Measurement of antibiotic use in cats and dogs presenting to US primary care and referral practices provides insights for antimicrobial stewardship

Objective To measure the prevalence of antibiotic use in dogs and cats, identify the most common antibiotic drugs prescribed, and determine the most common indications for use. Methods Point-prevalence survey methodology was used to collect antibiotic prescribing data for cats and dogs from 1 practice day in 2021 at nonacademic primary care and referral practices in the US. Results 52 practices participated, comprising records for 2,599 dogs and cats. Antibiotics were prescribed to 29.2% of animals, including 24.6% prescribed antibiotics for systemic and 6.3% for topical administration. The most common systemically administered antibiotics prescribed were aminopenicillins with beta-lactamase inhibitors (29.7%), imidazoles (16.4%), first-generation cephalosporins (15.9%), and third-generation cephalosporins (12.5%). Of the 810 clinical conditions associated with antibiotic prescriptions, the majority were skin (17.0%), gastrointestinal (15.9%), surgical (12.5%), otic (8.6%), ocular (8.5%), urinary (7.8%), and respiratory (7.3%). Dogs, inpatients, and animals presenting to referral practices were more likely to receive an antibiotic prescription. For the 478 dogs and cats prescribed an antibiotic intended to treat infection, 13.4% had bacterial culture and susceptibility testing. Conclusions This study highlights areas for targeted antimicrobial stewardship efforts, including the limited use of bacterial culture and susceptibility testing, the frequent prescribing of third-generation cephalosporins and imidazoles, and the common use of prophylactic antibiotics for clean surgical procedures. Clinical Relevance Measurement of antibiotic use in companion animals is critical to focus antibiotic use guideline development, highlight the need for outcomes-based research, and identify barriers to engage in antimicrobial stewardship efforts.