Vets prescribing metronidazole against AMR guidelines, study finds
The study calls for adapted guidelines in future antimicrobial stewardship programmes.
New research suggests that veterinary professionals have been prescribing metronidazole in contradiction to antimicrobial use guidelines.
In 42 per cent of cases, it was discovered that metronidazole was being used for non-antimicrobial targeted therapies. It was most often prescribed for acute diarrhoea, chronic diarrhoea or giardiasis.
This is despite advice that antimicrobials are very rarely appropriate for treating acute and chronic diarrhoea.
The findings were discovered as part of a survey of 138 veterinary professionals, primarily in the UK and working in primary care small animal practice. These professionals treated 332 cases (285 dogs and 47 cats) with metronidazole.
Those which had used metronidazole mostly justified its use by describing its anti-inflammatory or immunomodulatory properties.
Among the other justifications included suspected/confirmed anaerobic or susceptible bacterial infection, patients being systematically unwell or having severe disease, treating protozoal infections, and owner/practice expectations.
There were also 19 per cent of veterinary professionals using metronidazole based on prior positive outcomes, either in similar cases or the same patient.
This reliance on anecdotal reasoning corresponded with previous research, involving interviews with practitioners, with its frequency being linked to prescribing practices. This could lead to the inappropriate use of antimicrobials, therefore contributing to antimicrobial resistance.
Researchers are now calling for future stewardship programmes to learn from such behaviours. They say that these programmes should focus on advocating the use of non-prescription forms of medication.
The study also calls for adapted guidelines to tackle the inappropriate prescribing of metronidazole ad the development of educational resources that question specific rationales for metronidazole use.
Justin Ng, lead author of the study, said: “These insights are alarming given that such practices frequently deviate from current antimicrobial use guidelines, potentially contributing to ongoing challenges with antimicrobial resistance and adverse effects on gastrointestinal health.”
The full study can be found in the Journal of Small Animal Practice.
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Defra has published guidance for the vet sector ahead of a proposed UK-EU Sanitary and Phytosanitary agreement.
