Factors Associated with Prescription of Antimicrobial Drugs for Dogs and Cats, United Kingdom, 2014–2016

Antimicrobial stewardship is a cornerstone of efforts to curtail antimicrobial resistance dissemination. However, little is known about factors potentially influencing likelihood of companion animal antimicrobial prescription. Here, we analysed unwell canine (n=155,732 unique dogs, 281,543 consultations) and feline (n=69,236 unique cats, 111,139 consultations) electronic health records (EHRs) voluntarily contributed by 173 UK veterinary practices, using multivariable mixed effects logistic regression. Preventive health-focused owner care decisions including vaccination (dogs: odds ratio, OR 0.93, 95% confidence interval, CI, 0.90-0.95; cats: OR 0.92, CI 0.89-0.95), insurance (dogs: OR 0.87, CI 0.84-0.90; cats: OR 0.82, CI 0.79-0.86) or neutering in dogs (OR 0.90, CI 0.88-0.92) were associated with decreased systemic antimicrobial prescription odds, as were dogs presenting to Royal College of Veterinary Surgeons accredited practices (OR 0.79, CI 0.68-0.92). This large multi-centre companion animal EHR study successfully demonstrated the potential of preventive healthcare and owner engagement to encourage responsible antimicrobial use.