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荷兰兽医对抗生素使用和选择性干奶牛治疗的态度。

Veterinarians' attitudes toward antimicrobial use and selective dry cow treatment in the Netherlands.

机构信息

GD Animal Health, PO Box 9, 7400 AA Deventer, the Netherlands.

GD Animal Health, PO Box 9, 7400 AA Deventer, the Netherlands.

出版信息

J Dairy Sci. 2018 Jul;101(7):6336-6345. doi: 10.3168/jds.2017-13591. Epub 2018 Mar 28.

Abstract

In the Netherlands, regulations have been in place since 2008 to reduce the overall use of antimicrobials to mitigate antimicrobial resistance. As part of these regulations, a ban on the preventive use of antimicrobials, such as applying blanket dry cow treatment, was introduced and alternative measures such as selective dry cow treatment (SDCT) were implemented. Both farmers and veterinarians play an important role in implementing these measures and have a shared responsibility with respect to prudent antimicrobial use (AMU). The attitude of Dutch dairy veterinarians toward restricted AMU and toward SDCT is unknown, but a favorable attitude toward this approach seems crucial for successful implementation. In 2015, an online questionnaire was collected from 181 veterinarians that contained questions with regard to their attitude and behavior toward reduction of AMU and toward SDCT. Descriptive statistics were used to describe the data, and multivariable logistic regression models with a logit link function were applied to evaluate potential associations between veterinarians' attitudes toward AMU and SDCT and the rationale behind their mindset, based on positive and negative aspects of reduction in AMU. The veterinarians were divided into 3 groups based on their opinion on 4 statements with regard to AMU and SDCT: veterinarians with an unfavorable, a neutral, and a favorable attitude toward reduction of AMU and toward SDCT. For the multivariable logistic regression analysis, the first 2 groups were combined and compared with the veterinarians with a favorable attitude. The general attitude of Dutch dairy veterinarians toward reduction of AMU was positive, and most expressed the belief that they can still be a good veterinarian when they prescribe less antimicrobials. Veterinarians indicated they progressively promoted SDCT beginning in 2013. Most veterinarians see the advice they provide to farmers on SDCT as the best possible approach and are convinced that their farmers apply this SDCT approach. The results of the multivariable analyses showed that veterinarians with a favorable attitude mentioned positive aspects of SDCT, such as an increased consciousness of AMU among farmers, improving animal health, reducing antimicrobial resistance, and a chance to add value for the farmer, more often than other veterinarians. The latter group significantly more often indicated negative aspects of SDCT, such as a higher risk of sick cows and feeling pushed to follow the rules. In conclusion, the general attitude of Dutch dairy veterinarians toward reduction of AMU and SDCT was found to be positive. However, given the influence veterinarians potentially have on the attitude of farmers and the variability found in their attitude and behavior, veterinarians need specific attention if regional or national programs are organized trying to change behavior of farmers and encourage prudent AMU and SDCT.

摘要

在荷兰,自 2008 年以来,一直有法规要求减少抗生素的总体使用量,以减轻抗生素耐药性。作为这些法规的一部分,禁止了预防性使用抗生素,如普遍使用干奶牛处理,同时实施了替代措施,如选择性干奶牛处理(SDCT)。农民和兽医在实施这些措施方面都发挥着重要作用,在谨慎使用抗生素(AMU)方面负有共同责任。荷兰奶牛兽医对限制 AMU 和 SDCT 的态度尚不清楚,但对这种方法持有利态度似乎对成功实施至关重要。2015 年,从 181 名兽医中收集了一份在线问卷,其中包含有关他们减少 AMU 和 SDCT 的态度和行为的问题。使用描述性统计来描述数据,并应用具有对数链接函数的多变量逻辑回归模型,根据减少 AMU 的积极和消极方面,评估兽医对 AMU 和 SDCT 的态度与思维背后的基本原理之间的潜在关联。根据兽医对 4 项关于 AMU 和 SDCT 的陈述的意见,将兽医分为 3 组:对减少 AMU 和 SDCT 的态度不利、中立和有利的兽医。对于多变量逻辑回归分析,将前 2 组合并,并与持有利态度的兽医进行比较。荷兰奶牛兽医对减少 AMU 的总体态度是积极的,大多数兽医表示,当他们开的抗生素较少时,他们仍然可以成为一名好兽医。兽医表示,他们从 2013 年开始逐步推广 SDCT。大多数兽医认为他们向农民提供的关于 SDCT 的建议是最好的方法,并相信他们的农民会应用这种 SDCT 方法。多变量分析的结果表明,持有利态度的兽医更频繁地提到了 SDCT 的积极方面,例如农民对 AMU 的意识提高、改善动物健康、减少抗生素耐药性以及为农民增加价值的机会,而其他兽医则更频繁地提到了 SDCT 的消极方面,例如奶牛患病的风险更高以及感到被迫遵守规则。总的来说,荷兰奶牛兽医对减少 AMU 和 SDCT 的态度是积极的。然而,鉴于兽医对农民态度的潜在影响,以及他们的态度和行为的可变性,如果组织区域性或国家性的项目来改变农民的行为,鼓励谨慎使用 AMU 和 SDCT,兽医需要特别关注。

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