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一项针对诊断为细菌性尿路感染的猫的抗菌处方的多中心研究。

A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease.

机构信息

Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada.

出版信息

J Feline Med Surg. 2022 Aug;24(8):806-814. doi: 10.1177/1098612X211054815. Epub 2021 Oct 28.

Abstract

OBJECTIVES

The aim of this study was to evaluate initial antimicrobial therapy in cats diagnosed with upper or lower bacterial urinary tract infections at veterinary practices in the USA and Canada.

METHODS

Electronic medical records from a veterinary practice corporation with clinics in the USA and Canada were queried between 2 January 2016 and 3 December 2018. Feline patient visits with a diagnosis field entry of urinary tract infection, cystitis and pyelonephritis, as well as variation of those names and more colloquial diagnoses such as kidney and bladder infection, and where an antimicrobial was prescribed, were retrieved.

RESULTS

Prescription data for 5724 visits were identified. Sporadic cystitis was the most common diagnosis (n = 5051 [88%]), with 491 (8.6%) cats diagnosed with pyelonephritis and 182 (3.2%) with chronic or recurrent cystitis. Cefovecin was the most commonly prescribed antimicrobial for all conditions, followed by amoxicillin-clavulanic acid. Significant differences in antimicrobial drug class prescribing were noted between practice types and countries, and over the 3-year study period. For sporadic cystitis, prescription of amoxicillin-clavulanic acid increased significantly and cefovecin decreased between 2016 and 2018, and 2017 and 2018, while fluoroquinolone use increased between 2017 and 2018.

CONCLUSIONS AND RELEVANCE

The results indicate targets for intervention and some encouraging trends. Understanding how antimicrobials are used is a key component of antimicrobial stewardship and is required to establish benchmarks, identify areas for improvement, aid in the development of interventions and evaluate the impact of interventions or other changes.

摘要

目的

本研究旨在评估美国和加拿大兽医诊所中诊断为上尿路感染或下尿路感染的猫的初始抗菌治疗。

方法

检索了一家在美国和加拿大设有诊所的兽医实践公司的电子病历,检索时间为 2016 年 1 月 2 日至 2018 年 12 月 3 日。检索的猫就诊记录包括诊断字段为尿路感染、膀胱炎和肾盂肾炎的记录,以及这些名称的变体,或更通俗的诊断,如肾脏和膀胱感染,以及开了抗菌药物的记录。

结果

确定了 5724 次就诊的处方数据。散发性膀胱炎是最常见的诊断(n=5051 [88%]),491 例(8.6%)猫诊断为肾盂肾炎,182 例(3.2%)为慢性或复发性膀胱炎。头孢噻肟是所有疾病中最常开的抗菌药物,其次是阿莫西林克拉维酸。不同类型的诊所和国家在抗菌药物种类的处方上存在显著差异,且在 3 年的研究期间存在差异。对于散发性膀胱炎,阿莫西林克拉维酸的处方量在 2016 年至 2018 年以及 2017 年至 2018 年期间显著增加,头孢噻肟的处方量减少,而氟喹诺酮类药物的使用在 2017 年至 2018 年期间增加。

结论

结果表明存在干预的目标和一些令人鼓舞的趋势。了解抗菌药物的使用情况是抗菌药物管理的关键组成部分,需要建立基准,确定需要改进的领域,为干预措施的制定提供帮助,并评估干预措施或其他变化的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a7/10812280/b172a472d10a/10.1177_1098612X211054815-fig1.jpg

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