Schrag Nora F D, Apley Michael D, Godden Sandra M, 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 1:69-81. doi: 10.1111/zph.12772.
As stewardship programmes seek to influence therapeutic choices and reduce resistance selection pressure, it is essential to understand the multiple factors which may influence any given antimicrobial use measure. This article compares 9 measures of antimicrobial use pertaining to adult cows in US dairy systems based on treatment records standardized to a single standardized regimen (SReg) format. There are 3 fundamental parameters underlying the nine measures: amount of active substance (AMOUNT), number of SRegs (ANIMALS) and treatment time (TIME). Additionally, three use categories were considered in the analysis: control of mastitis (Dry Cow), treatment of detected mastitis (Clinical Mastitis) and treatment of other diseases (Other Treatment). The assumptions necessary for calculation of each of the nine measures are identified. The influence of measure choice on farm rank was explored at the farm level both within and across fundamental parameters. Across all use categories, when measures of TIME and ANIMALS were compared, correlations between measures were greater than 0.91. However, when measures of AMOUNT were compared to either measures of TIME or ANIMALS, the correlation between measures was more variable across use categories (R = 0.31-0.91). These comparisons demonstrate that the selection of antimicrobial use metric can affect which dairies are considered the highest users of antimicrobials. Measurement selection also influences which use category has the greatest potential for use reduction. This indicates that measure selection can influence which use category is prioritized as a target for reduction of antimicrobial use. Utilization of this information may allow those developing dairy antimicrobial stewardship programmes to better understand the potential effects of measurement selection on driving changes in antimicrobial use.
由于抗菌药物管理计划旨在影响治疗选择并降低耐药性选择压力，因此了解可能影响任何给定抗菌药物使用措施的多种因素至关重要。本文基于标准化为单一标准化方案（SReg）格式的治疗记录，比较了美国奶牛养殖系统中与成年奶牛相关的9种抗菌药物使用措施。这9种措施基于3个基本参数：活性物质用量（AMOUNT）、SReg数量（ANIMALS）和治疗时间（TIME）。此外，分析中考虑了3种使用类别：乳腺炎控制（干奶牛）、已检测到的乳腺炎治疗（临床乳腺炎）和其他疾病治疗（其他治疗）。确定了计算这9种措施中每一种所需的假设。在农场层面，在基本参数内部和之间探讨了措施选择对农场排名的影响。在所有使用类别中，当比较TIME和ANIMALS的措施时，各措施之间的相关性大于0.91。然而，当将AMOUNT的措施与TIME或ANIMALS的措施进行比较时，各措施之间的相关性在不同使用类别中变化更大（R = 0.31 - 0.91）。这些比较表明，抗菌药物使用指标的选择会影响哪些奶牛场被视为抗菌药物的最高使用者。测量选择还会影响哪种使用类别具有最大的使用减少潜力。这表明措施选择可以影响将哪种使用类别作为减少抗菌药物使用的目标进行优先排序。利用这些信息可能会使制定奶牛抗菌药物管理计划的人员更好地了解测量选择对推动抗菌药物使用变化的潜在影响。
