Infectious urinary tract disease is commonly diagnosed in cats, and as a result, antimicrobials are often prescribed. Antimicrobial stewardship aims to optimise antimicrobial therapy in patients, maximizing clinical outcomes, while minimising adverse effects on the patient or population. A core aspect of antimicrobial stewardship is understanding how antimicrobials are used to assess antimicrobial use practices, establish benchmarks and targets, identify areas for improvement, develop interventions and evaluate the impact of interventions or other changes. This study aimed to evaluate initial antimicrobial therapy in cats diagnosed with upper or lower bacterial urinary tract infections at veterinary practices in the USA and Canada. Electronic medical records were queried between 2 January 2016 and 3 December 2018 and feline patient visits with a diagnosis field entry of urinary tract infection, cystitis and pyelonephritis, as well as variations of those names and more colloquial diagnoses such as kidney and bladder infection, and where an antimicrobial was prescribed, were retrieved. Prescription data for 5724 visits were identified. Sporadic cystitis was the most common diagnosis and cefovecin was the most commonly prescribed antimicrobial for all conditions, followed by amoxicillin–clavulanic acid. Significant differences in antimicrobial drug class prescribing were noted between practice types and countries, and over the 3-year study period. The results indicate targets for intervention and some encouraging trends.
