Schrag Nora F D, Godden Sandra M, Apley Michael D, Singer Randall S, Lubbers Brian V
College of Veterinary Medicine, Department of Clinical Sciences Kansas State University, Manhattan, KS, USA.
Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, MN, USA.
Zoonoses Public Health. 2020 Nov;67 Suppl 1:82-93. doi: 10.1111/zph.12773.
This study describes antimicrobial use in terms of standardized regimens per cow year (REG/CY) and grams per cow year (GMS/CY) for 29 dairies in the United States during the years 2016 and 2017. To explore potential priorities for antimicrobial stewardship programs, these measures were stratified by both disease syndrome and antimicrobial class. Potential confounders of use measurements are discussed and challenges for measure interpretation are identified. When measured as REG/CY, the results indicate that mastitis is the disease syndrome with the greatest contribution to overall antimicrobial use. However, when GMS/CY is measured, metritis, lameness and unknown disease syndromes are also significant contributors. When use is stratified by antimicrobial class, measures of REG/CY indicate the greatest magnitude of use is the cephalosporin class. However, when measures of GMS/CY are stratified by drug class, use within the penicillin class contributes more than any other single class. These differences highlight the need for a more complete understanding of the relationship between antimicrobial use measures and their relationship to antimicrobial resistance selection pressure.
本研究描述了2016年和2017年美国29家奶牛场按每头奶牛年标准化用药方案（REG/CY）和每头奶牛年用药克数（GMS/CY）计算的抗菌药物使用情况。为了探索抗菌药物管理计划的潜在重点，这些指标按疾病综合征和抗菌药物类别进行了分层。讨论了用药量度的潜在混杂因素，并确定了量度解释方面的挑战。以REG/CY衡量时，结果表明乳腺炎是对总体抗菌药物使用贡献最大的疾病综合征。然而，以GMS/CY衡量时，子宫内膜炎、跛行和不明疾病综合征也是重要的贡献因素。当按抗菌药物类别进行分层时，REG/CY的量度表明头孢菌素类的使用量最大。然而，当按药物类别对GMS/CY的量度进行分层时，青霉素类药物的使用贡献超过任何其他单一类别。这些差异凸显了更全面了解抗菌药物使用量度及其与抗菌药物耐药性选择压力之间关系的必要性。
