Four years after our original antibiotic myth-busting episode (Ep 60), we’re back with Dr Riati Scarborough to talk antibiotic prescribing habits. This time we’re joined by fellow stewardship expert Dr Laura Hardefeldt, and this time we’re asking the harder question:

Have we actually changed?

The good news? Some prescribing habits are shifting. We’re seeing shorter courses and less ‘just in case antibiotic usage.

But let’s not pat ourselves on the back too quickly. Because some of our most entrenched habits are still alive and well, like how we treat skin disease, and our ongoing love affair with amoxiclav.

This episode is a practical, clinically grounded update on what the evidence says in 2026 - and how to make realistic changes without compromising patient care.

We cover:

• Why skin disease remains the single biggest driver of antimicrobial resistance in small animal practice, and what to do about it
• Amoxicillin vs amoxiclav: when de-escalation is not just safe, but smarter
• Why convenience (you know the brand we’re talking about right…) is not a clinical indication
• Trimethoprim-sulphonamide and the real story on KCS risk
• Dentals, heart murmurs, and what prophylaxis actually looks like in 2026
• Simple in-clinic stewardship strategies that genuinely shift prescribing behaviour

This isn’t about perfection. It’s about progress.

If you’d like effective antibiotics to still exist in five to ten years…

This episode is essential listening.

Find out how we can support you in your vet career at ⁠⁠⁠⁠⁠⁠⁠thevetvault.com⁠⁠⁠⁠⁠⁠⁠.

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Tips and Timestamps

• 3:03 Progress in prescribing habits including UTI durations and surgical prophylaxis
• 4:55 Skin disease as the biggest problem area in small animal practice
• 7:01 Topical therapy versus systemic antibiotics for skin conditions
• 9:28 Deep pyoderma and the new consensus statement
• 11:00 Gut bacteria as a source of resistant infections
• 12:41 Rise of MRSP, methicillin-resistant Staphylococcus pseudintermedius
• 14:00 Amoxicillin-clavulanate overuse
• 16:47 Vets on Tour conferences advertisement
• 18:08 Pharmacology refresher on amoxicillin, amoxicillin-clavulanate, and cefovecin
• 19:45 Why cefovecin is classified as high importance, vs the convenience argument for cefovecin in cats
• 22:56 Long-acting amoxicillin injections as an alternative
• 24:00 Getting amoxicillin back on the shelf
• 24:53 Communicating antibiotic choices to clients
• 29:32 Dental antibiotics and debunking the heart murmur myth
• 34:07 Subclinical bacteriuria and stopping cultures in asymptomatic patients
• 38:30 Reassessing the dry eye risk of trimethoprim-sulfonamide
• 41:43 Antimicrobial stewardship trial using colour-coded pharmacy shelves