Point-prevalence surveys (PPS) are structured to collect uniform data from multiple sites over a specific period of time. Our goal of this study was to conduct a PPS of antimicrobial use and antimicrobial resistance in small animal and equine practices. On four PPS survey dates, trained personnel collected retrospective data at each practice using existing health records. Data from all survey days and study sites were compiled to summarize patient characteristics and presenting complaints and antibiotic prescribing rates.

Measurement and reporting of antimicrobial use and antimicrobial resistance is a core component of antimicrobial stewardship. In public health, the PPS approach has been used to establish national estimates of antimicrobial use in acute care and long-term care settings. A PPS is an approach to identify the number of people with a disease or condition at a specific point in time. In the case of antimicrobial use, the PPS has been used to determine the number of people receiving antimicrobial treatment on a given day. National PPS for healthcare settings have compiled the number of individuals on an antibiotic in many individual facilities into a national estimate of how many people receive antimicrobials in these settings per day. Information is also gathered about antimicrobial type, class, and reason for use, as well as general patient details.

The companion animal (considered here as canine, feline, equine) veterinary profession lacks data to evaluate antimicrobial use and antimicrobial stewardship practices, but inappropriate antimicrobial use is likely as prevalent in clinic-based veterinary practice as it is in human medicine. In a single-center study, 38% of canine antibiotics in a veterinary teaching hospital were prescribed without documented evidence of infection (Wayne, 2011). The International Society for Companion Animal Infectious Diseases has published antimicrobial use guidelines for canine superficial bacterial folliculitis and for canine and feline urinary tract and respiratory tract disease. However, without antimicrobial use data, we cannot assess adherence to these guidelines, measure trends, or describe broader antimicrobial stewardship practices. Point-prevalence surveys can be used to collect uniform data from multiple sites over a single time period, providing a snapshot of practice and information to guide profession-wide improvement.

The study is designed as a point-prevalence survey. A designated vet, tech, or staffer in your practice will meet with a research project staff member for a maximum of 2-3 hours once quarterly for the next year (4 meetings) to review medical records from a representative day of practice (of your choosing) within a 2-week window each quarter. Depending on your case volume and how many patients your practice sees in a day, the time commitment may be shorter! You will be able to choose the date/time of the meeting from a broad window to ensure it is convenient for you and your practice. The first meeting will likely be in-person, and our staff will come to you to minimize inconvenience. Subsequent meetings may be held by teleconference, if possible, or we can continue to visit you at your location of choice.

We do NOT want any information regarding your clients and you will NOT be giving us any direct access to your medical record system! Rather, your designated representative will work with us to collect data from your records system regarding all patients seen on those 4 specific quarterly days. The key information needed for each patient is age, breed, gender, chief body system affected, diagnosis, antibiotic treatment prescribed (if any), and culture/sensitivity results if available. Rest assured that the data you share with us will remain completely confidential, and any published summary of the study results will contain no information that will make it possible to identify any patient, client, or practice.

Absolutely - we would be delighted to talk further with you and share more details. Please reach out to Emma Leof Bollig, Program Manager and Lead Epidemiologist, University of Minnesota at cavsnet@umn.edu.

This work is supported by the University of Minnesota College of Veterinary Medicine Emerging, Zoonotic and Infectious Disease Signature Program.

In addition to contributing to a baseline of knowledge for the profession, each participating facility will gain experience reviewing antimicrobial use data and using protocols that can be used internally for continued antimicrobial use tracking and improvement of facility-level prescribing. Data from survey days can be summarized to describe patient characteristics and presenting complaints, antibiotic prescribing rates (e.g., overall, by syndrome, season, clinic setting), and rates of diagnostic testing.

Read more at MN/ND PPS: Overview and Benefits of Participation

Measurement and reporting of antibiotic use (AU) and antimicrobial resistance (AMR) is a core component of antibiotic stewardship (AS). In public health, the point-prevalence survey (PPS) approach has been used to establish national estimates of AU in acute care and long-term care settings. A PPS is an approach to identify the number of people with a disease or condition at a specific point in time. In the case of AU, the PPS has been used to determine the number of people receiving antimicrobial treatment on a given day. National PPS for healthcare settings have compiled the number of individuals on an antibiotic in many individual facilities into a national estimate of how many people receive antimicrobials in these settings per day. Information is also gathered about antibiotic type, class, and reason for use, as well as general patient details.

Learn more: Overview of Point-Prevalence Survey of Antibiotic Use in Eastern North Dakota and Minnesota Companion Animal Veterinary Clinics, 2020

The companion animal (considered here as canine, feline, equine) veterinary profession lacks data to evaluate antibiotic use (AU) and antibiotic stewardship (AS) practices, but inappropriate AU is likely as prevalent in clinic-based veterinary practice as it is in human medicine. In a single-center study, 38% of canine antibiotics in a veterinary teaching hospital were prescribed without documented evidence of infection. The International Society for Companion Animal Infectious Diseases (ISCAID) has published AU guidelines for canine superficial bacterial folliculitis and for canine and feline urinary tract and respiratory tract disease. However, without AU data, we cannot assess adherence to these guidelines, measure trends, or describe broader AS practices. PPS can be used to collect uniform data from multiple sites over a single time period, providing a snapshot of practice and information to guide profession-wide improvement.

The goal of this study is to establish an estimate of antibiotic use (AU) in Eastern North Dakota and Minnesota companion animal hospitals for use in setting antibiotic stewardship (AS) objectives, developing AS resources for veterinarians, and benchmarking progress. There are no published state-specific or national data on AU in U.S. companion animal hospitals and few data on practices in individual hospitals. During 2018–19, a research team at the University of Minnesota College of Veterinary Medicine used the point-prevalence survey approach for internal AU measurement and has summarized this methodology to facilitate establishment of a statewide snapshot of AU in referral companion animal hospitals.

Learn more: Serial point-prevalence surveys to estimate antibiotic use in a small animal veterinary teaching hospital, November 2018 to October 2019

The study is designed as a point-prevalence survey. A designated vet, tech, or staffer in your practice will meet with a research project staff member for a maximum of 2-3 hours once quarterly for the next year (4 meetings) to review medical records from a representative day of practice (of your choosing) within a 2-week window each quarter. Depending on your case volume and how many patients your practice sees in a day, the time commitment may be shorter! You will be able to choose the date/time of the meeting from a broad window to ensure it is convenient for you and your practice. The first meeting will likely be in-person, and our staff will come to you to minimize inconvenience. Subsequent meetings may be held by teleconference, if possible, or we can continue to visit you at your location of choice.

We do NOT want any information regarding your clients and you will NOT be giving us any direct access to your medical record system! Rather, your designated representative will work with us to collect data from your records system regarding all patients seen on those 4 specific quarterly days. The key information needed for each patient is age, breed, gender, chief body system affected, diagnosis, antibiotic treatment prescribed (if any), and diagnostic testing. Rest assured that the data you share with us will remain completely confidential, and any published summary of the study results will contain no information that will make it possible to identify any patient, client, or practice.

Absolutely - we would be delighted to talk further with you and share more details. Please reach out to Emma Bollig, Program Manager and Lead Epidemiologist, University of Minnesota at cavsnet@umn.edu.

This work is supported by the University of Minnesota College of Veterinary Medicine Emerging, Zoonotic and Infectious Disease Signature Program.