CVS funded PhD on interventions to promote responsible prescribing habits of HPCIAs in equine and small animal practices

Antimicrobials are one of the most utilised medications in both human and veterinary medicine. Responsible use of antimicrobials considered of highest importance for human health is essential in order to preserve efficacy for all species in the long term, amid the global threat of antimicrobial resistance (AMR). These have been termed Highest Priority Critically Important Antimicrobials (HPCIAs) by the World Health Organisation. Veterinary industry guidelines recommend that HPCIAs should be prescribed based on culture and sensitivity (C&S) testing as far as possible to ensure appropriate use and protect these critical agents. However, HPCIAs are still commonly used inappropriately in equine and small animal practice despite this, frequently with a lack of justification and diagnostic testing.

This project will explore how we can increase C&S testing before HPCIA use in equine and small animal practices, with the ultimate aim of reducing inappropriate HPCIA use. Large-scale electronic health record data for equine and small animal practices, through collaboration with SAVSNET, will be utilised to explore the dynamics of how C&S is performed alongside HPCIA use. The extent of HPCIA use with and without C&S will be analysed and factors that appear associated with either identified. These may relate to patient signalment, type of disease process or practice type for example. Alongside this, we will work together with veterinary staff and other stakeholders, such as animal owners and laboratory staff, to further improve understanding of the reasons for HPCIA use with and without testing. This information will be harnessed to address important knowledge gaps around how diagnostics are perceived in relation to HPCIA use in small animal and equine practice.

This mixed methods project will enable a holistic approach to understanding the reasons for HPCIA use with and without testing in both species sectors. The data collected will be used to map the processes involved for use of C&S and HPCIAs. This will enable exploration of dynamic interactions between factors and identification of leverage points where interventions may be most effective. Potential interventions aimed at increasing C&S testing and reducing HPCIA use will then be developed through collaboration with stakeholders and piloted in equine and small animal practices. The results of this intervention will be applicable to the wider veterinary profession and can be used in the urgent battle to limit AMR.