Redding L E, Cubas-Delgado F, Sammel M D, Smith G, Galligan D T, Levy M Z, Hennessy S
School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Universidad Nacional de Cajamarca, Department of Veterinary Medicine, Peru.
Prev Vet Med. 2014 Jun 1;114(3-4):213-22. doi: 10.1016/j.prevetmed.2014.02.006. Epub 2014 Feb 19.
Antibiotics are commonly used in animal agriculture; they can improve animal health and productivity, but their use may also represent a public health threat. Very little is known about antibiotic use on small farms in lower/middle income countries. To understand antibiotic use on these farms and promote the judicious use of these drugs, pharmacoepidemiologic data are necessary. However, acquiring such data can be difficult, as farmers are often illiterate (and therefore cannot participate in written surveys or keep treatment records), antibiotics can be obtained over-the-counter (in which case no prescriptions are generated) and monitoring and surveillance systems for drug use are often non-existent. The goal of this study was to compare two methods of acquiring pharmacoepidemiologic data pertaining to antibiotics that are well-adapted to farms in lower-middle income countries: self-report and the collection of discarded drug packaging. A convenience sample of 20 farmers in Cajamarca, Peru, participated in the study. Farmers placed discarded antibiotic packaging in bins for six months. At the end of the six-month period, farmers were interviewed and asked to recall the antibiotic usage that occurred on their farm over the past month and past six months; these self-reported data were quantitatively and qualitatively compared to the bin contents collected in the last month and previous six months. We found that the agreement between the bins and self-report was relatively poor for both the quantity and types of antibiotics used. The bins appeared to perform better than self-report when bottles and mLs of antibiotics were measured, while self-report appeared to perform better for intra-mammary infusions. The bins also appeared to perform better when data pertaining to an extended time period (six months) were collected. The results of this study will provide guidance to investigators seeking to collect pharmacoepidemiologic data in similar environments.
抗生素在畜牧业中普遍使用；它们可以改善动物健康状况并提高生产力，但抗生素的使用也可能对公共卫生构成威胁。对于低收入/中等收入国家小农场抗生素的使用情况，人们知之甚少。为了解这些农场抗生素的使用情况并促进这些药物的合理使用，药物流行病学数据是必要的。然而，获取此类数据可能很困难，因为农民往往是文盲（因此无法参与书面调查或保存治疗记录），抗生素可以非处方购买（在这种情况下不会开具处方），而且药物使用监测和监督系统往往不存在。本研究的目的是比较两种适合在低收入和中等收入国家农场获取与抗生素相关的药物流行病学数据的方法：自我报告和收集废弃药品包装。秘鲁卡哈马卡的20名农民组成的便利样本参与了该研究。农民们将废弃的抗生素包装放入箱子中，为期六个月。在六个月期限结束时，对农民进行了访谈，并要求他们回忆过去一个月和过去六个月农场中发生的抗生素使用情况；将这些自我报告的数据与最后一个月和前六个月收集的箱子中的内容进行定量和定性比较。我们发现，对于所使用抗生素的数量和种类，箱子中的数据与自我报告之间的一致性相对较差。在测量抗生素的瓶数和毫升数时，箱子中的数据似乎比自我报告表现更好，而在乳房内注射方面，自我报告似乎表现更好。当收集与较长时间段（六个月）相关的数据时，箱子中的数据似乎也表现更好。本研究结果将为寻求在类似环境中收集药物流行病学数据的研究人员提供指导。
