Antimicrobial stewardship in veterinary practice: A Participatory Action Research approach to evolving knowledge and awareness of prescribing practice

The importance of addressing the rise in antimicrobial resistance is widely recognised, alongside the increasing acknowledgement of the relevance that the One Health initiative has in tackling the issue. There are antimicrobial prescribing guidelines and research available that promote antimicrobial stewardship within the veterinary profession. However, what is missing is research that asks the question ‘what are the beyond-clinical factors that prevent veterinary professionals from prescribing in line with the guidelines?’. This research aims to fill this gap, through using a participatory action research, systems-based approach to explore and develop the knowledge that is held at various levels of the system. The project concentrated on the use of antibacterial use in a first-opinion companion animal veterinary practice in the United Kingdom. Firstly, the level of antibacterial use and resistance knowledge, and the reasons why this knowledge is below ‘par’ are discussed, identifying a lack of appreciation for the subject. Secondly, the beyond-clinical factors were identified (including time, habit and colleague pressure) and their relationships to each other and their influence on the system were explored. Finally, the research proposes actionable initiatives to enact antibacterial prescribing change within the system, such as tighter prescribing controls.