The utility of quality indicators for antimicrobial stewardship from human medicine for antimicrobial stewardship implementation in companion animal practices in the Netherlands

Abstract

Antimicrobial Resistance (AMR) is currently among the biggest threats to healthcare. To reduce AMR, it is necessary to limit the selective pressure of antimicrobial usage (AMU) leading to AMR. To achieve this, there is an emerging interest in Antimicrobial Stewardship Programs (ASPs). Research in human medicine has yielded positive results in the design and implementation of ASPs. To help implement, improve and evaluate the effectiveness of ASPs, Quality Indicators (QIs) that measure the quality of AMU are used in human medicine. Companion animal medicine also contributes to the development of AMR and therefore there is an emerging interest in ASPs for this sector. Currently, ASPs are not routinely implemented and QIs are not developed for companion animal practices. Therefore, this literature review investigates which QIs for antimicrobial stewardship, derived from human medicine, can contribute to the implementation of ASPs in companion animal practices in the Netherlands.

To address this research gap, literature research was conducted using the PubMed and Web of Science databases. This has led to an overview of QIs and associated themes for ASPs used in hospitals and general practices (GPs) in human medicine. In addition, core elements for ASPs with associated challenges in companion animal practices have been identified.

Subsequently, QIs were identified that can contribute to the implementation of ASPs in companion animal practices. There are currently no QIs that are directly applicable to companion animal practices in the Netherlands. However, QIs that have the most potential to be applied first in companion animal practices, are drug- and disease-specific QIs that are used in GP. Other QIs are too advanced or complex or not applicable in companion animal practices. Future research should focus on ways to take the hurdles that currently hinder the adaptation and implementation of the drug- and disease-specific QIs into ASPs for companion animal practices.