ENOVAT review questions routine antibiotics in companion animal surgery

A new systematic review and meta-analysis developed to support the European Network for Optimization of Veterinary Antimicrobial Therapy, or ENOVAT, guidelines found that surgical antimicrobial prophylaxis in dogs and cats appears to have only a trivial to small effect on reducing surgical site infections across companion animal procedures. The review, published in the Journal of Small Animal Practice, included eight randomized controlled trials and seven observational studies, and grouped procedures into nine categories spanning clean soft tissue, clean-contaminated, contaminated, and orthopedic surgeries. The companion ENOVAT 2025 guideline uses that evidence to encourage more selective perioperative antibiotic use, rather than routine prophylaxis or extended postoperative courses. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, the message is less about abandoning prophylaxis altogether and more about tightening indications. The evidence base behind these recommendations suggests many common procedures may see limited benefit from antibiotics, while stewardship concerns remain high. That aligns with earlier AAFP/AAHA guidance that surgical prophylaxis is usually not needed for clean procedures, should begin 30 to 60 minutes before incision when used, and rarely needs to continue after surgery. For practices reviewing protocols, this adds fresh evidence to support narrower use, especially for routine clean surgeries in otherwise stable patients. (pubmed.ncbi.nlm.nih.gov)

What to watch: Watch for national and local veterinary groups to adapt the ENOVAT recommendations into practice-specific protocols, formularies, and antimicrobial stewardship policies. (pubmed.ncbi.nlm.nih.gov)