Representative, scalable, and sustainable surveillance methodologies to track companion animal antimicrobial use

Project Summary
Antimicrobials are critical for medicine, but the problem of antimicrobial
resistance (AMR) threatens the effectiveness of these valuable drugs. Widespread use of
antibiotics is the main driver of AMR. In human and animal health settings, this makes
infections difficult, and sometimes impossible, to treat. Tracking of antimicrobial use
(AU) is an essential strategy to combat AMR. There are no systematic, ongoing national-
or state-level programs to track AU in dogs and cats in the United States. Measurement
of AU is hampered by logistical challenges of accessing prescribing data within and
across the many diverse veterinary electronic health record (EHR) systems. Veterinary
medicine lacks standard diagnostic coding, as such codes are not required for billing nor
disease reporting. Often the details of the patient encounter (e.g., diagnosis, indication
for prescriptions) are recorded only in free-text fields of the EHR rather than in easily
searchable fields. Methodologies that overcome obstacles to data collection are a critical
need in the fight against AMR.
The overarching goal of this project is to optimize long-term strategies for
collecting and reporting AU data from companion animal practices to understand
baseline prescribing behaviors and provide actionable targets for antimicrobial
stewardship (AS). Two practical, scalable, and sustainable approaches to track AU in
companion animal veterinary practices will be utilized. These include the use of point
prevalence surveys (PPS) and the Companion Animal Veterinary Surveillance Network
(CAVSNET). PPS have been used by the Centers for Disease Control and Prevention to
establish baseline national measures of AU in human hospital and long-term care
settings. This project will establish national estimates of AU prevalence in referral and
small animal general practices by conducting national PPS in veterinary teaching
hospitals and general and referral practices. CAVSNET is a secure passive surveillance
system for long-term tracking of companion animal health, disease, and treatment.
CAVSNET will gather AU data on a routine basis directly from EHR systems. With these
two complementary approaches, we will build a comprehensive national picture of AU
in dogs and cats.