Hardefeldt L Y, Browning G F, Thursky K, Gilkerson J R, Billman-Jacobe H, Stevenson M A, Bailey K E
Asia-Pacific Centre for Animal Health, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, Australia.
National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Carlton, Victoria, Australia.
Equine Vet J. 2018 Jan;50(1):65-72. doi: 10.1111/evj.12709. Epub 2017 Jul 10.
Antimicrobials are widely used in Australian veterinary practices, but no investigation into the classes of antimicrobials used, or the appropriateness of use in horses, has been conducted.
The aim of the study was to describe antimicrobial use for surgical prophylaxis in equine practice in Australia.
Cross-sectional questionnaire survey.
An online questionnaire was used to document antimicrobial usage patterns. Information solicited in the questionnaire included demographic details of the respondents, the frequency with which antimicrobials were used for specific surgical conditions (including the dose, timing and duration of therapy) and practice antimicrobial use policies and sources of information about antimicrobials and their uses.
A total of 337 members of the Australian veterinary profession completed the survey. Generally, the choice of antimicrobial was appropriate for the specified equine surgical condition, but the dose and duration of therapy varied greatly. While there was poor optimal compliance with British Equine Veterinary Association guidelines in all scenarios (range 1-15%), except removal of a nonulcerated dermal mass (42%), suboptimal compliance (compliant antimicrobial drug selection but inappropriate timing, dose or duration of therapy) was moderate for all scenarios (range 48-68%), except for an uninfected contaminated wound over the thorax, where both optimal and suboptimal compliance was very poor (1%). Veterinarians practicing at a university hospital had higher odds of compliance than general practice veterinarians (Odds ratio 3.2, 95% CI, 1.1-8.9, P = 0.03).
Many survey responses were collected at conferences which may introduce selection bias, as veterinarians attending conferences may be more likely to have been exposed to contemporary antimicrobial prescribing recommendations.
Antimicrobial use guidelines need to be developed and promoted to improve the responsible use of antimicrobials in equine practice in Australia. An emphasis should be placed on antimicrobial therapy for wounds and appropriate dosing for procaine penicillin.
抗菌药物在澳大利亚兽医实践中广泛使用，但尚未对所使用的抗菌药物类别或在马匹中的使用适当性进行调查。
本研究的目的是描述澳大利亚马匹实践中用于手术预防的抗菌药物使用情况。
横断面问卷调查。
使用在线问卷记录抗菌药物使用模式。问卷中征求的信息包括受访者的人口统计学细节、抗菌药物用于特定手术情况的频率（包括治疗剂量、时间和持续时间）以及实践中的抗菌药物使用政策和有关抗菌药物及其用途的信息来源。
共有337名澳大利亚兽医专业人员完成了调查。总体而言，抗菌药物的选择对于指定的马匹手术情况是合适的，但治疗剂量和持续时间差异很大。虽然在所有情况下，除了切除无溃疡的皮肤肿物（42%）外，对英国马术兽医协会指南的最佳依从性都很差（范围为1 - 15%），但除胸部未感染的污染伤口外，所有情况下次优依从性（抗菌药物选择合规但治疗时间、剂量或持续时间不合适）都处于中等水平（范围为48 - 68%），在胸部未感染的污染伤口中，最佳和次优依从性都非常差（1%）。在大学医院执业的兽医比普通执业兽医的依从几率更高（优势比3.2，95%置信区间，1.1 - 8.9，P = 0.03）。
许多调查回复是在会议上收集的，这可能会引入选择偏倚，因为参加会议的兽医可能更有可能接触到当代抗菌药物处方建议。
需要制定和推广抗菌药物使用指南，以改善澳大利亚马匹实践中抗菌药物的合理使用。应强调伤口的抗菌治疗以及普鲁卡因青霉素的适当剂量。
