Antimicrobial resistance in companion animals – Veterinarians' attitudes and prescription drivers in Portugal.

• Veterinarians divided in protocol oriented versus empirical prescriptors. • Lack of recommendations on antimicrobial resistance issues to owners. • Majority of respondents expressed a preference for empirical prescriptions. • Portuguese vet centres' lack of protocols for prudent antimicrobial use. • Hospital-working respondents' positive association with protocol-oriented attitude. Antimicrobial resistance transmitted from companion animals is a threat to public health increased by the pet's relationship with humans. This study aims to understand the attitude and drivers of antimicrobial (AM) prescription among companion animal veterinarians in Portugal and identify actions to combat antimicrobial resistance (AMR). This cross-sectional study is based on a questionnaire with 417 respondents representing the Portuguese veterinary population. The results allowed grouping the respondents according to the attitude of prescription. Two types of veterinarians were identified: those who prefer to prescribe treatments based on the animals' signs and their own experience – empirical-oriented type – and those who refer to a guidance protocol to assist the prescription decision – protocol-oriented type. Respondents working in hospitals displayed a positive association with the use of guidance protocols. Efficacy was the main driver of prescription for both groups, suggesting that no matter the attitude in prescribing, the veterinarian's aim is achieving positive clinical results. Most respondents prefer empirical-oriented prescriptions, declare the absence of protocols for the prudent use of AM at the workplace and do not refer to AMR issues nor the need for hygiene reinforcement measures with owners. Owners are less likely to request AMs from veterinarians aged over 43 years old. It was discovered that communication between owners and veterinarians about risks associated with AMR was poor and must be improved and the adoption of a national guideline for the adequate use of AM directed for companion animals would be beneficial. [ABSTRACT FROM AUTHOR]