Led by clinicians from Davies Veterinary Specialists, the Royal Veterinary College, and Willows Veterinary Centre and Referral Service, the study assessed the proportion of metronidazole use that was prescribed for non-antimicrobial purposes, and the rationale for it.
A survey was completed by 138 veterinarians, primarily in the UK and working in primary care small animal practice, who treated 332 cases (285 dogs and 47 cats) with metronidazole.
In 42% of cases, metronidazole was selected exclusively for non-antimicrobial targeted therapy, and was most commonly prescribed to treat acute diarrhoea, chronic diarrhoea, or giardiasis.
This, say researchers, is despite recommendations that antimicrobials are very rarely warranted for the management of acute and chronic diarrhoea.
The most common rationale cited by vets to justify metronidazole use was its supposed anti-inflammatory or immunomodulatory properties.
Other reasons included: treatment of suspected or confirmed anaerobic or susceptible bacterial infection, the patient being systemically unwell or having severe disease, treatment of protozoal infections, experiencing a previous positive outcome in a similar case or the same patient, anti-diarrhoeal action and owner or practice expectations.
Dr Justin Ng, lead author of the study, said: “These insights are alarming given that such practices frequently deviate from current antimicrobial use guidelines, potentially contributing to ongoing challenges with antimicrobial resistance and adverse effects on gastrointestinal health.”
https://onlinelibrary.wiley.com/doi/10.1111/jsap.13910
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