Knowledge and awareness of antimicrobial resistance and antimicrobial prescribing behaviour among young companion animal veterinary practitioners in Sri Lanka

The emergence of antimicrobial resistant (AMR) organisms has become a serious public health threat as it reduces the effectiveness of treatment and increases healthcare costs and mortality. The development of new antimicrobial drugs is extremely slow. The genetic capacity of bacteria to develop resistance is difficult to manipulate. Thus, antimicrobial stewardship among health professionals is encouraged to reduce the rate of developing AMR. This study assesses the awareness and prescription behaviour of companion animal veterinary practitioners in Sri Lanka using a web-based questionnaire. Two outcome variables, awareness of AMR and prescription behaviour were assessed using a scoring system and ranked as appropriate or inappropriate behaviour or high or moderate/low knowledge. Bivariate analysis was performed using the Chi-square test to explore the relationship between two selected outcome variables with the categorical variables (years of experience, gender, geographical area). A total of 102 veterinarians participated in the survey. The respondents included 49 % male and 51% female and were mainly in the age range of 25-35 years (92.4%). Of the listed 18 antimicrobials, doxycycline (93%), metronidazole (92 %), cefuroxime (89%), amoxicillin (87%) and cephalexin (84%) were prescribed often by companion animal practitioners and carbapenems (3%) and aminoglycosides (6%) were rarely prescribed and were complied with the guidelines. Good antimicrobial prescription behaviours such as performing antimicrobial susceptibility testing were often practised only by 1.95% of respondents. Around 23 % of respondents prescribed antimicrobial drugs without confirming an infection as further diagnostics are expensive, and 22 % prescribed antimicrobial drugs as a prophylactic measure and a similar percentage when prescribing immunosuppressive drugs. When the prescription behaviour was evaluated, 41% of the respondents had appropriate prescription behaviour and 59% had inappropriate behaviour. Even though statistically non-significant, the appropriate behaviour was higher among veterinarians with more than two years of experience. When awareness of AMR was assessed, 40% had high awareness and 60% had moderate/low awareness. Conducting awareness programs and developing or adopting appropriate prescription guidelines are essential to improve the prescription behaviour of companion animal veterinary practitioners in Sri Lanka.