title: Use of large-scale veterinary data for the investigation of antimicrobial prescribing practices in equine medicine.
abstract: BACKGROUND
  As antimicrobial resistant bacterial strains continue to emerge and spread in human and animal populations, understanding prescription practices is key in benchmarking current performance and setting goals. Antimicrobial prescription (AP) in companion veterinary species is widespread, but is neither monitored nor restricted in the USA and Canada. The veterinary use of certain antimicrobial classes is discouraged in some countries, in the hope of preserving efficacy for serious human infections.
  
  
  OBJECTIVE
  The aim of this study was to ascertain the rate of prescription of a number of 'reserved' antimicrobials in a first-opinion US and Canadian horse cohort, and identify trends in their empirical use.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A large convenience sample of electronic medical records (2006-2012) was interrogated using text mining to identify enrofloxacin, clarithromycin and ceftiofur prescriptions. Time series analysis and logistic regression were used to identify trends and risk factors for prescription.
  
  
  RESULTS
  Prescription of these antimicrobials as a first-line intervention, without culture and sensitivity testing (CST), was common in this population. Enrofloxacin prescriptions were found to increase over the study period, and there was evidence of either a reducing, or static trend in the proportion of reserved APs informed by CST.
  
  
  CONCLUSIONS
  Dose adequacy could not be included due to the nature of the data used.
  
  
  CONCLUSIONS
  Empirical use of reserved antimicrobials was common in this population, and further advice and guidance should be issued to first-opinion veterinarians to safeguard antimicrobial efficacy.
authors: Equine Clinical Sciences Division, School of Veterinary Medicine, University of Glasgow, UK.
authors: C E
authors: CE
authors: Welsh
authors: Equine Clinical Sciences Division, School of Veterinary Medicine, University of Glasgow, UK.
authors: T D H
authors: TDH
authors: Parkin
authors: Equine Clinical Sciences Division, School of Veterinary Medicine, University of Glasgow, UK.
authors: J F
authors: JF
authors: Marshall
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002170:Canada; D006736:Horses; D006801:Humans; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D018634:Veterinarians; D014730:Veterinary Medicine / Q000592:standards / Q000706:statistics & numerical data*
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial; horse; prescription; resistance