Welsh study links equine antibiotic use to client trust and habits: full analysis

CURRENT FULL VERSION: A new study in Equine Veterinary Journal adds a client-side dimension to equine antimicrobial stewardship, showing that Welsh horse care decisions are influenced not only by clinical need, but also by relationships, expectations, and practical constraints. The research, based on an online survey of 319 equine owners in Wales and interviews with 21 participants, found that while most respondents obtained antibiotics from their veterinarian, some reported using leftover drugs or sourcing antibiotics outside the veterinary channel, and a notable minority said they might switch practices if antibiotics were denied. (pubmed.ncbi.nlm.nih.gov)

That matters because antimicrobial resistance policy in Wales is moving forward quickly. In March 2025, the Welsh Government published its Animal Antimicrobial Resistance Control Plan for Wales 2025-2029 and announced £2 million in new funding for the Arwain program's next phase, including continued veterinary prescribing champions, monitoring, training, and engagement work. The new equine-owner study fits squarely into that agenda by highlighting a part of stewardship that surveillance data alone can't capture: how pet parent beliefs and vet-client interactions shape antibiotic use on the ground. (gov.wales)

The paper's core findings point to both reassurance and risk. Most respondents, 68.9%, said they sourced antibiotics from their vet, which aligns with UK rules that classify antibiotics as prescription-only veterinary medicines. But 16.6% reported using leftover antibiotics, and 5.1% said they had never sourced them from a veterinarian, which the full paper notes could indicate illegal or otherwise inappropriate sourcing that warrants further study. The interviews added nuance, with three main themes emerging: relationships of care, competing priorities such as treatment need versus ease of administration, and imperfect comprehension around antimicrobial use and resistance. (pure.aber.ac.uk)

The study also suggests that prescribing pressure can be subtle rather than overt. More than one in eight respondents, 13.6%, said they would consider changing veterinary practices if they did not receive antibiotics when they asked for them. That doesn't prove inappropriate prescribing, but it does underline the commercial and relational realities equine clinicians may face in stewardship conversations. The authors also reported that 84.8% of respondents regarded their horses as members of the family, a finding that helps explain why treatment decisions may be emotionally charged and why convenience, reassurance, and perceived action can carry so much weight. (pubmed.ncbi.nlm.nih.gov)

Industry messaging has already started to address some of the same behaviors. The British Equine Veterinary Association has warned horse owners not to keep antibiotics "for a rainy day," saying leftover or old antibiotics may be the wrong drug, may be given in insufficient amounts, and can contribute to resistance; it also urges clients to return unused medicines to their vet rather than discard them improperly. That advice maps closely to the Welsh study's concern about leftover use and gaps in understanding. (beva.org.uk)

For veterinary professionals, the broader lesson is that equine stewardship needs both prescribing discipline and communication strategy. A separate Equine Veterinary Journal point-prevalence survey across eight equine hospitals in Australia, Belgium, South Africa, the UK, and the US evaluated 742 inpatients and found that 41.8% of surgical cases and 25.9% of nonsurgical cases were receiving antibiotics on survey days. The most commonly prescribed drugs were penicillin, gentamicin, and trimethoprim-sulfonamides. Overall, 45.2% of antibiotic prescriptions were prophylactic, therapeutic treatment was based on a biomarker in 48.8% of cases, culture samples were submitted in 56.9% of therapeutic cases, and stop or review dates were missing in 59.5% of uses. Among submitted cultures, 49.3% were positive and 90.4% of those positive cultures had an antibiogram available. The authors identified several stewardship targets, including heavy prophylactic use, missing stop/review dates, and empiric use of European Medicines Agency Category A and B antibiotics; they also suggested the survey itself could serve as a repeatable tool to measure improvement over time. (pubmed.ncbi.nlm.nih.gov)

Taken together, the two studies suggest stewardship pressure points exist at both ends of the care pathway: inside the hospital, where prescribing systems, review dates, culture use, and antibiotic choice matter, and outside it, where client expectations, medicine storage, and treatment practicality influence what happens after the consult. In Wales especially, those steps would align with a policy climate that is explicitly investing in stewardship capability and education across animal health. (gov.wales)

That has practical implications for equine clinics. Practices may need clearer client-facing explanations for when antibiotics are and are not indicated, stronger protocols around dispensing only appropriate quantities, routine prompts to return unused medicines, and communication training that helps clinicians navigate requests without eroding trust. On the hospital side, repeat point-prevalence surveys could help teams benchmark prescribing patterns and track whether stewardship interventions actually reduce prophylactic use, improve culture-guided treatment, and increase documentation of stop or review dates. (gov.wales)

What to watch: The next phase is likely to be translation into practice, whether through targeted equine education campaigns, stewardship toolkits, or research that tests which interventions actually reduce leftover antibiotic use and improve pet parent understanding without compromising horse welfare or client relationships. It will also be worth watching whether equine hospitals adopt repeatable point-prevalence surveys as a practical way to monitor antibiotic use and resistance stewardship over time. (gov.wales)