ArticlePloS one2019
Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: A stepped-wedge design intervention study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 45 citations in OpenAlex.
- Use of VetCompass Australia data to estimate body weight for antimicrobial stewardship in Australian dogs.Australian veterinary journal · 2026Article
- Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact.Antibiotics (Basel, Switzerland) · 2026Review
- The Impact of Vaginal Bacteria and Antimicrobial Treatment on Pregnancy Outcomes in Healthy Breeding Bitches.Antibiotics (Basel, Switzerland) · 2026Article
- A structured, behavioural science approach to the preparation of antimicrobial stewardship interventions for companion animal veterinarians.The Veterinary record · 2026Article
- Antimicrobial stewardship from a One Health perspective.Nature reviews. Microbiology · 2026Review
- Benchmarking: A Tool for Veterinary Practices to Improve Prudent Use of Antibiotics in Cats and Dogs in Switzerland.Antibiotics (Basel, Switzerland) · 2026Article
- Antimicrobial prescribing in dogs and cats with urinary tract disease in a prospective intervention trial.Journal of veterinary internal medicine · 2026Article
- Use of Antibiotics in Companion Animals from 133 German Practices from 2018 to 2023.Antibiotics (Basel, Switzerland) · 2025Article
- Article
- German veterinarians asked: a cross-sectional study on microbiological examination and antimicrobial use in canine reproductive medicine.Frontiers in veterinary science · 2025Article
- Factors associated with the use of important human antimicrobials in Japanese small-animal clinics.Frontiers in veterinary science · 2025Article
- Reduced antimicrobial use in weaned pigs through an intervention program supporting veterinarians' adherence to the clinical practice Streptococcus suis guideline.Scientific reports · 2024Article
- Antimicrobial stewardship: a definition with a One Health perspective.npj antimicrobials and resistance · 2024Review
- How low can you go? Antibiotic use in Swedish dogs with gastroenteritis.Frontiers in veterinary science · 2024Article
- A coaching approach to strengthen farm management teams to reduce antimicrobial use in Dutch high usage pig farms: a 2 year intervention study.Frontiers in veterinary science · 2024Article
- Antibiotic usage patterns in exotic pets: A study in Curitiba, Paraná, Brazil.Open veterinary journal · 2023Article
- The potential role of veterinary technicians in promoting antimicrobial stewardship.BMC veterinary research · 2023Article
- Article
- Behavior-change interventions to improve antimicrobial stewardship in human health, animal health, and livestock agriculture: A systematic review.PLOS global public health · 2023Article
- Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo curb increasing resistance rates, responsible antimicrobial use (AMU) is needed, both in human and veterinary medicine. In human healthcare, antimicrobial stewardship programmes (ASPs) have been implemented worldwide to improve appropriate AMU. No ASPs have been developed for and implemented in companion animal clinics yet.
objectivesThe objective of the present study was to implement and evaluate the effectiveness of an ASP in 44 Dutch companion animal clinics. The objectives of the ASP were to increase awareness on AMU, to decrease total AMU whenever possible and to shift AMU towards 1st choice antimicrobials, according to Dutch guidelines on veterinary AMU.
methodsThe study was designed as a prospective, stepped-wedge, intervention study, which was performed from March 2016 until March 2018. The multifaceted intervention was developed using previous qualitative and quantitative research on current prescribing behaviour in Dutch companion animal clinics. The number of Defined Daily Doses for Animal (DDDAs) per clinic (total, 1st, 2nd and 3rd choice AMU) was used to quantify systemic AMU. Monthly AMU data were described using a mixed effect time series model with auto-regression. The effect of the ASP was modelled using a step function and a change in the (linear) time trend.
resultsA statistically significant decrease of 15% (7%-22%) in total AMU, 15% (5%-24%) in 1st choice AMU and 26% (17%-34%) in 2nd choice AMU was attributed to participation in the ASP, on top of the already ongoing time trends. Use of 3rd choice AMs did not significantly decrease by participation in the ASP. The change in total AMU became more prominent over time, with a 16% (4%-26%) decrease in (linear) time trend per year.
conclusionsThis study shows that, although AMU in Dutch companion animal clinics was already decreasing and changing, AMU could be further optimised by participation in an antimicrobial stewardship programme.
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