Enhancing antimicrobial stewardship in veterinary medicine the implementation of the Streptococcus suis guideline

Antimicrobial agents are crucial for combating infectious diseases, but excessive use also contributes to antimicrobial resistance posing a serious global threat to both humans and animals. In the Netherlands, several successful measures have already been taken to reduce antimicrobial use in animals. However, there remains significant differences in antimicrobial use between farms. The Streptococcus suis guideline for weaned piglets was introduced to promote more selective and responsible antibiotic use. However, research showed that swine veterinarians rarely followed this guideline. This research focused on developing, implementing, and evaluating an intervention program to improve adherence to this guideline. The development was approached systematically in three steps: (1) qualitative research into the barriers and facilitators/enablers for adherence of veterinarians, (2) designing an eight-month, theory-based intervention program that included individual e-learning and peer discussions, and (3) developing measurable indicators. The effectiveness of the intervention was evaluated in a stepped study design involving 49 veterinarians. The intervention program successfully reduced antimicrobial prescription for weaned pigs at farms with Streptococcus suis problems: 25% during and 49% after the intervention. Additionally, veterinarians improved their argumentation for antimicrobial use and increased the number of bacterial examination conducted on pigs. In conclusion, the intervention program contributes to responsible antimicrobial use in the veterinary sector. The methodology can serve as a model for similar implementation strategies in the Netherlands and beyond, enhancing the impact of veterinary guidelines and contributing to the fight against antimicrobial resistance.