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Fig 1.

Time schedule of the applied stepped-wedge design.

The time schedule indicates the start and the duration of the period considered as the “intervention period” for the four separate clusters of participating clinics.

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Table 1.

Separate intervention elements as offered during the ASP, including when they were offered, who were involved and the estimated time investment for participants.

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Table 2.

Classification of veterinary AMU according to Dutch policy on veterinary AMU [26].

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Table 3.

Mean (range) or distribution of characteristics of 44 clinics participating in the ASP.

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Table 4.

Mean total, 1st, 2nd and 3rd choice AMU (in numbers of DDDA/month and percentage of total AMU) in participating clinics, before and during participation in the antimicrobial stewardship programme (ASP).

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Table 5.

Stepwise change and change in (linear) trend of total, 1st, 2nd, and 3rd choice AMU.

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Fig 2.

Average and clinic-specific effects of the ASP on total, 1st, 2nd and 3rd choice AMU.

Combined effect of participation in the ASP (stepwise change & change in time trend) are shown for the average effect (black) and for each individual clinic (grey) after standardisation to the estimated AMU before the intervention period (as 100%).

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