Pleydell E J, Souphavanh K, Hill K E, French N P, Prattley D J
Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
N Z Vet J. 2012 Mar;60(2):115-22. doi: 10.1080/00480169.2011.643733.
To describe the patterns of use of antimicrobial drugs by veterinary surgeons treating commonly presented bacterial infections in companion animals in New Zealand.
A postal survey of 800 randomly selected companion animal veterinarians practicing in New Zealand was conducted between August and December 2008. Data were collected regarding the antimicrobials prescribed for recent cases of skin, ear and urinary tract infections; the use of culture and susceptibility testing; and veterinarian characteristics such as proportion of time spent treating companion animals and recent attendance at continuing professional development (CPD) events. Potential associations within the data were explored using extended mosaic plots and multivariable regression models.
Completed surveys from 393 respondents were available for analysis, providing data on systemic antimicrobial drug use for 1,799 cases of presumptive bacterial infections. The most frequently prescribed drugs were amoxicillin-clavulanic acid (864 cases, 48%), cephalexin (558, 31%), and fluoroquinolones (198, 11%). Of 359 cases of canine superficial pyoderma, 157 (44%) were treated with amoxicillin-clavulanic acid and 155 (43%) were treated with cephalexin with median reported treatment durations of 7 and 10 days, for these two drugs respectively. Culture and susceptibility tests had been used in 376 of 1,984 (19%) of all reported cases and 160 (43%) of these were suspected urinary tract infections. Practitioners that spent 100% of their time treating companion animals and who had attended a CPD course related to companion animals within the 12 months prior to completing the survey were more likely to submit a sample for culture and susceptibility testing and to prescribe longer courses of antimicrobials for the treatment of canine pyoderma than practitioners who spent less than 100% of their time treating companion animals and had not attended a CPD course in the last 12 months.
Broad-spectrum drugs considered by the World Health Organisation to be critically important for human health, such as fluoroquinolones and amoxicillin-clavulanic acid, are amongst the most frequently prescribed antimicrobials in companion animal medicine, and these drugs are often prescribed without submitting a sample for culture and susceptibility testing.
Many cases of superficial pyoderma were treated for less than the recommended duration of 21 days, which may contribute to a higher rate of recurrent pyoderma and the development of drug resistance within the causal bacteria. Veterinarians should be aware that the use of fluoroquinolones, in particular, should be based upon the results of a culture and susceptibility test.
描述新西兰治疗伴侣动物常见细菌感染的兽医使用抗菌药物的模式。
2008年8月至12月期间，对随机抽取的800名在新西兰执业的伴侣动物兽医进行了邮寄调查。收集了有关为近期皮肤、耳部和尿路感染病例开具的抗菌药物的数据；培养和药敏试验的使用情况；以及兽医的特征，如用于治疗伴侣动物的时间比例和近期参加持续专业发展（CPD）活动的情况。使用扩展镶嵌图和多变量回归模型探索数据中的潜在关联。
有393名受访者完成的调查问卷可供分析，提供了1799例推定细菌感染的全身抗菌药物使用数据。最常开具的药物是阿莫西林 - 克拉维酸（864例，48%）、头孢氨苄（558例，31%）和氟喹诺酮类（198例，11%）。在359例犬浅表脓皮病病例中，157例（44%）用阿莫西林 - 克拉维酸治疗，155例（43%）用头孢氨苄治疗，这两种药物报告的中位治疗时间分别为7天和10天。在所有报告病例的1984例中有376例（19%）使用了培养和药敏试验，其中160例（43%）为疑似尿路感染。在完成调查前12个月内将100%的时间用于治疗伴侣动物且参加过与伴侣动物相关的CPD课程的从业者，比那些用于治疗伴侣动物的时间少于100%且在过去12个月内未参加CPD课程的从业者，更有可能提交样本进行培养和药敏试验，并为治疗犬脓皮病开具更长疗程的抗菌药物。
世界卫生组织认为对人类健康至关重要的广谱药物，如氟喹诺酮类和阿莫西林 - 克拉维酸，是伴侣动物医学中最常开具的抗菌药物之一，而且这些药物经常在未提交样本进行培养和药敏试验的情况下就被开具。
许多浅表脓皮病病例的治疗时间短于推荐的21天疗程，这可能导致脓皮病复发率较高以及致病细菌产生耐药性。兽医应意识到，特别是氟喹诺酮类药物的使用应基于培养和药敏试验的结果。
