More Than a Prescription: Behavioural Drivers of Antimicrobial Use in Companion Animals

Antimicrobial resistance (AMR) represents a major global health challenge requiring coordinated action across human and animal sectors. While antimicrobial use (AMU) in livestock has been extensively studied, prescribing and treatment practices in companion animals remain comparatively underexamined despite the potential for resistant organisms to circulate within shared household environments. Understanding the drivers of antimicrobial exposure in pets is therefore critical for advancing stewardship efforts.

This study evaluated patterns of AMU in dogs and identified behavioural factors influencing treatment decisions among veterinarians and dog owners in Northern Ireland. A behavioural economics framework was applied to explore how time-related decision preferences, particularly present bias, may contribute to antimicrobial demand.

Questionnaire data from 355 dog owners were analysed to characterise prescribing trends and determine predictors associated with antimicrobial exposure. Overall, 58% of dogs had received antimicrobials at least once (mean treatment duration 6 days, SD = 2.06). Amoxicillin-clavulanic acid and metronidazole were the most frequently reported agents, commonly prescribed for skin or wound infections (25%) and gastrointestinal conditions (18%). Logistic regression demonstrated higher odds of antimicrobial use among older dogs (≥8 years; β = 0.11, p = 0.002), insured animals (β = 0.61, p = 0.011), and owners exhibiting present-biased decision-making (β = 0.52, p = 0.048). Owner demographics and household characteristics were not significantly associated with AMU. Although familiarity with AMR was limited (26%), most respondents reported strong trust in veterinary guidance (87%).

These findings suggest that behavioural influences play an important role in antimicrobial exposure in companion animals. Stewardship strategies that align with short-term decision priorities such as emphasising active management plans, structured follow-up, and clear clinical thresholds may help reduce precautionary prescribing. Strengthening behaviourally informed communication within veterinary practice could support more judicious antimicrobial use and contribute to broader One Health AMR mitigation efforts.