Antibiotic prescription practices and attitudes towards the use of antimicrobials among veterinarians in the City of Tshwane, South Africa

Ronita Samuels; Daniel Nenene Qekwana; James W Oguttu; Agricola Odoi

doi:10.7717/peerj.10144

Antibiotic prescription practices and attitudes towards the use of antimicrobials among veterinarians in the City of Tshwane, South Africa

PeerJ. 2021 Jan 13:9:e10144. doi: 10.7717/peerj.10144. eCollection 2021.

Authors

Ronita Samuels^#¹, Daniel Nenene Qekwana², James W Oguttu³, Agricola Odoi^#¹

Affiliations

¹ Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA.
² Section of Veterinary Public Health, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.
³ Department of Agriculture and Animal Health, College of Agriculture & Environmental Sciences, University of South Africa, Johannesburg, South Africa.

^# Contributed equally.

Abstract

Background: Understanding the prescription practices and attitudes of veterinarians towards antimicrobial resistance (AMR) is crucial in guiding efforts to curb AMR. This study investigated prescription practices and attitudes towards AMR among veterinarians in the City of Tshwane, South Africa.

Methods: Out of the 83 veterinarians invited to participate in the study, 54 signed the consent form and completed the questionnaire. Percentages and 95% confidence intervals of all categorical variables were computed. A multinomial logistic model was used to identify predictors of the veterinarians' view towards antimicrobial use.

Results: The majority (88%) of respondents indicated that improper use of antimicrobials contributed to selection for AMR. Veterinarians relied on clinical signs and symptoms (88%, 48/54) to decide whether to prescribe antimicrobials or not. However, the choice of antimicrobials depended on the cost of antibiotics (77.2%), route of administration (81.5%), and risk of potential adverse reactions (79.6%; 43/54). Many (61.5%) veterinarians were of the view that often antimicrobials are appropriately prescribed and 88.7% agreed that improper use of antimicrobials contributed to selection for antimicrobial resistant organisms. Compared to females, males were significantly more likely (Relative Risk Ratio (RRR) = 9.0; P = 0.0069) to agree rather than to "neither agree nor disagree" that their colleagues over-prescribed antimicrobials.

Conclusions: The decisions to prescribe antimicrobials by the veterinarians depended on clinical presentation of the patient, while the choice of antimicrobial depended on cost, route of administration, and risk of potential adverse reactions. Most veterinarians were of the view that antimicrobials were prescribed judiciously.

Keywords: Antimicrobial resistance; Antimicrobial stewardship; City of Tshwane; Judicious antimicrobial use; Prescription practices; South Africa.

Grants and funding

This work was supported by the University of Tennessee faculty/student research award that funded Ronita Samuel’s travel to South Africa to collect study data. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.