Stewards TTSH

30/09/2025

💡New Protocol Alert: Using Social Influencers for Public Health Education on Antibiotic Use and Antimicrobial Resistance

📕Read the full protocol here:
https://doi.org/10.1186/s12889-025-24338-z

09/08/2025

Happy 60th Birthday, Singapore!

11/07/2025

🔬 New Research Alert: 𝐊𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐞, 𝐚𝐭𝐭𝐢𝐭𝐮𝐝𝐞𝐬, 𝐚𝐧𝐝 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬 𝐨𝐟 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐮𝐬𝐞 𝐚𝐧𝐝 𝐚𝐧𝐭𝐢𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐚𝐥 𝐫𝐞𝐬𝐢𝐬𝐭𝐚𝐧𝐜𝐞 𝐟𝐨𝐫 𝐩𝐞𝐭 𝐜𝐚𝐭𝐬 𝐚𝐧𝐝 𝐝𝐨𝐠𝐬 𝐢𝐧 𝐒𝐢𝐧𝐠𝐚𝐩𝐨𝐫𝐞: 𝐀 𝐜𝐫𝐨𝐬𝐬-𝐬𝐞𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐬𝐭𝐮𝐝𝐲

Read the full study here: https://doi.org/10.1016/j.ijantimicag.2025.107489

04/07/2025

📊 𝗡𝗲𝘄 𝗠𝗶𝘅𝗲𝗱-𝗠𝗲𝘁𝗵𝗼𝗱𝘀 𝗥𝗲𝘀𝗲𝗮𝗿𝗰𝗵: 𝗔𝗻 𝗲𝘅𝗽𝗹𝗼𝗿𝗮𝘁𝗼𝗿𝘆 𝗺𝗶𝘅𝗲𝗱 𝗺𝗲𝘁𝗵𝗼𝗱𝘀 𝘀𝘁𝘂𝗱𝘆 𝗼𝗻 𝘀𝗵𝗮𝗿𝗲𝗱 𝗱𝗲𝗰𝗶𝘀𝗶𝗼𝗻-𝗺𝗮𝗸𝗶𝗻𝗴 𝗮𝗻𝗱 𝗮𝗻𝘁𝗶𝗯𝗶𝗼𝘁𝗶𝗰 𝗽𝗿𝗲𝘀𝗰𝗿𝗶𝗯𝗶𝗻𝗴 𝗳𝗼𝗿 𝗽𝗲𝘁 𝗰𝗮𝘁𝘀 𝗮𝗻𝗱 𝗱𝗼𝗴𝘀 𝗶𝗻 𝗦𝗶𝗻𝗴𝗮𝗽𝗼𝗿𝗲 𝘃𝗲𝘁𝗲𝗿𝗶𝗻𝗮𝗿𝘆 𝗰𝗹𝗶𝗻𝗶𝗰𝘀.

🐶 🐱 A comprehensive study, combining results from a quantitative survey amongst 1,080 pet owners and qualitative interviews with 19 veterinarians, provides robust insights into antibiotic stewardship in the veterinary setting.

Key Quantitative Findings:
• Half of the pet owners were informed of the different treatment options available, and weighed the pros and cons with their vets, in shared decision-making on antibiotic prescribing for their pets
• Cat owners were twice as likely as non-cat owners to engage in these discussions
• 86.8% of pet owners prioritised appropriate antibiotics over ease of administration
• 74.4% wanted more training on administering medication to their pets
Key Qualitative Insights from Veterinarians:
• Shared decision-making was mostly driven by the vet’s individual initiative
• Discussions often focused on how pet owners would like to administer the antibiotic, but rarely on antibiotic choice
• Vets were motivated by the belief that pet owners have the right to choose antibiotic options that fit their circumstances
• Pet owners often had to initiate conversations about antibiotic administration or feeding concerns; otherwise, shared decision-making would not occur

Proactive exploration of pet owners’ needs and concerns during shared decision-making, and provision of the necessary training and advice to pet owners, can enhance antibiotic stewardship for pet cats and dogs.

Read the full paper here:
doi.org/10.1038/s41598-025-04881-w

Veterinarians primarily engage pet owners in shared decision-making (SDM) to enhance treatment outcomes and owner satisfaction, but not specifically for antibiotic stewardship. This study aims to understand how SDM occurs and how to better involve pet owners in appropriate antibiotic prescribing for...

02/05/2025

📰Extra, extra! Read all about it!

Our pet owners’ study just hit The Straits Times!

