Impact of antimicrobial stewardship resources on reducing DOG owners' expectation of antimicrobial drugs

The Food and Drug Administration awarded North Carolina State University a $136,662 cooperative agreement on September 25, 2025, under the Food and Drug Administration Research program (CFDA 93.103) to assess the impact of antimicrobial stewardship educational resources on dog owners' expectations for antibiotic treatment.

The recipient will develop and test two educational interventions—a short video on antimicrobial stewardship and an evidence-based handout with citations—designed to reduce dog owners' intentions to request antibiotics for canine acute diarrhea. Using the theory of planned behavior, the project will quantify dog owners' knowledge, attitudes, perceived social pressure regarding prescribing guidelines, and perceived ability to follow guidelines related to antimicrobial use. A cross-sectional study will assess which resource characteristics dog owners identify as effective in changing their intention to request antimicrobials. The work addresses a public health priority: up to 70 percent of dogs receive antibiotics for acute diarrhea treatment despite unclear benefit in many cases, and dog ownership spans 45.5 percent of U.S. households (89.7 million dogs). Reducing unnecessary antimicrobial use in veterinary settings supports antimicrobial stewardship and counters resistance development.

Work is performed in Raleigh, North Carolina, with a period of performance from September 25, 2025, through July 31, 2027.

Abstract

Since any antimicrobial drug use has the potential to increase resistance, a key goal is to align antimicrobial drug use (AU) with the prescribing guidelines in veterinary settings. Pet owners have expressed a preference for receiving antibiotics over watchful waiting including in cases where the benefit of antibiotics is unclear and a lack of awareness of the risk of antimicrobial use on their pets and the greater society have been found to be barriers to judicious use. Information is lacking on the impact of available educational resources to reduce DOG owners' intentions to request antibiotics and increase their confidence in alternatives to antimicrobial drugs. Since 45.5% (59.8 million) households own an estimated total of 89.7 million dogs, and since up to 70% of dogs receive antibiotics for the treatment of acute diarrhea, IT is crucial to test the impact of targeted resources designed to persuade DOG owners that antimicrobials are not needed in these cases. To foster antimicrobial stewardship in veterinary settings using training or education tools, we will use the theory of planned behavior to quantify the knowledge, attitude, subjective norm (perceived social pressure regarding guidelines), and perceived behavioral control (perceived ability to follow the guideline) related to requesting antimicrobials for dogs with a common medical condition (i.e., acute diarrhea). We will explore whether a short educational video on antimicrobial stewardship or a handout summarizing evidence-based guidance with accompanying citations can impact DOG owners' opinions on antibiotics for canine acute diarrhea and define characteristics of antimicrobial use resources that DOG owners identify as effective in changing their intention to request antimicrobials for canine acute diarrhea. The impact of these resources will be assessed using a cross-sectional survey of DOG owners in the united states randomized to 3 arms (no resource, educational video, written summary of evidence-based guidance) followed by focus groups with participants drawn from each group to define which aspects of as resources are effective in reducing DOG owners' intent to request antimicrobial drugs and confidence in alternatives to antimicrobial drugs. The outcome of these aims will facilitate a greater understanding of the potential impact of as resources on aligning DOG owners' expectations for antibiotics with prescribing guidelines and inform further research into the creation and implementation of resources for DOG owners to further the goals of antimicrobial stewardship.