Evaluation of the KNMvD guideline “Antimicrobial use in dry cow therapy"
Eekelen, D.C.G. van
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In January 2014 the guideline ‘Antimicrobials used in dry cow therapy’ (shortened as: guideline dry cow therapy) was introduced with the aim of giving tools for implementation of the Dutch legislation on banning prophylactic use of antimicrobials (in dry cow treatment) in daily practice. Because a thorough review of the guideline is important, the aim of this evaluation was to quantify the opinion of veterinarians on the guideline, to identify perceived bottlenecks and to propose possible improvements. To execute the study an online survey was chosen enabling all qualified bovine practitioners (in Dutch: geborgde rundveedierenartsen) to give their opinion on the guideline dry cow therapy. Therefore, the public list of qualified bovine practitioners was used as recipient list. In general, the opinions of bovine practitioners on the guideline dry cow therapy seem to be positive. Veterinarians responded positively to questions on clarity and communication of the guideline and most of them have been informed about the guideline by the communication paths from the KNMvD, which indicates these paths being effective. Besides this, the implementation rates of the guideline in veterinary practices (78%) and at clients of the veterinarians (76% implemented the guideline written in the herd treatment plan of 90-100% of their clients) were high. Finally, 65% of the interviewed practitioners agreed on the fact the cell count cut-off values stated in the guideline are manageable and practicable. Nevertheless, the survey showed there is still some lack of clarity on the exact aim and way of using the guideline, as well as the frequency of evaluating the drying-off strategy. A large majority (84%) of the respondents has a need for more selection criteria to be included in the guideline dry cow therapy. However, the selection criteria mentioned for integration in the guideline are mainly indicative of prophylactic use of antimicrobials, which makes it is not acceptable to use these in decision making on dry cow therapy. Thereby, veterinarians indicated they evaluated the drying-off procedures with their farmers with very different frequencies (46% schedules evaluation once per year; 20% once every six months and 18% once per quarter). Hence, it is recommended to communicate to the bovine practitioners in the Netherlands what the aim of the guideline is exactly and how the guideline should be interpreted and used to reach that aim. At the same time, there should be communicated the guideline is not designed to be seen as legislation. Taking all results of the survey into consideration, bovine practitioners in the Netherlands are generally pleased with the guideline 'Antimicrobial use in dry cow therapy'. Only few results of the survey showed respondents being (slightly) divided on some of the subjects about the content of the guideline. Therefore, it is at this point in time not definitely needed to expand reviewing the guideline further at this point in time. Besides this, there is no need for the guideline as a whole to be revised.