Outcomes from an intervention study implementing fee-free culture and susceptibility urine testing in dogs and cats

Abstract

Background: Urine culture and susceptibility (C&S) testing is important to confirm the presence of infection and aid in antimicrobial selection to ensure that the most appropriate drug is used. Veterinarians often cite the cost of C&S as a prohibitive factor limiting its uptake. Methods: From January to December 2022, 10 general practice veterinary clinics in Melbourne, Victoria, Australia, were provided with access to free urine C&S and a decision support tool. At the end of the study period, a survey was distributed to veterinarians at participating clinics. Results: A total of 480 urine C&S submissions were received in the 11-month study period. Several clinics had an increase in submission rate, with an overall 2.4-fold increase in the submission rate. Most survey respondents (80%) reported submitting more urine samples for C&S during the trial, compared to before. Many of the veterinarians (74%) reported delaying prescribing antimicrobials while awaiting C&S results. Limitations: The small number of practices involved in this study may not be representative of all types of clinics in Australia. Conclusion: Cost is a barrier to susceptibility testing being undertaken in most cases. Removal of the cost barrier and provision of a decision support tool resulted in positive changes to reported antimicrobial prescribing behaviour.