title: Antimicrobial prescribing practice in UK equine veterinary practice.
abstract: BACKGROUND
  Antimicrobial use is known to select for the emergence of resistant strains of bacteria; therefore prudent use in both human and veterinary medicine is essential to preserve their efficacy.
  
  
  OBJECTIVE
  To characterise antimicrobial prescribing patterns in UK equine practice and evaluate factors associated with prescribing.
  
  
  METHODS
  A postal questionnaire including 4 clinical scenarios was sent to 740 veterinary surgeons that treat horses. Data were collected on the clinician, their practice and sources of information regarding antimicrobials and their use. Multivariable logistic regression analysis was used to ascertain factors associated with 5 outcomes; prescribing off-licence drugs; prescribing at incorrect doses; prescribing 3rd or 4th generation cephalosporins; prescribing fluoroquinolones and prescribing potentiated sulphonamides.
  
  
  RESULTS
  Questionnaires were completed by 38% of veterinary surgeons who were sent questionnaires. Less than 1% of practices had antimicrobial use guidelines. Trimethoprim-sulphonamides were most commonly prescribed in each clinical scenario. Eleven percent of prescriptions were for antimicrobial drugs not licensed for use in horses in the UK. Five percent of prescriptions for licensed antimicrobials were under the recommended dose rate and 56% over the recommended dose rate. Fluoroquinolones and 3rd and 4th generation cephalosporins accounted for 1 and 3% of prescriptions, respectively. Veterinary surgeons working at referral practices were more likely to prescribe 3rd and 4th generation cephalosporins and fluoroquinolones and off-licence antimicrobials whereas those working in first-opinion practices were more likely to prescribe potentiated sulphonamides. Sources of information regarding antimicrobials also had an effect on prescribing.
  
  
  CONCLUSIONS
  Prescription of antimicrobials at inappropriate doses was common even when provided with the weight of the animal. It is uncommon for UK equine veterinary practices to have guidelines for antimicrobial use. The introduction of such guidelines could lead to more prudent use of antimicrobials.
authors.affiliation: Department of Epidemiology and Population Health Group, Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Neston, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: Hughes
authors.forename: G
authors.initials: G
authors.lastname: Pinchbeck
authors.forename: R
authors.initials: R
authors.lastname: Callaby
authors.forename: S
authors.initials: S
authors.lastname: Dawson
authors.forename: P
authors.initials: P
authors.lastname: Clegg
authors.forename: N
authors.initials: N
authors.lastname: Williams
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003141:Communicable Diseases / Q000662:veterinary; D003625:Data Collection; D005260:Female; D006734:Horse Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D018634:Veterinarians / Q000706:statistics & numerical data*; D014730:Veterinary Medicine / Q000592:standards; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents