Antimicrobial stewardship priorities and prescribing in Australian equine practice

Abstract Background Antimicrobial resistance is a global health crisis that needs to be addressed by all areas of human and animal health sectors to safeguard effective antibiotics into the future. Understanding current antimicrobial prescribing patterns and veterinary antimicrobial stewardship (AMS) priorities is crucial for effective stewardship program design and sustainable uptake. Objective To identify focus areas for stewardship interventions, implementation, resource allocation, and future campaign targets for equine practice. Study Design Cross‐sectional study of equine veterinarians in Australia. Methods A cross‐sectional study of equine veterinarians attending equine conferences and meetings in Australia was conducted. A combination of closed‐ended questions and free‐text responses were used to obtain perspectives, priorities and antimicrobial prescribing behaviours of equine veterinarians in Australia. Descriptive statistics were computed, with percentages reported as the proportion of respondents answering each question. Results There were 103 responses, 85 of which were complete, from equine veterinarians across a broad range of sectors and levels of experience. Results indicate that equine veterinarians are overwhelmingly in favour of adopting AMS programs that have been developed for equine practice. Respondents consider unnecessary antimicrobial use and use of high importance antimicrobials when lower importance alternatives may be equally effective to be key targets. Mixed practice veterinarians showed an interest in client‐facing resources, particularly those addressing wound management and reproduction. There was a lack of consensus among participants regarding when to stop antimicrobials in the treatment of equine pneumonia. Main Limitations The sample size of this study was small, consequently, the study was underpowered for formal inferential comparisons between subgroups. Selection and response bias need to be considered especially since participants were recruited during an equine conference. Conclusions This study serves to inform focus areas for stewardship interventions, including high‐importance antimicrobial use, equine‐specific antimicrobial prescribing guidelines, client‐facing educational resources and guidance on antimicrobial duration for equine pneumonia, to improve stewardship efforts of equine veterinarians.