Abstract

Background:
Antimicrobial resistance (AMR) is a growing global concern, and veterinary prescribing practices play an important role in stewardship efforts. Evidence guiding postoperative antibiotic use in veterinary ophthalmic surgery is limited, and there is a lack of consistency in prescribing practices.

Aim:
This study aimed to characterize the attitudes toward antibiotic use and stewardship among veterinary practitioners in the Republic of Ireland and Northern Ireland.

Methods:
A cross-sectional anonymous online survey was distributed to veterinary surgeons performing ophthalmic procedures. Data on postoperative antibiotic use for enucleation, extraocular, and conjunctival surgeries, as well as antibiotic selection and factors influencing prescribing decisions, were collected.

Results:
Ninety-two responses were analysed. Postoperative antibiotics were commonly reported across procedures, with use in 61.4% (95% CI 50.9-70.9%) of enucleations, 64.0% (95% CI 53.4-73.3%) of extraocular surgeries, and 65.2% (95% CI 50.8-77.3%) of conjunctival surgeries. Amoxicillin–clavulanate was the most frequently prescribed systemic antibiotic, whereas fusidic acid was the predominant topical agent. Systemic use of antibiotics classified under the WHO AWaRe Watch category was uncommon, reported in 4/88 (4.5%; 95% CI 1.8-11.1%) enucleation cases. However, topical Watch-category antibiotics were used more frequently, reported in 15/86 (17.4%; 95% CI 10.9-26.8%) of extraocular procedures and 16/46 (34.8%; 95% CI 22.7-49.2%) of conjunctival procedures. Prescribing behaviour was significantly associated with procedure frequency and practice type, but not with years of practice.

Conclusion:
Postoperative antibiotic use in ophthalmic surgery is common but variable, highlighting the need for clearer, procedure-specific guidance and opportunities for improved antimicrobial stewardship.

Key words: Antibiotic stewardship; Antimicrobial resistance; Ophthalmology; Surgical site infection.