Division of Small Animal Internal Medicine, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
J Vet Intern Med. 2020 Nov;34(6):2418-2431. doi: 10.1111/jvim.15906. Epub 2020 Oct 28.
Antimicrobial stewardship programs (ASPs) are important tools to foster prudent antimicrobial use.
To evaluate antimicrobial prescriptions by Swiss veterinarians before and after introduction of the online ASP AntibioticScout.ch in December 2016.
Dogs presented to 2 university hospitals and 14 private practices in 2016 or 2018 for acute diarrhea (AD; n = 779), urinary tract infection (UTI; n = 505), respiratory tract infection (RTI; n = 580), or wound infection (WI; n = 341).
Retrospective study. Prescriptions of antimicrobials in 2016 and 2018 were compared and their appropriateness assessed by a justification score.
The proportion of dogs prescribed antimicrobials decreased significantly between 2016 and 2018 (74% vs 59%; P < .001). The proportion of prescriptions in complete agreement with guidelines increased significantly (48% vs 60%; P < .001) and those in complete disagreement significantly decreased (38% vs 24%; P < .001) during this time. Antimicrobial prescriptions for dogs with AD were significantly correlated with the presence of hemorrhagic diarrhea in both years, but a significantly lower proportion of dogs with hemorrhagic diarrhea were unnecessarily prescribed antimicrobials in 2018 (65% vs 36%; P < .001). In private practices, in 2018 a bacterial etiology of UTI was confirmed in 16% of dogs. Prescriptions for fluoroquinolones significantly decreased (29% vs 14%; P = .002). Prescriptions for antimicrobials decreased significantly in private practices for RTI (54% vs 31%; P < .001).
Antimicrobials were used more prudently for the examined indications in 2018 compared to 2016. The study highlights the continued need for ASPs in veterinary medicine.
抗菌药物管理计划（ASPs）是促进合理使用抗菌药物的重要工具。
评估 2016 年 12 月在线 ASP AntibioticScout.ch 引入前后瑞士兽医对抗菌药物的处方。
2016 年或 2018 年，779 只急性腹泻（AD）、505 只尿路感染（UTI）、580 只呼吸道感染（RTI）和 341 只伤口感染（WI）犬就诊于 2 所大学医院和 14 家私人诊所。
回顾性研究。比较 2016 年和 2018 年的抗菌药物处方，并通过合理性评分评估其适宜性。
2016 年至 2018 年，接受抗菌药物治疗的犬的比例显著下降（74%比 59%；P < .001）。与指南完全一致的处方比例显著增加（48%比 60%；P < .001），而完全不一致的处方比例显著减少（38%比 24%；P < .001）。在这两年中，AD 犬的抗菌药物处方与出血性腹泻的存在显著相关，但 2018 年出血性腹泻犬不必要使用抗菌药物的比例显著降低（65%比 36%；P < .001）。在私人诊所中，2018 年 UTI 的细菌病因在 16%的犬中得到确认。氟喹诺酮类药物的处方显著减少（29%比 14%；P =.002）。RTI 的私人诊所中，抗菌药物的处方显著减少（54%比 31%；P < .001）。
与 2016 年相比，2018 年针对上述检查指征使用抗菌药物更为谨慎。本研究强调了兽医领域继续需要 ASP 的必要性。
