Magalhães-Sant'Ana Manuel, More Simon J, Morton David B, Hanlon Alison J
Escola Universitária Vasco da Gama, Av. José R. Sousa Fernandes, Campus Universitário - Bloco B, 3020-210 Coimbra, Portugal.
School of Veterinary Medicine, University College Dublin, Dublin, Ireland.
Ir Vet J. 2017 Sep 15;70:28. doi: 10.1186/s13620-017-0106-9. eCollection 2017.
Antimicrobial resistance has emerged in recent years as a significant public health threat, which requires both an ethical and a scientific approach. In a recent Policy Delphi study, on-farm use of antimicrobials was a key concern identified by veterinary professionals in Ireland. In this case study (the second in a series of three resulting from a research workshop exploring the challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for responsible use of veterinary antimicrobials in Ireland.
Using a qualitative focus group approach, this study gathered evidence from relevant stakeholders, namely veterinarians working in public and private organisations, a representative from the veterinary regulatory body, a dairy farmer and a general medical practitioner. Three overarching constraints to prudent on-farm use of veterinary antimicrobials emerged from the thematic analysis: 'Defective regulations', 'Lack of knowledge and values' regarding farmers and vets and 'Farm-centred concerns', including economic and husbandry concerns. Conversely, three main themes which reflect possible opportunities to the barriers were identified: 'Improved regulations', 'Education' and 'Herd health management'.
Five main recommendations arose from this study based on the perspectives of the study participants including: a) the potential for regulatory change to facilitate an increase in the number of yearly visits of veterinarians to farms and to implement electronic prescribing and shorter validity of prescriptions; b) a 'One Health' education plan; c) improved professional guidance on responsible use of veterinary antimicrobials; d) improved on-farm herd health management practices; and e) the promotion of a 'One Farm-One Vet' policy. These findings may assist Veterinary Council of Ireland and other competent authorities when revising recommendations concerning the prudent use of veterinary antimicrobials in farmed animals.
近年来,抗菌药物耐药性已成为重大的公共卫生威胁,这需要采取伦理和科学的方法。在最近一项政策德尔菲研究中,爱尔兰兽医专业人员确定农场使用抗菌药物是一个关键问题。在本案例研究(这是探索爱尔兰兽医行业面临挑战的研究研讨会产生的三个系列案例研究中的第二个;另外两个案例研究调查临床兽医服务和紧急/伤亡屠宰认证)中,我们旨在对爱尔兰负责任使用兽用抗菌药物的限制因素和可能的机会进行基于价值的反思。
本研究采用定性焦点小组方法,从相关利益相关者那里收集证据,这些利益相关者包括在公共和私人组织工作的兽医、兽医监管机构的一名代表、一名奶农和一名全科医生。主题分析得出了在农场谨慎使用兽用抗菌药物的三个主要限制因素:“有缺陷的法规”、农民和兽医“缺乏知识和价值观”以及“以农场为中心的担忧”,包括经济和饲养方面的担忧。相反,确定了反映这些障碍可能机会的三个主要主题:“改进法规”、“教育”和“畜群健康管理”。
基于研究参与者的观点,本研究提出了五项主要建议,包括:a)监管变革有可能促进兽医每年对农场的访问次数增加,并实施电子处方和缩短处方有效期;b)制定“同一健康”教育计划;c)改进关于负责任使用兽用抗菌药物的专业指导;d)改进农场畜群健康管理做法;e)推广“一农场一兽医”政策。这些研究结果可能有助于爱尔兰兽医委员会和其他主管当局在修订有关农场动物谨慎使用兽用抗菌药物的建议时参考。