Rushton J
Veterinary Epidemiology Economics and Public Health Group, Production and Population Health Department, Royal Veterinary College, Hatfield, UK.
Zoonoses Public Health. 2015 Apr;62 Suppl 1(Suppl 1):10-21. doi: 10.1111/zph.12193.
Antimicrobials are widely used in preventive and curative medicine in animals. Benefits from curative use are clear - it allows sick animals to be healthy with a gain in human welfare. The case for preventive use of antimicrobials is less clear cut with debates on the value of antimicrobials as growth promoters in the intensive livestock industries. The possible benefits from the use of antimicrobials need to be balanced against their cost and the increased risk of emergence of resistance due to their use in animals. The study examines the importance of animals in society and how the role and management of animals is changing including the use of antimicrobials. It proposes an economic framework to assess the trade-offs of anti-microbial use and examines the current level of data collection and analysis of these trade-offs. An exploratory review identifies a number of weaknesses. Rarely are we consistent in the frameworks applied to the economic assessment anti-microbial use in animals, which may well be due to gaps in data or the prejudices of the analysts. There is a need for more careful data collection that would allow information on (i) which species and production systems antimicrobials are used in, (ii) what active substance of antimicrobials and the application method and (iii) what dosage rates. The species need to include companion animals as well as the farmed animals as it is still not known how important direct versus indirect spread of resistance to humans is. In addition, research is needed on pricing antimicrobials used in animals to ensure that prices reflect production and marketing costs, the fixed costs of anti-microbial development and the externalities of resistance emergence. Overall, much work is needed to provide greater guidance to policy, and such work should be informed by rigorous data collection and analysis systems.
抗菌药物在动物预防医学和治疗医学中被广泛使用。治疗用途的益处显而易见——它能让患病动物恢复健康,从而增进人类福祉。抗菌药物预防性使用的情况则不那么明确,在集约化畜牧业中,关于抗菌药物作为生长促进剂的价值存在争议。使用抗菌药物可能带来的益处需要与其成本以及因在动物中使用而导致耐药性出现风险增加相权衡。该研究探讨了动物在社会中的重要性,以及动物的角色和管理方式是如何变化的,包括抗菌药物的使用。它提出了一个经济框架来评估抗菌药物使用的权衡,并审视了当前这些权衡的数据收集和分析水平。一项探索性综述发现了一些不足之处。我们在应用于动物抗菌药物使用经济评估的框架方面很少保持一致,这很可能是由于数据缺口或分析人员的偏见所致。需要更谨慎地收集数据,以便获取关于以下方面的信息:(i) 使用抗菌药物的动物种类和生产系统;(ii) 抗菌药物的活性成分、应用方法;(iii) 剂量率。物种范围需要涵盖伴侣动物以及养殖动物,因为目前尚不清楚耐药性对人类的直接传播与间接传播的重要程度。此外,还需要研究动物用抗菌药物的定价,以确保价格反映生产和营销成本、抗菌药物研发的固定成本以及耐药性出现的外部影响。总体而言,需要开展大量工作来为政策提供更有力的指导,此类工作应以严格的数据收集和分析系统为依据。