Singleton D A, Sánchez-Vizcaíno F, Dawson S, Jones P H, Noble P J M, Pinchbeck G L, Williams N J, Radford A D
Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, United Kingdom.
Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, United Kingdom; National Institute for Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, The Farr Institute @ HeRC, University of Liverpool, Waterhouse Building, Liverpool, L69 3GL, United Kingdom.
Vet J. 2017 Jun;224:18-24. doi: 10.1016/j.tvjl.2017.03.010. Epub 2017 May 3.
Antimicrobial resistance is an increasingly important global health threat and the use of antimicrobial agents is a key risk factor in its development. This study describes antimicrobial agent prescription (AAP) patterns over a 2year period using electronic health records (EHRs) from booked consultations in a network of 457 sentinel veterinary premises in the United Kingdom. A semi-automated classification methodology was used to map practitioner defined product codes in 918,333 EHRs from 413,870 dogs and 352,730 EHRs from 200,541 cats, including 289,789 AAPs. AAP as a proportion of total booked consultations was more frequent in dogs (18.8%, 95% confidence interval, CI, 18.2-19.4) than cats (17.5%, 95% CI 16.9-18.1). Prescription of topical antimicrobial agents was more frequent in dogs (7.4%, 95% CI 7.2-7.7) than cats (3.2%, 95% CI 3.1-3.3), whilst prescription of systemic antimicrobial agents was more frequent in cats (14.8%, 95% CI 14.2-15.4) than dogs (12.2%, 95% CI 11.7-12.7). A decreasing temporal pattern was identified for prescription of systemic antimicrobial agents in dogs and cats. Premises which prescribed antimicrobial agents frequently for dogs also prescribed frequently for cats. AAP was most frequent during pruritus consultations in dogs and trauma consultations in cats. Clavulanic acid potentiated amoxicillin was the most frequently prescribed antimicrobial agent in dogs (28.6% of prescriptions, 95% CI 27.4-29.8), whereas cefovecin, a third generation cephalosporin, was the most frequently prescribed antimicrobial agent in cats (36.2%, 95% CI 33.9-38.5). This study demonstrated patterns in AAP over time and for different conditions in a population of companion animals in the United Kingdom.
抗菌药物耐药性是一个日益严重的全球健康威胁，而抗菌药物的使用是其产生的一个关键风险因素。本研究利用来自英国457家定点兽医诊所预约会诊的电子健康记录（EHRs），描述了两年期间的抗菌药物处方（AAP）模式。采用半自动分类方法，对413,870只犬的918,333份EHRs和200,541只猫的352,730份EHRs中的从业者定义的产品代码进行映射，其中包括289,789份AAP。AAP占预约会诊总数的比例在犬中（18.8%，95%置信区间，CI，18.2 - 19.4）比猫中（17.5%，95% CI 16.9 - 18.1）更常见。犬外用抗菌药物的处方（7.4%，95% CI 7.2 - 7.7）比猫（3.2%，95% CI 3.1 - 3.3）更频繁，而全身性抗菌药物的处方在猫中（14.8%，95% CI 14.2 - 15.4）比犬（12.2%，95% CI 11.7 - 12.7）更频繁。在犬和猫中，全身性抗菌药物的处方呈现出随时间下降的趋势。经常给犬开抗菌药物的诊所给猫开抗菌药物也很频繁。犬的瘙痒会诊和猫的创伤会诊期间AAP最为常见。克拉维酸增强型阿莫西林是犬中最常处方的抗菌药物（占处方的28.6%，95% CI 27.4 - 29.8），而第三代头孢菌素头孢维星是猫中最常处方的抗菌药物（36.2%，95% CI 33.9 - 38.5）。本研究展示了英国伴侣动物群体中AAP随时间以及针对不同病症的模式。