Dive into the interesting findings about antibiotic use in pets, vis-a-vis their owners:

https://straitstimes.com/singapore/health/share-a-bed-with-your-fur-kid-heres-what-you-should-know-about-antibiotic-resistant-bacteria

A local study shows 3 in 4 pet owners don't know such bacteria can spread between them and their pets. Read more at straitstimes.com. Read more at straitstimes.com.

28/04/2025

Our Principal Epidemiologist, Dr Guo Huiling, shared her research findings as a featured speaker at the Singapore Veterinary Association Local Vet Conference 2025, last weekend.

Her presentation on the VALUE of Companion SteWARdS: Understanding the facilitators and barriers to appropriate antibiotic prescribing in veterinary clinics for companion animals in Singapore revealed valuable insights in the local veterinary setting.

Thank you, Singapore Veterinary Association and Dr Boon Han Teo for the opportunity to be part of this significant event.

24/04/2025

𝐏𝐥𝐚𝐬𝐭𝐢𝐜 𝐖𝐚𝐬𝐭𝐞 𝐚𝐧𝐝 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐈𝐧𝐜𝐢𝐝𝐞𝐧𝐜𝐞 𝐀𝐦𝐨𝐧𝐠 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥 𝐒𝐭𝐚𝐟𝐟 𝐀𝐟𝐭𝐞𝐫 𝐃𝐞𝐞𝐬𝐜𝐚𝐥𝐚𝐭𝐢𝐨𝐧 𝐢𝐧 𝐏𝐏𝐄 𝐔𝐬𝐞 🌿🩺

A quality improvement project using retrospective data from Tan Tock Seng Hospital and National Centre for Infectious Diseases compared COVID-19 incidence rates among hospital staff with those in the community, before and after implementation of PPE deescalation measures:

🦠 Pandemic phase/Before PPE deescalation (Oct 2021–Sept 2022): Full PPE (N95 + gown + gloves)

😷 Endemic phase/After PPE deescalation (Oct 2022–Sept 2023): N95-only for routine COVID-19 care

📉 The key finding:

No significant association between PPE de-escalation and COVID-19 incidence in HCP, with infection trends mirroring population infection rates.

🌱 The sustainability gains were significant:

– 66,080 kg less plastic waste

– 393,258 kg fewer CO₂-equivalent emissions

– SGD 453,748 in cost savings

As we mark , this is a timely reminder: small systemic changes in healthcare can have significant environmental impact without compromising patient safety.

📖 Read the full publication: doi.org/10.1001/jamanetworkopen.2025.5264

This quality improvement study evaluates whether personal protective equipment (PPE) deescalation guidelines in Singapore was associated with staff COVID-19 incidence as well as the environmental sustainability outcomes of PPE deescalation.

31/03/2025

Selamat Hari Raya! 🌙✨
May your heart be light, your home be bright, and your day be filled with love and laughter! 💛

28/02/2025

📢 𝐓𝐡𝐞 𝐕𝐀𝐋𝐔𝐄 𝐨𝐟 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐬𝐭𝐞𝐰𝐚𝐫𝐝𝐬𝐡𝐢𝐩 𝐟𝐨𝐫 𝐜𝐨𝐦𝐩𝐚𝐧𝐢𝐨𝐧 𝐚𝐧𝐢𝐦𝐚𝐥𝐬: 𝐔𝐧𝐝𝐞𝐫𝐬𝐭𝐚𝐧𝐝𝐢𝐧𝐠 𝐚𝐩𝐩𝐫𝐨𝐩𝐫𝐢𝐚𝐭𝐞 𝐚𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐩𝐫𝐞𝐬𝐜𝐫𝐢𝐛𝐢𝐧𝐠 𝐟𝐨𝐫 𝐩𝐞𝐭 𝐜𝐚𝐭𝐬 𝐚𝐧𝐝 𝐝𝐨𝐠𝐬 𝐢𝐧 𝐯𝐞𝐭𝐞𝐫𝐢𝐧𝐚𝐫𝐲 𝐜𝐥𝐢𝐧𝐢𝐜𝐬 𝐢𝐧 𝐒𝐢𝐧𝐠𝐚𝐩𝐨𝐫𝐞 🐶🐱

Our study explored factors influencing antibiotic prescribing for pet cats & dogs in Singapore. We found that:

✔️ There were autonomous, yet unanimous, efforts by veterinarians to ensure appropriate antibiotic prescribing practices for pet cats and dogs, but these efforts were often attributed to the purpose of sustaining business revenue for the clinics.
✔️ National guidelines were loosely followed; Clinic-level antibiotic practices were a reflection of key decision-making veterinarians’ personal valuing of AMR.
✔️ Taking reference from laboratory-based diagnostics for treatment with antibiotics was the known best practice, but potential poor owner satisfaction due to additional costs incurred was a misalignment with clinic valuing of business viability.
✔️ Open discussions amongst colleagues to share knowledge and best practices in antibiotic prescribing were observed, and they involved veterinary nurses and technicians as well.
✔️ Shared decision-making between veterinarians and pet owners were common, but it was usually for the purpose of respecting owners’ rights and not for improving appropriate antibiotic prescribing.
✔️ Audits were welcomed, but resource limitations, such as manpower and effort, remained a key barrier.

