{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:52:21Z","timestamp":1792468341725,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Judicious antimicrobial use is essential for the continued treatment of infections in small and mixed animal veterinary medicine. To better support Washington (WA) State veterinarians in antimicrobial stewardship, we surveyed licensed small and mixed animal veterinarians and led group conversations regarding antimicrobial prescription practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Survey questions included demographic information, factors influencing prescription practices and clinical cases. Responses were summarised and logistic regressions were performed to identify factors associated with antibiotic treatment choices. Group conversations, led by a licensed veterinarian, focused on resource gaps for veterinarians, management of clinical scenarios and interpretation of minimum inhibitory concentrations (MICs) and breakpoints. A systematic qualitative analysis of conversation transcripts identified key themes such as common barriers to stewardship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 53 responses to clinical scenarios, veterinarians selected the most appropriate treatment choice, according to a veterinary microbiologist, 62% of the time. Variability was observed in culture and susceptibility practices and antibiotic choices. Survey respondents reported an influence of the client ability to medicate (92%), considerations of resistance (91%), client finances (75%) and availability of antimicrobials (75%) on their prescription decisions. There were no significant associations between opinions about contributing factors to antimicrobial resistance (AMR) or guidelines used and treatment choices in clinical scenarios. Among 15 veterinarians interviewed in group conversations, a systematic qualitative analysis of conversation transcripts revealed key themes, including reliance on human medicine as a resource and a lack of support for veterinarians in interpreting MICs and breakpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The variability in veterinary antibiotic treatment decisions in this study suggests a need for further dissemination of standardised antimicrobial stewardship resources for veterinarians. Client\u2010related challenges and the cost of culture and susceptibility are major barriers to stewardship. To address these barriers, it is necessary to provide standardised, easy\u2010to\u2010access guidance for veterinarians in interpreting MICs and breakpoints, as well as develop antimicrobial use resources for clients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/zph.13187","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T08:33:50Z","timestamp":1729499630000},"page":"117-126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Antimicrobial Prescription Practices and Stewardship in Washington State Small and Mixed Animal Veterinary Medicine"],"prefix":"10.1111","volume":"72","author":[{"given":"Shannon","family":"Cassel","sequence":"first","affiliation":[{"name":"Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"},{"name":"Center for One Health Research University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah T.","family":"Fenelon","sequence":"additional","affiliation":[{"name":"Center for One Health Research University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Rott","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby","family":"Blazes","sequence":"additional","affiliation":[{"name":"Ecology and Evolutionary Biology Princeton University  Princeton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah M.","family":"Willess","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Baines","sequence":"additional","affiliation":[{"name":"Center for One Health Research University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vickie","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Center for One Health Research University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Kauber","sequence":"additional","affiliation":[{"name":"Communicable Disease Epidemiology Washington State Department of Health  Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"},{"name":"Center for One Health Research University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire R.","family":"Burbick","sequence":"additional","affiliation":[{"name":"Washington Animal Disease Diagnostic Lab, Department of Veterinary Microbiology and Pathology Washington State University  Pullman Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica R.","family":"Fuhrmeister","sequence":"additional","affiliation":[{"name":"Environmental and Occupational Health Sciences University of Washington  Seattle Washington USA"},{"name":"Civil and Environmental Engineering University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756\u2010020\u201000751\u20104"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13584\u2010023\u201000562\u2010z"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12979"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10030314"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.23.08.0481"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.23.08.0487"},{"key":"e_1_2_9_9_1","unstructured":"CDC.2022.\u201cThe Biggest Antibiotic\u2010Resistant Threats in the U.S.\u201dCenters for Disease Control and Prevention.https:\/\/www.cdc.gov\/drugresistance\/biggest\u2010threats.html."},{"key":"e_1_2_9_10_1","unstructured":"CLSI.2019.\u201cUnderstanding Susceptibility Test Data as a Component of Antimicrobial Stewardship in Veterinary Settings.\u201dVol. CLSI Report VET09. 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