Valiakos George, Pavlidou Eleni, Zafeiridis Christos, Tsokana Constantina N, Del Rio Vilas Victor J
Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece.
Centre for Universal Health, Chatham House, London, UK.
One Health Outlook. 2020 May 18;2:7. doi: 10.1186/s42522-020-00013-8. eCollection 2020.
The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece.
A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics.
The majority of practitioners report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents initiate empirical treatment while waiting for laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections.
Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.
抗生素的不当使用是希腊临床实践中的一个主要问题，对公共卫生和动物健康有着严重影响。本研究的目的是初步了解希腊小动物从业者对抗生素的使用情况，并评估他们对合理使用抗生素一般规则的遵守情况。这是希腊首次此类调查。
设计了一份问卷，以收集宠物兽医使用抗生素的基本信息。问卷共发送给70名主要在阿提卡地区执业的兽医，该地区人口几乎占希腊总人口的50%，且这些兽医仅从事小动物诊疗工作。问卷由37个关于抗生素使用各方面的封闭式问题组成。
大多数从业者报告称存在宠物主人在没有兽医处方的情况下自行开始抗生素治疗的情况。几乎每位临床医生都报告了主人依从性方面的挑战。关于微生物分析，73%的受访者在等待实验室结果时开始经验性治疗，或者仅在治疗不成功时才使用药敏试验结果。88%的受访者宣称在清洁手术术后使用抗菌药物。对于不同器官系统的感染，如泌尿系统和胃肠道感染，人们倾向于使用与抗生素合理使用指南建议不同类型的抗菌药物和治疗时长。
我们的研究结果表明，希腊需要制定小动物诊疗中抗生素使用的指南，并开展对抗菌药物使用和耐药性的系统监测，以便根据当地抗菌药物耐药情况为抗生素的初始选择提供依据。针对问题的另一端，即宠物主人，我们的研究结果表明有必要对他们进行抗生素合理使用方面的教育，关键是要停止无处方提供抗生素的行为。
