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Unnecessary or improper use of antibiotics leads to increased antibiotic resistance, making infections harder to treat and posing health risks to both humans and animals. A program was launched with general practitioners to better identify antibiotic use, provide feedback, and further educate them.

“The use of antibiotics in animals has fortunately been significantly reduced and improved in recent years,” says Els Broens, veterinarian and researcher at the Faculty of Veterinary Medicine. “The policy was primarily focused on livestock farming. Pet veterinarians naturally noticed these developments but still regularly prescribed antibiotics even when guidelines deemed it unnecessary. Or they prescribed antibiotics that we prefer to reserve for difficult and exceptional cases.”

Inspired by General Practitioners

Unnecessary prescribing is undesirable, says Broens, especially because pets and their owners often have close contact. “About thirty percent of dogs sleep with their owners in their beds. This facilitates the easier exchange of germs, including resistant bacteria, between animals and humans.” Enough reason to take action. Broens: “We were inspired by general practitioners. In recent years, this led to the establishment and enrollment of the project ‘Mirror Information Antibiotics Primary Care’ (SABEL).”

In this project, anonymous medical data from digital patient files are used to track how often general practitioners prescribe antibiotics and which antibiotics are prescribed for which diagnoses. This information is clarified per practice during intervision meetings and compared with the prescription behavior of GP practice colleagues and national results. “Although the formal evaluation is still pending, many general practitioners are enthusiastic,” says SABEL researcher of ľ�ϸ���Ӱ�� Medical Centre Utrecht. “More insight leads to fewer unnecessary treatments with antibiotics. And less use of antibiotics leads to fewer resistant bacteria. It’s a positive development for public health.”

Broens is enthusiastic. “It is incredibly logical to do this with veterinarians as well.” That is exactly what is going to happen within SABEL-MedVet.

Similarities

Broens and Van der Velden point out similarities between general practitioners and veterinarians. “Consultations in primary care are short, and there are often too few diagnostic tests available,” says Broens. “The trust relationship between general practitioner and patient is comparable. The veterinarian wants to help, and the owner respects this. This interpersonal relationship enables veterinarians, like general practitioners, to err on the side of caution and prescribe antibiotics, even when guidelines deem it unnecessary.”

The way veterinarians document patient data is currently less structured. “This will be challenging,” thinks Broens. “Fortunately, we have various partners on board that can help with this, ranging from primary care veterinarians to software suppliers that practices use, like IDEXX Animana.”

Veterinarians with No-Nonsense Mentality

By combining different systems, it is possible to clarify the prescription behavior of veterinarians. The diagnostic registration system PetScan, developed by the Expertise Center for Genetics in Veterinary Medicine, makes central monitoring of diagnoses possible. The Veterinary Medicine Authority foundation (SDa) is equipped with a database containing data on antibiotics. When PetScan integrates the prescription guidelines of veterinarians and the SDa system into the patient management software of participating veterinary practices, diagnoses and prescriptions of antibiotics are connected and sent to a central database managed by the Faculty of Veterinary Medicine. This data is anonymous and cannot be linked to the animal or owner. However, the database will clarify the prescription behavior of veterinarians and establish feedback on this.

Broens and Van der Velden are excited about the new collaboration. Broens: “We all see the necessity to present the results of this project to all companion animal practices in the Netherlands and possibly even foreign practices.” Van der Velden: “It is inspiring to see how open colleagues in veterinary medicine are to our experiences in human settings. It’s an honor that we can transfer the insights of SABEL virtually one-on-one to companion animals. Collaborating on a personal level with veterinarians is also particularly special: they have a no-nonsense mentality and are very practical. I’m looking forward to seeing SABEL-MedVet through with a good PhD student and each other.”

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