national outcomes. SABEL-MedVet applies a similar approach for companion animal practices.
Enthusiastic
Broens explains: “It makes so much sense start this with veterinarian as well! GPs who participated in SABEL were enthusiastic about the feedback and training they received. The clinical diagnoses where unnecessary or improper antibiotics are prescribed in primary care are often similar between GPs and veterinarians, such as respiratory, skin, or urinary tract infections. However, veterinarians’ recording of patient data is less structured, which will be a challenge. Fortunately, we have various partners on board who can assist with this.”
Registration via PetScan
The PetScan diagnosis registration system, developed by the Expertise Center for Genetics in Veterinary Medicine, enables centralized monitoring of diagnoses. Additionally, the SDa has years of experience with centralized recording and processing of antibiotic prescription data. Integrating PetScan and the SDa system into the patient management system (PMS) used by participating veterinary practices will link diagnoses with prescribed antibiotics, sending anonymized data to a central database managed by the Faculty of Veterinary Medicine. While this data cannot be traced back to specific animals or owners, it provides insights into prescribing behavior, enabling feedback to practices.
For All Companion Animal Practices
Broens adds, “We also need input from first-line veterinarians, which is why KNMvD and IVC Evidensia are involved. We’re also pleased to have IDEXX Animana as a partner, as they can contribute to data registration in the PMS and retrieving the necessary information from the system. Importantly, this program is not being developed exclusively for Evidensia practices or those using IDEXX Animana’s PMS. All partners recognize the need to make the project’s outcomes accessible to all companion animal practices in the Netherlands and potentially beyond.”
After PMS implementation, veterinarians will easily be able to retrieve their own prescribing data for specific indications over a particular timeframe and compare it with national data, information from a collaborative network, or colleagues within the same practice. This feedback empowers veterinarians to evaluate and adjust their prescribing patterns.
Building on Progress in Livestock
In recent years, antibiotic use in livestock farming has been significantly reduced and improved thanks to the efforts of many collaborating parties. The next step is to achieve similar progress in veterinary companion animals practices.
The file number at ZonMw is 10680012310013 (in Dutch).