Antimicrobial susceptibility testing reporting style and education to support clinical decision-making in small animal medicine.

Abstract

Objective: The increasing threat of antimicrobial-resistant (AMR) organisms highlights the need for effective antimicrobial stewardship in veterinary medicine. This study evaluated how veterinarians treating companion animals utilize antimicrobial susceptibility testing (AST) reports and antimicrobial use guidelines and their impact on antimicrobial selection.

Methods: An online survey was distributed to veterinarians across the US, collecting data on demographics, clinical case management, AST report preferences, and perceptions of AMR, diagnostic stewardship, and antimicrobial stewardship.

Results: A total of 216 veterinarians participated. Results indicated a preference (83% to 89%) for AST reports with interpretative comments on antimicrobial selection and dosing. Most respondents (55% to 62%) preferred selective reporting over cascade reporting (25% to 30%). Clinical cases revealed the frequent selection of systemic antimicrobial therapy, with many respondents indicating the need for therapeutic consultation. Two identical cases with different AST report styles (full vs cascade) showed a 26% increase in good antimicrobial stewardship with the cascade report. Gaps in knowledge regarding AST principles were identified, with many respondents misunderstanding the establishment of breakpoints, AST and topical therapy, and the interpretation of MICs.

Conclusions: These findings suggest that while veterinarians prefer full or selective AST reports, their antimicrobial choices align more closely with guidelines when cascade reports are used. This indicates that the AST report style may influence the antimicrobial stewardship practices of veterinarians and warrants further investigation.

Clinical relevance: This study demonstrates the need for improved AST reporting and education on AST interpretation and antimicrobial selection to support antimicrobial stewardship in veterinary medicine.