Prevalence of Antimicrobial Use in Small Animal Dermatology Referral Practices in the United States

BACKGROUND: Antimicrobial resistance is a critical global health concern driven by antimicrobial use. Dermatological conditions are common reasons for antimicrobial prescriptions in small animal practice, yet data on prescribing patterns in veterinary dermatology referral settings are lacking. HYPOTHESIS/OBJECTIVES: To characterise the frequency, types and indications for antimicrobial use in dogs and cats seen by board-certified or residency-trained first-opinion veterinary surgeons in the United States. ANIMALS: Medical record data about 550 client-owned animals (479 dogs, 71 cats) presenting to 22 US veterinary dermatology referral practices were included. MATERIALS AND METHODS: A prospective, cross-sectional point-prevalence study was conducted in August 2023. Each clinic enrolled the first 25 consecutive dogs or cats evaluated by a referral clinician. Data collected included clinical diagnoses, antimicrobial and antiseptic prescriptions and diagnostic testing. RESULTS: Antimicrobials were prescribed in 54.9% (302 of 550) of cases. Third-generation cephalosporins accounted for 43.9% (54 of 123) of systemic antibiotics to dogs. Of topical antimicrobials prescribed for otitis externa associated with bacteria only or yeast only, 36.4% (20 of 55) were a combination formulation containing both an antibiotic and an antifungal. Antiseptics were prescribed in 62.7% of cases. Cytological investigation was performed in 86.3% of conditions treated with antimicrobials, whereas bacterial culture was used in only 15.3%. CONCLUSIONS AND CLINICAL RELEVANCE: This study provides a benchmark for antimicrobial use in veterinary dermatology referral practices. Findings highlight opportunities to align prescribing with updated guidelines to reduce reliance on broad-spectrum systemic antibiotics, favouring topical therapies and underscore the need for narrow-spectrum topical options.