Factors associated with antimicrobial drug prescription in dogs receiving outpatient care at a veterinary teaching hospital.

Antimicrobial prescribing varies significantly by service and diagnostic findings; facility benchmarking needed.

This retrospective study analyzed electronic medical records from 9,685 dogs with 19,597 outpatient visits at a veterinary teaching hospital in 2022 to identify factors associated with antimicrobial drug prescription (PAD). Approximately 10% of visits resulted in systemic antimicrobial prescription. Key factors significantly associated with PAD included age, male sex, intact status, hospital service, visit duration, diagnostics performed, lower owner income, visit date, and prescriber training level. Hospital service visited and urine culture performance most strongly influenced odds of any PAD prescription (ORs 0.08-1.55 and 4.32, respectively). For WHO Access-Watch-Reserve classification, multiple discrete PADs during visit and advanced imaging (CT/MRI) most strongly predicted Watch/Reserve PAD receipt (ORs 10.1 and 3.41). Findings support implementation of facility-level antimicrobial use monitoring, development of normalized benchmarks, and One Health antimicrobial stewardship initiatives in companion animal practice.

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