CVS collaborates with the University of Bristol on new antimicrobial stewardship clinical research
Project aims to increase responsible use of antimicrobials in acute diarrhoea, cat bite abscess and otitis externa
CVS and the University of Bristol are collaborating on a new antimicrobial stewardship clinical research project, aiming to increase the responsible use of antimicrobials in three common conditions presented in small animal veterinary practices.
The project will collect data from participating practices on antimicrobial prescriptions and assess the impact of antimicrobial stewardship programmes in otitis externa, acute (haemorrhagic) diarrhoea and cat bite abscess.
Antimicrobial resistance (AMR) is a global health priority. The overuse and misuse of antimicrobials in humans, animals and plants is one of the main drivers in the development of drug-resistant pathogens. Therefore, it is particularly important to reduce the usage of Highest Priority Critically Important Antimicrobials (HPCIA’s). AMR is particularly relevant in small animal practice due to the close interaction between humans and their pets, the frequent use of antimicrobials in small animal veterinary medicine, and the potential risk of resistant pathogens transferring between animals and humans. Clinicians are now increasingly focussing on Antimicrobial Stewardship (AMS) to ensure the responsible use of antimicrobials in small animals. However, limited robust evidence exists on AMS in small animal veterinary medicine.
The CVS and Bristol project will initially review the proportion of acute diarrhoea, cat bite abscess and otitis externa consultations, where antimicrobials have been prescribed in over 50 CVS practices across the country. It will compare current prescription levels with two-year retrospective data, to gain an understanding of prescribing behaviour. In addition, it will look at the proportion of prescriptions that are HPCIAs.
Individual practice data will then be given to a dedicated AMS representative at each surgery, who will be responsible for sharing it with their team - to gain an understanding of their prescribing for these key conditions and to review actions which can be taken at practice level . Enhanced support and formal CPD on antimicrobial stewardship will be provided to all practices involved to encourage positive changes and responsible antimicrobial usage. The research project will then capture ongoing data - from August 2024 until July 2025 - to show changes in antimicrobial prescribing for these key conditions.
The research is expected to provide an opportunity to build upon ongoing veterinary antimicrobial stewardship strategies. This could include: using diagnostics to ensure accurate diagnoses and appropriate treatment plans; informing a change in prescribing behaviour; selecting antimicrobials responsibly; educating pet owners on antimicrobial resistance; and, using evidence-based guidance.
The clinical research project is being run by Kezia Wareham, Doctor of Philosophy student at Bristol Veterinary School (supervised by Dr Fernando Sanchez-Vizcaino, Dr Emi Barker, Dr Nicola Rooney and Dr Irene Bueno Padilla) and Deb Komianos, Regional Clinical Lead at CVS.
Deb Komianos, Regional Clinical Lead at CVS who is overseeing the project, said:
“Antimicrobial resistance is one of the top ten global health threats, and the figures projected by the WHO for attributable deaths are truly startling. Addressing the development of drug-resistant pathogens requires a One Health approach. It is not enough to pay lip service to AMS, we need to be leading the change.
Our veterinary staff have an important role to play in safeguarding antimicrobials for future use. As an evidence-based profession, we look for data to support decision making but there is limited robust evidence about antimicrobial stewardship in small animal veterinary medicine.
Therefore, this project aims to contribute to filling this gap, alongside supporting veterinary professionals. We hope it will help us identify, develop and share evidence and best practice to support responsible antimicrobial prescribing and use for these commonly presented cases. The project has begun and early engagement is high. We have had our first two CPD sessions and the quality of conversation and self-awareness among members is inspiring which fills me with hope for making a positive impact.”
CVS is supporting the project as part of its antimicrobial stewardship priorities. These include; collating and generating the evidence to support responsible antimicrobial prescribing; providing clinical decision-making support; and, responsible antimicrobial prescribing. The group has already made a significant impact on measuring the use of HPCIAs within its practices through the use of site-specific dashboards, giving individual clinicians the ability to monitor usage. The team is also providing face-to-face and online CPD, monthly reports, guidelines for treatment, support materials for practice discussions, and coaching on reflection using accepted models.
CVS Group operates across small animal, farm animal, equine, laboratories and crematoria, with over 500 veterinary practices and referral centres in the UK and Australia. In the last five years the company has invested nearly £80 million in its sites, facilities and equipment, in addition to industry leading training and support, to give the best possible care to animals.