Antimicrobial prescribing practices and perceptions of antimicrobial resistance in companion animal veterinary practice in Peru.

This study assessed antimicrobial prescribing practices and perceptions of antimicrobial resistance (AMR) among veterinarians working in companion animal practice in Peru. A cross-sectional study was conducted using an open online survey administered between 2022 and 2023. Responses from 442 veterinarians were analyzed descriptively, and multivariable logistic regression models were used to identify factors associated with selected prescribing practices. Fever (82.2%) was the most frequently reported clinical indicator for initiating antimicrobial treatment. Approximately half of respondents reported always performing culture and antimicrobial susceptibility testing before prescribing antimicrobials. Overall, 82.9% of respondents reported being unfamiliar with the WHO and/or WOAH classification of critically important antimicrobials (CIA). Regarding last-resort antimicrobial use, 29.0% reported having used these agents, including carbapenems, for severe clinical conditions. Prescribing patterns varied across clinical systems, with penicillins combined with β-lactamase inhibitors exhibiting the highest overall reported frequency of use, particularly in respiratory, dermatological, and urogenital conditions. In multivariable logistic regression analysis, frequent use of culture and susceptibility testing was associated with higher odds of last-resort antimicrobial use (OR = 4.30; 95% CI: 1.94-9.54), whereas postgraduate training was associated with greater odds of knowledge of CIA (OR = 3.29; 95% CI: 1.65-6.54). These findings reveal heterogeneity in prescribing patterns, substantial knowledge gaps regarding CIA, and professional factors associated with practices relevant to resistance selection, providing evidence to support the strengthening of antimicrobial stewardship strategies in companion animal practice in Peru.