Dr Stuart Becker
In 2024 the VetCompass group at the RVC began a collaborative project with Vets for Pets and Companion Care, aiming to examine how providing different types of information on antimicrobial use and stewardship to veterinary professionals in small animal practice could help to optimise antimicrobial stewardship in dogs and cats. The project uses highly efficient interventions to deliver relevant information in a way that is easy for practices to implement with low impact on workload, and practical to roll-out at a national level.
The effect of interventions is monitored via the VetCompass database (https://www.rvc.ac.uk/vetcompass), which receives anonymised clinical records from over a quarter of UK veterinary practices including all branches of Vets for Pets and Companion Care. The VetCompass research programme has produced over 140 publications of scientific benefit to the veterinary community, and supports evidence-based veterinary practice, identifies welfare and research priorities, and contributes to the training of veterinary students and professionals. Practices have been allocated to one of four intervention groups or a control group, with each of the intervention groups having access to one category of stewardship information. The four interventions include: 1. posters highlighting antimicrobial prioritisation and the protection of high-priority critically-important drugs; 2. CPD videos focusing on specific conditions commonly treated with antimicrobials where alternative effective treatment options are available; 3. feedback on practice-level antimicrobial usage via an online dashboard and written reports; and 4. recruitment of practice colleagues as ‘antimicrobial stewardship champions’, with provision of newsletters containing information about publicly available antimicrobial stewardship resources
In the context of the current antimicrobial project, the data from around 450 Vets for Pets and Companion Care practices will allow VetCompass researchers to use advanced statistical methods to analyse antimicrobial use before and after the introduction of the interventions. The experienced team behind the experimental design includes epidemiologists and vets who have worked for many years in first opinion practice, and the interventions are designed to be realistic to implement and maintain while minimising their impact on practice workload. Antimicrobial usage will be measured primarily by the Defined Daily Dose (DDDVet per animal), introduced recently in the VMD’s VARSS Report (https://www.gov.uk/government/publications/veterinary-antimicrobial-resistance-and-sales-surveillance-2022) and the PDSA’s Antimicrobial Stewardship Report (https://www.pdsa.org.uk/media/14348/amr-stewardship-report-2023.pdf). This measure records antimicrobial use as ‘days of treatment per head of population at risk’, and so allows fairer comparison of usage between different time periods and groups of practices, compared to previously used measures such as total weight of drug, or rate of dispensing that may be more easily confounded by variations in practice workload, patient demographics, or prevalence of specific conditions.
The project is currently ongoing and will continue until mid-2025, when all contributing practices at Vets for Pets and Companion Care will be given access to project resources from other intervention groups. Helpful interventions identified by the project will then also be shared free-of-charge with the wider veterinary community via partners such as RUMA CA&E and RCVS Knowledge, helping in efforts to optimise antimicrobial stewardship in small animal veterinary practices across the UK and beyond.