Antimicrobials are critical for medicine, but the problem of antimicrobial resistance (AMR) threatens the effectiveness of these valuable drugs. Widespread use of antibiotics is the main driver of AMR. In human and animal health settings, this makes infections difficult, and sometimes impossible, to treat. Tracking of antimicrobial use (AU) is an essential strategy to combat AMR. There are no systematic, ongoing national- or state-level programs to track AU in dogs and cats in the United States. Measurement of AU is hampered by logistical challenges of accessing prescribing data within and across the many diverse veterinary electronic health record (EHR) systems. Veterinary medicine lacks standard diagnostic coding, as such codes are not required for billing nor disease reporting. Often the details of the patient encounter (e.g., diagnosis, indication for prescriptions) are recorded only in free-text fields of the EHR rather than in easily searchable fields. Methodologies that overcome obstacles to data collection are a critical need in the fight against AMR. The overarching goal of this project is to optimize long-term strategies for collecting and reporting AU data from companion animal practices to understand baseline prescribing behaviors and provide actionable targets for antimicrobial stewardship (AS). Two practical, scalable, and sustainable approaches to track AU in companion animal veterinary practices will be utilized. These include the use of point prevalence surveys (PPS) and the Companion Animal Veterinary Surveillance Network (CAVSNET). PPS have been used by the Centers for Disease Control and Prevention to establish baseline national measures of AU in human hospital and long-term care settings. This project will establish national estimates of AU prevalence in referral and small animal general practices by conducting national PPS in veterinary teaching hospitals and general and referral practices. CAVSNET is a secure passive surveillance system for long-term tracking of companion animal health, disease, and treatment. CAVSNET will gather AU data on a routine basis directly from EHR systems. With these two complementary approaches, we will build a comprehensive national picture of AU in dogs and cats.
Antimicrobial use is the major driver of the emergence of antimicrobial-resistant infections, a significant threat to human and companion animal health. Measurement of antimicrobials is critical to improve antimicrobial use for dogs and cats, however, efforts to collect this data are hampered by the nature of diverse pet health records and lack of resources and technical expertise in veterinary practices. This project will overcome barriers to tracking antimicrobial use by 1) utilizing a low-tech point prevalence survey approach to gather a snapshot of antimicrobial use in veterinary facilities across the country, and 2) establishing an electronic surveillance system for antimicrobial use that incorporates collection of uniform data across varied electronic health record platforms without the need for information technology expertise in participating practices.
