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美国伴侣动物兽医抗菌药物处方实践及抗菌药物使用指南知晓情况的调查

Survey of companion animal veterinarians' antimicrobial drug prescription practices and awareness of antimicrobial drug use guidelines in the United States.

作者信息

Taylor Daniel D, Martin Jennifer N, Scallan Walter Elaine J

机构信息

Colorado School of Public Health, Colorado Integrated Food Safety Center of Excellence, Aurora, Colorado, USA.

College of Agricultural Sciences, Department of Animal Sciences, Colorado State University, Fort Collins, Colorado, USA.

出版信息

Zoonoses Public Health. 2022 Jun;69(4):277-285. doi: 10.1111/zph.12915. Epub 2022 Jan 30.

Abstract

Antimicrobial drug use in companion animal medicine, the subsequent development of antimicrobial resistance and the potential hazard of animals transmitting resistant bacteria to humans are of increasing concern. Antimicrobial prescription patterns among companion animal veterinarians in the United States are understudied, and the association between antimicrobial drug use guideline awareness and antimicrobial drug prescription practices is unknown. Information on antimicrobial recommendations for five hypothetical clinical scenarios, including canine pyoderma, acute canine diarrhoea, feline lower urinary tract illness, canine dental procedures and feline upper respiratory illness, was gathered using an anonymous, online cross-sectional survey. A logistic regression approach was used to assess the association between self-reported awareness of antimicrobial drug use guidelines and prescribing recommendations for the five hypothetical scenarios. Responses (n = 2,410) indicated antimicrobial drugs were commonly recommended for the five hypothetical clinical scenarios. After controlling for key demographic characteristics, prescribers who reported an awareness of existing antimicrobial drug use guidelines were significantly less likely to recommend antimicrobial drugs for the scenarios describing feline lower urinary symptoms, feline upper respiratory illness and canine acute diarrhoea. Results from hypothetical clinical scenarios point to the possibility for widespread unsupported prescribing of antimicrobial drugs in companion animal medicine. Additionally, results provide evidence of an association between awareness of antimicrobial drug use guidelines and lower prescribing levels for certain hypothetical disease presentations.

摘要

伴侣动物医学中抗菌药物的使用、随后出现的抗菌药物耐药性以及动物将耐药菌传播给人类的潜在危害日益受到关注。美国伴侣动物兽医的抗菌药物处方模式研究不足,抗菌药物使用指南意识与抗菌药物处方实践之间的关联尚不清楚。通过一项匿名的在线横断面调查,收集了关于五种假设临床情况的抗菌药物推荐信息,包括犬脓皮病、犬急性腹泻、猫下泌尿道疾病、犬牙科手术和猫上呼吸道疾病。采用逻辑回归方法评估自我报告的抗菌药物使用指南意识与五种假设情况的处方推荐之间的关联。回复(n = 2410)表明,抗菌药物常用于这五种假设的临床情况。在控制关键人口统计学特征后,报告知晓现有抗菌药物使用指南的处方者,对于描述猫下泌尿道症状、猫上呼吸道疾病和犬急性腹泻的情况,推荐使用抗菌药物的可能性显著降低。假设临床情况的结果表明,伴侣动物医学中可能广泛存在无依据使用抗菌药物的情况。此外,结果提供了证据,证明抗菌药物使用指南意识与某些假设疾病表现的较低处方水平之间存在关联。

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