Faculty of Veterinary Medicine, Department of Population Health Sciences, Division Farm Animal Health, Utrecht University, 3584 CL, Utrecht, the Netherlands.
Faculty of Veterinary Medicine, Department of Population Health Sciences, Division Farm Animal Health, Utrecht University, 3584 CL, Utrecht, the Netherlands.
J Dairy Sci. 2021 Aug;104(8):9106-9114. doi: 10.3168/jds.2020-19616. Epub 2021 May 10.
There is increased concern about the selection pressure of antimicrobial use (AMU) in humans as well in farm animals resulting in antimicrobial (AM) resistance. The introduction of monitoring of AMU in food-producing animals since 2011 has led to a considerable quantitative reduction of AMU in those animal species in the Netherlands. This survey was conducted to explore the possibilities to improve prudent use of AM in the cattle industry. We sent an online questionnaire to 373 veterinarians and asked which antimicrobial prophylaxis they used for their most recently performed cesarean section (CS) and left displaced abomasum (LDA) correction. With a response rate of 30%, we found that older graduates used more AM for CS than recently graduated veterinarians (odds ratio = 2.4 to 2.7 depending on category), whereas antimicrobial prophylaxis in LDA surgeries was significantly different for the available surgical correction methods. The results indicate that the respondents do not adjust the surgical antimicrobial prophylaxis for different conditions of the patient or the environment; 37 (38%) respondents consider that the risks of contamination are similar for CS and LDA. In CS and all LDA correction methods preoperative prophylaxis was significantly less often applied than postoperative antimicrobial treatments (odds ratio = 0.05 and 0.08, respectively). When preoperative prophylaxis was applied, the choice of (combinations of) the AM and the timing of administration were not adequate at the start of the surgical procedure (88% for CS and 90% for LDA). We conclude that considerable qualitative (timing, choice of antimicrobial, route of administration) and quantitative (limit AMU to indicated procedures) improvement on antimicrobial prophylaxis for CS and LDA is possible by appreciation of the risks of the type of surgery (CS, LDA) and its conditions as well as by selecting classes of AM and timing and routes of administration that result in effective drug concentrations at the start of the procedure.
人们越来越关注人类和农场动物中抗菌药物使用(AMU)的选择压力,这导致了抗菌药物(AM)耐药性的产生。自 2011 年以来,对食用动物中 AMU 的监测的引入,导致荷兰这些动物物种中的 AMU 数量有了相当大的减少。本调查旨在探讨在奶牛行业中改善谨慎使用 AM 的可能性。我们向 373 名兽医发送了一份在线问卷,询问他们最近进行的剖腹产(CS)和左移位真胃(LDA)矫正手术中使用了哪些抗菌预防措施。我们收到了 30%的回复率,发现较老的毕业生在 CS 中使用的 AM 比最近毕业的兽医多(取决于类别,比值比为 2.4 至 2.7),而 LDA 手术中的抗菌预防措施因可用的手术矫正方法而有显著差异。结果表明,受访者没有根据患者或环境的不同情况调整手术抗菌预防措施;37(38%)名受访者认为 CS 和 LDA 的污染风险相似。在 CS 和所有 LDA 矫正方法中,术前预防用药明显少于术后抗菌治疗(比值比分别为 0.05 和 0.08)。当进行术前预防时,(组合)AM 的选择和给药时间在手术开始时并不合适(CS 为 88%,LDA 为 90%)。我们的结论是,通过了解手术类型(CS、LDA)及其条件的风险,以及通过选择 AM 类别以及开始手术时能够达到有效药物浓度的给药时间和途径,对 CS 和 LDA 的抗菌预防措施进行相当大的定性(时机、选择抗菌药物、给药途径)和定量(将 AMU 限制在指示性程序)的改进是可能的。