Prevalence of Antimicrobial Use in Small Animal Dermatology Referral Practices in the United States.

High antimicrobial use in dermatology referrals warrants guideline alignment and diagnostic culture.

This prospective, cross-sectional point-prevalence study examined antimicrobial prescribing patterns in 22 US veterinary dermatology referral practices during August 2023, involving 550 animals (479 dogs, 71 cats). Antimicrobials were prescribed in 54.9% of cases, with third-generation cephalosporins representing 43.9% of systemic antibiotics in dogs. Notably, 36.4% of topical antimicrobial prescriptions for bacterial or yeast-only otitis externa were combination formulations containing both antibiotics and antifungals, suggesting potential overtreatment. Antiseptics were prescribed in 62.7% of cases. While cytological investigation was performed in 86.3% of antimicrobial-treated conditions, bacterial culture was used in only 15.3%, indicating limited diagnostic confirmation. The findings establish a benchmark for antimicrobial use in dermatology referral settings and identify significant opportunities for prescribing optimization, including reducing broad-spectrum systemic antibiotic reliance, increasing topical therapy utilization, and developing narrow-spectrum topical alternatives.

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