Systematic Review Examines How Veterinarians Decide on Antibiotics

A systematic review of qualitative studies on veterinarians' knowledge, attitudes and practices around antibiotic prescription was published online in The Veterinary Journal on 19 October 2026, offering practices a consolidated picture of the human factors behind prescribing decisions rather than another resistance dataset.

The review, led by Leonardo de Rago Nery Alves with colleagues including Jacinta Oliveira Pinho, Ana Cláudia Coelho and Maria Teresa Herdeiro, synthesizes qualitative research — interview and focus-group studies rather than prescription-audit numbers — on how veterinarians actually decide whether, when and how to prescribe antibiotics.

That design choice matters for readers. Quantitative surveillance tells the profession how much antibiotic volume moves through clinics. Qualitative synthesis tells the profession why. For antimicrobial stewardship programs, the second question is the harder one.

Why a qualitative systematic review?

Reviews of this type gather primary studies that asked veterinarians directly about their reasoning: what they know about resistance, how they weigh diagnostic uncertainty, how clients and farm economics press on the prescription pad. By pooling those findings systematically — with defined search, inclusion and quality-appraisal steps — the authors convert scattered single-country interview studies into a body of evidence others can cite and build on.

The scope spans the professions' shared prescribing contexts. Companion-animal clinicians face client expectations for a prescription at the end of a consult; food-animal veterinarians balance therapeutic need against production pressures and residue rules. Both groups operate inside the same public-health frame: every veterinary antibiotic course is a potential contributor to resistant organisms that cross species lines.

What changes at the exam table or in the barn?

For practice owners, the utility of a knowledge-attitudes-practices synthesis is targeted intervention design. If the compiled studies show, for example, that prescribing habits cluster around perceived client pressure or diagnostic delay, then stewardship resources should go to communication training or point-of-care diagnostics — not to more guidelines that restate what veterinarians already know.

For regulators and veterinary schools, the review provides a map of where attitudes diverge from knowledge. That gap is the standard target of undergraduate and continuing-education curricula on antimicrobial use, and a systematic synthesis gives curriculum designers a citable base rather than anecdote.

The full findings, including the number of primary studies included and the specific themes extracted, are detailed in the article itself; the publication carries the methodological detail — search strategy, databases, appraisal tools — expected of the systematic format.

The stewardship backdrop

Antimicrobial resistance remains a named priority for veterinary regulators across jurisdictions, with FDA CVM in the United States and the EMA in Europe both monitoring veterinary antimicrobial sales and use. Reviews like this one sit on the behavioral side of that effort: policy can restrict products and mandate oversight, but prescribing behavior at the individual clinician level determines outcomes.

The Veterinary Journal published the paper on 19 October 2026, with the author team drawn from Portuguese institutions with research programs in veterinary public health and pharmacoepidemiology.

Readers who design practice-level stewardship policies — antibiotic protocols, prescribing audits, client-communication scripts — will find in the review a structured account of the decision environment their policies must actually operate in. Subsequent empirical work can now test whether interventions built on the identified themes shift prescribing behavior measurably.