Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK

Background: Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice. This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N = 16). The objective of the research was to explore the drivers of companion animal veterinary surgeons’ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n = 4), Scotland (n = 11), Northern Ireland (n = 1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours. Results: Five components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors. Conclusion: This paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeons’ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR

Pig castration: will the EU manage to ban pig castration by 2018?

BACKGROUND: In 2010, the ‘European Declaration on alternatives to surgical castration of pigs’ was agreed. The Declaration stipulates that from January 1, 2012, surgical castration of pigs shall only be performed with prolonged analgesia and/or anaesthesia and from 2018 surgical castration of pigs should be phased out altogether. The Federation of Veterinarians of Europe together with the European Commission carried out an online survey via SurveyMonkey© to investigate the progress made in different European countries. This study provides descriptive information on the practice of piglet castration across 24 European countries. It gives also an overview on published literature regarding the practicability and effectiveness of the alternatives to surgical castration without anaesthesia/analgesia. RESULTS: Forty usable survey responses from 24 countries were received. Besides Ireland, Portugal, Spain and United Kingdom, who have of history in producing entire males, 18 countries surgically castrate 80% or more of their male pig population. Overall, in 5% of the male pigs surgically castrated across the 24 European countries surveyed, castration is performed with anaesthesia and analgesia and 41% with analgesia (alone). Meloxicam, ketoprofen and flunixin were the most frequently used drugs for analgesia. Procaine was the most frequent local anaesthetic. The sedative azaperone was frequently mentioned even though it does not have analgesic properties. Half of the countries surveyed believed that the method of anaesthesia/analgesia applied is not practicable and effective. However, countries that have experience in using both anaesthesia and post-operative analgesics, such as Norway, Sweden, Switzerland and The Netherlands, found this method practical and effective. The estimated average percentage of immunocastrated pigs in the countries surveyed was 2.7% (median = 0.2%), where Belgium presented the highest estimated percentage of immunocastrated pigs (18%). CONCLUSION: The deadlines of January 1, 2012, and of 2018 are far from being met. The opinions on the animal-welfare-conformity and the practicability of the alternatives to surgical castration without analgesia/anaesthesia and the alternatives to surgical castration are widely dispersed. Although countries using analgesia/anaesthesia routinely found this method practical and effective, only few countries seem to aim at meeting the deadline to phase out surgical castration completely

Use of antimicrobials in practice (targeted on cattle, pigs, poultry, horses)

Worldwide, antibiotics are used to treat and prevent bacterial infections, both in humans and animals. In Europe, 2014 data (2017 JIACRA) estimate that the average antimicrobial consumption (AMC) in animals was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 European countries, AMC was lower in animals than in humans. Most European countries have taken extensive actions to promote responsible and prudent use of antibiotics in animals. Since 2011, the overall sales of veterinary antibiotics in EU/EEA countries are decreasing [EMA European Medicines Agency: answer to the request from the European Commission for updating the scientific advice on the impact on public health and animal health of the use of antibiotics in animals - categorisation of antimicrobials (EMA/CVMP/CHMP/682198/2017), 2019], and this is mainly accounted for reduction in antibiotic use in food-producing animals. Nevertheless, there seems to be still space for improvement, especially in certain pharmaceutical forms used for mass medication, consumptions of which create big part of the total figures of overall sales. The use in animals like dogs and cats in tonnes is relatively low. ESVAC sales data indicated that the majority of consumption of veterinary medicinal products used in 2017 (excluding topical formulation) can be allocated to food-producing animals in most of the EEA countries. The sales, in mg/PCU (Population Correction Unit), of antimicrobial veterinary medicinal products differ extensively between EU/EEA countries. This can partly be explained, among other factors, by the differences in the animal demographics, production systems and dosing of the various antimicrobials