Equine Veterinary Surveillance Network (EVSNET): Occurrence and resistance patterns in <i>Streptococcus equi</i> subsp. <i>equi</i> and <i>Streptococcus equi</i> subsp. <i>zooepidemicus</i> from equine clinical submissions

recommended daily dose (RDD)/equid/year was calculated.All consultation notes associated with protected AMU were classified using an equine-adapted International Classification of Diseases (ICD)-11 method considering the primary reason(s) for AMU.A multi-label classification LLM for the automated annotation of EHRs was developed. Results:The study population included 41,137 equids and 12.9% received a systemic antimicrobial.Overall, AMU was 0.90 RDD/equid/year.Fluoroquinolones and third generation cephalosporins had the highest metrics of the protected antimicrobials (0.04 RDD/equid/ year, and 0.01 RDD/equid/year, respectively).Only 21% of equids had culture performed 0-7 days prior to initiating protected AMU.A third of protected AMU could not be assigned to an equine adapted ICD-11 classification due to lack of detail in the clinical notes.The most common disease classification was 'Injury, Poisoning or Certain Other Consequences of External Causes' (16.89%).The performance of the final multi-label LLM tested yielded a precision of 0.73, recall of 0.38 and F1-score of 0.50.Main limitations: Convenience sample of equine practices.Conclusions: This demonstrates a methodology that can report antimicrobial quantity and context for stewardship activities.A LLM to facilitate vast automated disease labelling would enable contextualisation of AMU without the need for manual annotation of records.