🔍 Recommendations:

✅ Formally recognise and integrate existing antibiotic stewardship efforts into clinic values and missions, that aligns with the clinic's prioritisation of business viability.
✅ Provide collective training for all clinic staff, not just licensed veterinarians, and encourage conversations across different One Health sectors.
✅ Continue shared decision-making with pet owners, extending further to educate and empower them to recognise and renounce unauthorised antibiotic use for their pets.
✅ Track meaningful indicators, such as engaging in shared decision-making and tailoring antibiotic courses to pet owners' capacity to administer medication, as part of future audits.
✅ Tap on technological advancements to address resource limitations for data extraction and monitoring.

Read the full study here: doi.org/10.1016/j.onehlt.2025.100994

Send a message to learn more

21/02/2025

👥 𝐌𝐨𝐝𝐢𝐟𝐲𝐢𝐧𝐠 𝐄𝐟𝐟𝐞𝐜𝐭𝐬 𝐨𝐟 𝐓𝐫𝐮𝐬𝐭𝐞𝐝 𝐅𝐫𝐢𝐞𝐧𝐝𝐬 𝐢𝐧 𝐭𝐡𝐞 𝐀𝐝𝐨𝐩𝐭𝐢𝐨𝐧 𝐨𝐟 𝐇𝐞𝐚𝐥𝐭𝐡𝐲 𝐁𝐞𝐡𝐚𝐯𝐢𝐨𝐮𝐫𝐬

Friends shape our behaviours, but how much do they influence our health choices?

Our study of 2004 Singaporean/PRs (Nov 2020 – Jan 2021) explored whether having trusted friends to discuss health issues impacts the adoption of healthy behaviours.

🔍 Key Findings:
✅ Only 16.5% of participants adopted a high level of healthy behaviours (healthy diet, regular exercise, no smoking, less sugar, good sleep).
✅ Older adults (60+) were generally 2.36x more likely to adopt a high level of healthy behaviours than younger adults (

Modifying Effects of Trusted Friends in the Adoption of Healthy Behaviors 1 Angela Chow Tan Tock Seng Hospital Singapore Modifying Effects of Trusted Friends in the Adoption of Healthy Behaviors

14/02/2025

🐶🐱 𝐏𝐞𝐭 𝐎𝐰𝐧𝐞𝐫𝐬’ 𝐊𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐞 𝐨𝐟 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐔𝐬𝐞 𝐚𝐧𝐝 𝐀𝐧𝐭𝐢𝐦𝐢𝐜𝐫𝐨𝐛𝐢𝐚𝐥 𝐑𝐞𝐬𝐢𝐬𝐭𝐚𝐧𝐜𝐞 𝐚𝐧𝐝 𝐓𝐡𝐞𝐢𝐫 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐏𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬: 𝐂𝐨𝐦𝐩𝐚𝐫𝐢𝐬𝐨𝐧 𝐁𝐞𝐭𝐰𝐞𝐞𝐧 𝐂𝐨𝐧𝐭𝐞𝐱𝐭𝐬 𝐨𝐟 𝐒𝐞𝐥𝐟 𝐚𝐧𝐝 𝐏𝐞𝐭

We compared pet owners’ knowledge of antibiotic use, understanding of AMR and antibiotic practices for themselves and their pets.

Results from our study of 1,080 pet owners across 16 vet clinics in Singapore found:

📉 Poor antibiotic knowledge – 33.2% for themselves vs. 46.3% for pets (p < 0.001)
💊 Inappropriate antibiotic use – 23.5% for themselves vs. 33.9% for pets (p < 0.001)
🐾 Non-dog owners had poorer knowledge of antibiotic use for their pet compared to dog owners (55.2% vs. 42.4%; p < 0.001)

These findings highlight the need for One Health education to improve antibiotic practices and curb AMR.

Read more here: doi.org/10.3390/antibiotics14020158

Objective: This study aimed to compare pet owners’ knowledge of antibiotic use, understanding of antimicrobial resistance (AMR) and antibiotic practices for themselves and their pets to guide behavioral interventions to reduce AMR. Methods: A cross-sectional study conducted between March 2023 and ...

29/01/2025

Wishing you a prosperous and healthful Lunar New Year! 🧧 ✨