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瑞士猪场的抗菌药物消费情况:瑞士与欧洲现场规定日剂量和疗程剂量的比较

Antimicrobial Drug Consumption on Swiss Pig Farms: A Comparison of Swiss and European Defined Daily and Course Doses in the Field.

作者信息

Echtermann Thomas, Muentener Cedric, Sidler Xaver, Kümmerlen Dolf

机构信息

Division of Swine Medicine, Department for Farm Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

Front Vet Sci. 2019 Jul 18;6:240. doi: 10.3389/fvets.2019.00240. eCollection 2019.

Abstract

Defined Daily Doses (DDD) and Defined Course Doses (DCD) have been established in both human and veterinary medicine in order to standardize the measurement of treatments in a population. In 2016 the European Medicines Agency published average defined daily dose (DDDvet) and defined course dose (DCDvet) values for antimicrobial agents used in livestock production. Similarly, national defined doses (DDDch and DCDch) for the pig sector in Switzerland have recently been determined. The aim of this study was to compare the outcome of calculating antimicrobial consumption based on either DDDvet/DCDvet or DDDch/DCDch. Data from 227 Swiss pig farms describing antimicrobial use in 2015 was collected. The numbers of treatment days and treatments were calculated using DDDvet/DCDvet and DDDch/DCDch respectively, for each farm in total and for different antimicrobial classes. Associations between calculated numbers of DDDvet/DCDvet and DDDch/DCDch on farm level were investigated. In addition, differences concerning antimicrobial use were investigated between different production types of farms (piglet-producer, finishing farm or farrow-to-finishing farm). Using DDDch/DCDch values we calculated 1,805,494 treatment days and 433,678 treatments compared to 1,456,771 treatment days (19% ratio) and 303,913 treatments (30% ratio) based on DDDvet/DCDvet. Penicillins (21.4/26.6%), polypeptides (18.6/27.6%) and fluoroquinolones (9.5/8.8%) were the most frequently used classes of antimicrobials based on calculation using both DDDch and DDDvet. Similar findings were observed for complete treatments (DCDch/vet) (penicillins: 52.8/39.6%; polypeptides: 7.8/14.2%; fluoroquinolones: 13.2/12.9%). The number of treatment days or treatments per farm was higher for piglet-producers and farrow-to-finishing farms compared to finisher farms regardless of whether Swiss or European DDD or DCD values were used for the calculation (each < 0.001). Similar results for antimicrobial use (AMU) obtained at farm level were observed when calculated either by Swiss or European definitions. Nevertheless, marked differences could be observed in the assessment of the use of specific antimicrobial classes in the field based on DDDvet/DCDvet compared to DDDch/DCDch.

摘要

为了规范人群中治疗量的衡量标准,人用和兽用医学领域均已确立了限定日剂量(DDD)和限定疗程剂量(DCD)。2016年,欧洲药品管理局公布了用于畜牧生产的抗菌药物的平均限定日剂量(DDDvet)和限定疗程剂量(DCDvet)值。同样,瑞士近期也确定了养猪业的国家限定剂量(DDDch和DCDch)。本研究的目的是比较基于DDDvet/DCDvet或DDDch/DCDch计算抗菌药物消费量的结果。收集了227个瑞士养猪场2015年描述抗菌药物使用情况的数据。分别使用DDDvet/DCDvet和DDDch/DCDch计算了每个农场总体以及不同抗菌药物类别的治疗天数和治疗次数。研究了农场层面计算得出的DDDvet/DCDvet和DDDch/DCDch数量之间的关联。此外,还调查了不同生产类型农场(仔猪生产场、育肥场或自繁自育场)之间抗菌药物使用的差异。使用DDDch/DCDch值,我们计算出治疗天数为1,805,494天,治疗次数为433,678次,而基于DDDvet/DCDvet计算得出的治疗天数为1,456,771天(比例为19%),治疗次数为303,913次(比例为30%)。根据DDDch和DDDvet计算,青霉素类(21.4/26.6%)、多肽类(18.6/27.6%)和氟喹诺酮类(9.5/8.8%)是最常使用的抗菌药物类别。对于完整疗程(DCDch/vet)也观察到了类似的结果(青霉素类:52.8/39.6%;多肽类:7.8/14.2%;氟喹诺酮类:13.2/12.9%)。无论使用瑞士还是欧洲的DDD或DCD值进行计算,仔猪生产场和自繁自育场每个农场的治疗天数或治疗次数均高于育肥场(均P<0.001)。无论是按照瑞士定义还是欧洲定义计算,在农场层面获得的抗菌药物使用(AMU)结果相似。然而,与DDDch/DCDch相比,基于DDDvet/DCDvet对特定抗菌药物类别的使用评估存在明显差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c49/6657740/34e639c9ec4a/fvets-06-00240-g0001.jpg

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