Antimicrobial Stewardship: Canine and Feline Urinary Tract Infection

Monique Engelbrecht. BSc BVSc. Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Soutpan Road (M35), Onderstepoort, 0110. E-mail: monique.engelbrecht@up.ac.za. Internal Small Animal Medicine Resident

Introduction

The development of antimicrobial resistance is inevitable and poses important challenges on both human and animal health and it is clear that there is a need for improved antimicrobial use practices in veterinary and human medicine, and animal production.10 The global community sits at the breaking point of a postantibiotic era, where common bacterial infections are no longer treatable with the antibiotics available to us. Currently, there is no significant development of novel antibiotics and recent veterinary antibiotics are modifications of already established compounds. As many veterinarians prescribe antibiotics empirically prior to doing investigative diagnostics, there is a need for the determination of resistance patterns of common isolates in a specific geographic region to allow rational antibiotic choices. This, in addition to determining whether an antibiotic is in fact indicated, de-escalating therapy and ensuring the correct dose and route of administration may further improve responsible antimicrobial use. In human medicine, antimicrobial use guidelines are widely respected and provide excellent guidance to physicians on the management of several infectious diseases.

The scarcity of resistance monitoring data from small animal practice in South Africa lead to a study in which the compliance with prudent use practices by veterinarians was undertaken. Antimicrobial usage patterns in South Africa are influenced by many factors with owner economic incentives playing a massive role in current prescribing practices.1 The dearth of availability of local epidemiological data, increasing rate of empirical antibiotic use and surge in treatment failures support that the development of antimicrobial resistance is an urgent issue in small animal veterinary practice in South Africa that warrants attention. General methods to reduce antimicrobial resistance include preventing disease occurrence, reducing overall antimicrobial drug use and improved antimicrobial drug use.10 Urinary tract infections are frequently encountered in companion animals and account for significant use of antimicrobials with inappropriate antimicrobial choice leading to a variety of patient health, economic, public health and regulatory concerns.

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