Department of Epidemiology and Population Health Group, Institute of Infection and Global Health, School of Veterinary Science, University of Liverpool, Neston, UK.
Equine Vet J. 2013 Mar;45(2):141-7. doi: 10.1111/j.2042-3306.2012.00602.x. Epub 2012 Sep 19.
Antimicrobial use is known to select for the emergence of resistant strains of bacteria; therefore prudent use in both human and veterinary medicine is essential to preserve their efficacy.
To characterise antimicrobial prescribing patterns in UK equine practice and evaluate factors associated with prescribing.
A postal questionnaire including 4 clinical scenarios was sent to 740 veterinary surgeons that treat horses. Data were collected on the clinician, their practice and sources of information regarding antimicrobials and their use. Multivariable logistic regression analysis was used to ascertain factors associated with 5 outcomes; prescribing off-licence drugs; prescribing at incorrect doses; prescribing 3rd or 4th generation cephalosporins; prescribing fluoroquinolones and prescribing potentiated sulphonamides.
Questionnaires were completed by 38% of veterinary surgeons who were sent questionnaires. Less than 1% of practices had antimicrobial use guidelines. Trimethoprim-sulphonamides were most commonly prescribed in each clinical scenario. Eleven percent of prescriptions were for antimicrobial drugs not licensed for use in horses in the UK. Five percent of prescriptions for licensed antimicrobials were under the recommended dose rate and 56% over the recommended dose rate. Fluoroquinolones and 3rd and 4th generation cephalosporins accounted for 1 and 3% of prescriptions, respectively. Veterinary surgeons working at referral practices were more likely to prescribe 3rd and 4th generation cephalosporins and fluoroquinolones and off-licence antimicrobials whereas those working in first-opinion practices were more likely to prescribe potentiated sulphonamides. Sources of information regarding antimicrobials also had an effect on prescribing.
Prescription of antimicrobials at inappropriate doses was common even when provided with the weight of the animal. It is uncommon for UK equine veterinary practices to have guidelines for antimicrobial use. The introduction of such guidelines could lead to more prudent use of antimicrobials.
众所周知，抗菌药物的使用会选择出具有耐药性的细菌菌株；因此，在人类和兽医医学中谨慎使用抗菌药物对于保持其疗效至关重要。
描述英国马科动物实践中的抗菌药物处方模式，并评估与处方相关的因素。
向 740 名治疗马的兽医发送了一份包括 4 个临床情况的邮寄问卷。收集了关于临床医生、他们的实践以及关于抗菌药物及其使用的信息来源的数据。使用多变量逻辑回归分析确定了与 5 个结果相关的因素；开出处方药物；开出处方剂量不正确；开处方 3 或 4 代头孢菌素；开处方氟喹诺酮类药物和开处方增效磺胺类药物。
发送问卷的兽医中有 38%完成了问卷。不到 1%的实践有抗菌药物使用指南。在每个临床情况下，最常开的处方是甲氧苄啶-磺胺类药物。11%的处方是为英国未批准用于马的抗菌药物开的。5%的许可证抗菌药物处方剂量低于推荐剂量率，56%的处方剂量高于推荐剂量率。氟喹诺酮类药物和 3 代和 4 代头孢菌素分别占处方的 1%和 3%。在转诊实践中工作的兽医更有可能开 3 代和 4 代头孢菌素和氟喹诺酮类药物以及非处方抗菌药物，而在第一意见实践中工作的兽医更有可能开增效磺胺类药物。抗菌药物信息来源也对抗菌药物的使用产生了影响。
即使提供了动物的体重，不适当剂量的抗菌药物处方也很常见。英国马科兽医实践中很少有抗菌药物使用指南。引入这样的指南可以导致更谨慎地使用抗菌药物。
