Representative Public Health Surveys Pose Several Challenges: Lessons Learned Across 9 Communities During the COVID-19 Pandemic.

Community surveillance surveys offer an opportunity to obtain important and timely public health information that may help local municipalities guide their response to public health threats. The objective of this paper is to present approaches, challenges, and solutions from SARS-CoV-2 surveillance surveys conducted in different settings by 2 research teams. For rapid assessment of a representative sample, a 2-stage cluster sampling design was developed by an interdisciplinary team of researchers at Oregon State University between April 2020 and June 2021 across 6 Oregon communities. In 2022, these methods were adapted for New York communities by a team of veterinary, medical, and public health practitioners. Partnerships were established with local medical facilities, health departments, COVID-19 testing sites, and health and public safety staff. Field staff were trained using online modules, field manuals describing survey methods and safety protocols, and in-person meetings with hands-on practice. Private and secure data integration systems and public awareness campaigns were implemented. Pilot surveys and field previews revealed challenges in survey processes that could be addressed before surveys proceeded. Strong leadership, robust trainings, and university-community partnerships proved critical to successful outcomes. Cultivating mutual trust and cooperation among stakeholders is essential to prepare for the next pandemic.

Divergent veterinarian and cat owner perspectives are barriers to reducing the use of cefovecin in cats.

OBJECTIVE: To understand veterinarian and cat owner perspectives on antimicrobial use in cats, reasons for prescribing cefovecin, and barriers to improving antimicrobial stewardship, including veterinarian and cat owner perspectives of giving oral medication to cats. SAMPLE: 21 New York veterinarians and 600 cat owners across the US. METHODS: Cat owners were surveyed about their preferences for and experiences in giving oral medications to cats and their experiences with antimicrobials specifically. Veterinarians were interviewed about antimicrobial use decisions in cats, benefits and drawbacks of cefovecin, and their perspectives on antimicrobial resistance. RESULTS: Many veterinarians reported feeling pressure to prescribe antimicrobials, while 41% of cat owners reported requesting antimicrobials. Although veterinarians are aware of the downsides of prescribing cefovecin, many prescribed cefovecin in situations where an antimicrobial was not needed or cefovecin may not have been the best choice. Veterinarians thought that 20% of cat owners could not give oral medications, but < 10% of cat owners had a cat that was impossible to medicate. CLINICAL RELEVANCE: The disconnect between veterinarians' assessment of and cat owners' reported abilities in administering oral medication may contribute to cefovecin use. Demonstrating for cat owners how to give oral medication may help improve compliance and reduce the use of parenteral long-acting formulations. Structural and educational interventions are needed to address other contributors to inappropriate antimicrobial use. This research provides the specific considerations about barriers and motivations for cat owners and veterinarians that are required to guide strategic, tailored interventions for both audiences to advance stewardship.

Pathways to sustainable antimicrobial use in cats.

Antimicrobial stewardship encompasses all the individual and collective actions that medical professionals take to preserve the efficacy of antimicrobials. It is a one-health problem, affecting animals and humans. The current state of antimicrobial use in cats, particularly (1) the overuse and improper use of cefovecin, which belongs to the third-generation cephalosporin class that is critically important to human health, and (2) use of antimicrobials when they are not needed, poses unsustainable risks of antimicrobial resistance. This paper describes the principles of antimicrobial stewardship and stewardship challenges faced by feline veterinarians, including (1) poor adherence to or awareness of antimicrobial use guidelines, (2) lack of access to affordable diagnostic tests and antibiograms, (3) lack of access to materials and tools for clients that may facilitate more sustainable antimicrobial use and help cat owners understand resistance risks, (4) underestimating the ability of cat owners to administer oral antimicrobials, and (5) limited time and resources to support stewardship efforts. Based on research described in this paper; an original research article by Cazer et al, JAVMA, December 2023; and a Currents in One Health article by Cobo-Angel et al, AJVR, December 2023, several solutions are proposed to advance antimicrobial stewardship in feline medicine. Many of these proposals were expressly requested by veterinarians interviewed in Cazer et al, JAVMA, December 2023. Education and training of veterinarians and cat owners is an essential step toward sustainable antimicrobial use, but it must be complemented with innovations in diagnostic testing, antimicrobial drug development, structural changes, and technological supports.