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南非茨瓦内市兽医的抗生素处方行为及对抗微生物药物使用的态度

Antibiotic prescription practices and attitudes towards the use of antimicrobials among veterinarians in the City of Tshwane, South Africa.

作者信息

Samuels Ronita, Qekwana Daniel Nenene, Oguttu James W, Odoi Agricola

机构信息

Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA.

Section of Veterinary Public Health, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.

出版信息

PeerJ. 2021 Jan 13;9:e10144. doi: 10.7717/peerj.10144. eCollection 2021.

DOI:10.7717/peerj.10144
PMID:33520429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7811296/
Abstract

BACKGROUND

Understanding the prescription practices and attitudes of veterinarians towards antimicrobial resistance (AMR) is crucial in guiding efforts to curb AMR. This study investigated prescription practices and attitudes towards AMR among veterinarians in the City of Tshwane, South Africa.

METHODS

Out of the 83 veterinarians invited to participate in the study, 54 signed the consent form and completed the questionnaire. Percentages and 95% confidence intervals of all categorical variables were computed. A multinomial logistic model was used to identify predictors of the veterinarians' view towards antimicrobial use.

RESULTS

The majority (88%) of respondents indicated that improper use of antimicrobials contributed to selection for AMR. Veterinarians relied on clinical signs and symptoms (88%, 48/54) to decide whether to prescribe antimicrobials or not. However, the choice of antimicrobials depended on the cost of antibiotics (77.2%), route of administration (81.5%), and risk of potential adverse reactions (79.6%; 43/54). Many (61.5%) veterinarians were of the view that often antimicrobials are appropriately prescribed and 88.7% agreed that improper use of antimicrobials contributed to selection for antimicrobial resistant organisms. Compared to females, males were significantly more likely (Relative Risk Ratio (RRR) = 9.0; = 0.0069) to agree rather than to "neither agree nor disagree" that their colleagues over-prescribed antimicrobials.

CONCLUSIONS

The decisions to prescribe antimicrobials by the veterinarians depended on clinical presentation of the patient, while the choice of antimicrobial depended on cost, route of administration, and risk of potential adverse reactions. Most veterinarians were of the view that antimicrobials were prescribed judiciously.

摘要

背景

了解兽医对抗菌素耐药性(AMR)的处方习惯和态度对于指导遏制AMR的工作至关重要。本研究调查了南非茨瓦内市兽医的处方习惯和对AMR的态度。

方法

在受邀参与研究的83名兽医中,54人签署了同意书并完成了问卷。计算了所有分类变量的百分比和95%置信区间。使用多项逻辑模型来确定兽医对抗菌素使用看法的预测因素。

结果

大多数(88%)受访者表示,抗菌药物的不当使用导致了AMR的选择。兽医依靠临床症状和体征(88%,48/54)来决定是否开具抗菌药物。然而,抗菌药物的选择取决于抗生素的成本(77.2%)、给药途径(81.5%)和潜在不良反应的风险(79.6%;43/54)。许多(61.5%)兽医认为抗菌药物经常被合理处方,88.7%的人同意抗菌药物的不当使用导致了抗菌耐药菌的选择。与女性相比,男性更有可能(相对风险比(RRR)=9.0; =0.0069)同意其同事过度开具抗菌药物,而不是“既不同意也不反对”。

结论

兽医开具抗菌药物的决定取决于患者的临床表现,而抗菌药物的选择取决于成本、给药途径和潜在不良反应的风险。大多数兽医认为抗菌药物的处方是明智的。