Measurement of antibiotic use in cats and dogs presenting to US primary care and referral practices provides insights for antimicrobial stewardship.

Objective: To measure the prevalence of antibiotic use in dogs and cats, identify the most common antibiotic drugs prescribed, and determine the most common indications for use.

Methods: Point-prevalence survey methodology was used to collect antibiotic prescribing data for cats and dogs from 1 practice day in 2021 at nonacademic primary care and referral practices in the US.

Results: 52 practices participated, comprising records for 2,599 dogs and cats. Antibiotics were prescribed to 29.2% of animals, including 24.6% prescribed antibiotics for systemic and 6.3% for topical administration. The most common systemically administered antibiotics prescribed were aminopenicillins with beta-lactamase inhibitors (29.7%), imidazoles (16.4%), first-generation cephalosporins (15.9%), and third-generation cephalosporins (12.5%). Of the 810 clinical conditions associated with antibiotic prescriptions, the majority were skin (17.0%), gastrointestinal (15.9%), surgical (12.5%), otic (8.6%), ocular (8.5%), urinary (7.8%), and respiratory (7.3%). Dogs, inpatients, and animals presenting to referral practices were more likely to receive an antibiotic prescription. For the 478 dogs and cats prescribed an antibiotic intended to treat infection, 13.4% had bacterial culture and susceptibility testing.

Conclusions: This study highlights areas for targeted antimicrobial stewardship efforts, including the limited use of bacterial culture and susceptibility testing, the frequent prescribing of third-generation cephalosporins and imidazoles, and the common use of prophylactic antibiotics for clean surgical procedures.

Clinical Relevance: Measurement of antibiotic use in companion animals is critical to focus antibiotic use guideline development, highlight the need for outcomes-based research, and identify barriers to engage in antimicrobial stewardship efforts.