J Am Vet Med Assoc. 2021 Jan 15;258(2):170-178. doi: 10.2460/javma.258.2.170.
Widespread use of antimicrobials in human and veterinary medicine drives the emergence and dissemination of resistant bacteria in human, animal, and environmental reservoirs. The AVMA and FDA Center for Veterinary Medicine have both taken public positions emphasizing the importance of incorporating antimicrobial stewardship in veterinary clinical settings; however, a model for implementing a comprehensive antimicrobial stewardship program in veterinary practice is not readily available. In 2015, The Ohio State University College of Veterinary Medicine began developing a veterinary antimicrobial stewardship program modeled on existing programs in human health-care institutions and the 7 core elements of a successful hospital antimicrobial stewardship program, as defined by the CDC. The program includes comprehensive antimicrobial use guidelines, active environmental surveillance, and enhanced infection control procedures in The Ohio State University Veterinary Medical Center, along with routine monitoring and reporting of antimicrobial prescribing practices and antimicrobial susceptibility patterns of common pathogens isolated from patients and the hospital environment. Finally, programs have been developed to educate clinicians, staff, and students on antimicrobial resistance and appropriate antimicrobial prescribing practices. The antimicrobial stewardship program has been designed to help clinicians and students confidently make judicious antimicrobial use decisions and provide them with actionable steps that can help them act as strong stewards while providing the best care for their patients. This report describes our program and the process involved in developing it, with the intent that the program could serve as a potential model for other veterinary medical institutions.
在人类和兽医医学中广泛使用抗生素会促使耐药细菌在人类、动物和环境储库中出现和传播。美国兽医协会和 FDA 兽医医学中心都采取了公开立场，强调在兽医临床环境中纳入抗菌药物管理的重要性；然而，在兽医实践中实施全面的抗菌药物管理计划的模式并不容易获得。2015 年，俄亥俄州立大学兽医学院开始开发一种兽医抗菌药物管理计划，该计划以现有的人类医疗机构和疾病预防控制中心定义的成功医院抗菌药物管理计划的 7 个核心要素为模型。该计划包括俄亥俄州立大学兽医学院的综合抗菌药物使用指南、积极的环境监测以及加强感染控制程序，以及对从患者和医院环境中分离出的常见病原体的抗菌药物处方实践和抗菌药物敏感性模式进行常规监测和报告。最后，还制定了计划来教育临床医生、工作人员和学生对抗菌药物耐药性和适当的抗菌药物处方实践。抗菌药物管理计划旨在帮助临床医生和学生有信心地做出明智的抗菌药物使用决策，并为他们提供可操作的步骤，帮助他们在为患者提供最佳护理的同时，成为强有力的管理者。本报告介绍了我们的计划以及制定该计划所涉及的过程，希望该计划可以作为其他兽医医疗机构的潜在模式。
