Agri-Food and Biosciences Institute Hillsborough, Hillsborough, UK
Agri-Food and Biosciences Institute Hillsborough, Hillsborough, UK.
Vet Rec. 2020 Nov 14;187(10):402. doi: 10.1136/vr.105727. Epub 2020 Apr 6.
A number of European countries currently conduct mandatory farm-level benchmarking for antimicrobial usage (AMU). This review describes the systems used, with emphasis on metric type and practical implications.
This report describes examples of four types of metrics used to measure AMU: count-based, mass-based, daily dose-based and course-based, each with its own advantages and disadvantages.
The Netherlands, Belgium, Denmark and Switzerland use daily dose-based metrics to benchmark AMU at farm-level, but each country diverges from the European Surveillance of Veterinary Antimicrobial Consumption methodology in its own way, including how the population 'at risk' is calculated. Germany operates a count-based system. Threshold AMU values have been specified at farm-level in the Netherlands, Belgium and Denmark, and action is required from producers to reduce AMU above these values. The Netherlands and Belgium also benchmark veterinarians.
For mixed species farms common in the UK and Ireland, splitting AMU by species is recommended. It is also recommended that high priority critically important antimicrobials are benchmarked separately to other antimicrobials. No one metric is optimum; however, for ruminant livestock a daily dose-based metric allows for country-specific adaptations which may allow a higher degree of precision at farm-level benchmarking in the UK and Ireland.
目前，一些欧洲国家对农场层面的抗菌药物使用（AMU）进行强制性基准测试。本综述描述了所使用的系统，重点介绍了度量类型和实际影响。
本报告介绍了用于衡量 AMU 的四种类型的指标示例：基于计数、基于质量、基于日剂量和基于疗程的指标，每种指标都有其自身的优缺点。
荷兰、比利时、丹麦和瑞士使用基于日剂量的指标在农场层面进行 AMU 基准测试，但每个国家都以自己的方式偏离了欧洲兽医抗菌药物使用监测方法，包括如何计算“风险”人群。德国采用基于计数的系统。荷兰、比利时和丹麦已在农场层面规定了 AMU 的阈值，超过这些值，生产商就需要采取行动降低 AMU。荷兰和比利时还对兽医进行基准测试。
对于在英国和爱尔兰常见的混合物种农场，建议按物种划分 AMU。还建议将高优先级的关键重要抗菌药物与其他抗菌药物分开进行基准测试。没有一种指标是最优的；然而，对于反刍动物，基于日剂量的指标允许进行特定于国家的调整，这可能允许在英国和爱尔兰的农场层面基准测试中达到更高的精度。
