Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
J Am Vet Med Assoc. 2022 May 21;260(S2):S21-S27. doi: 10.2460/javma.21.03.0123.
To describe patterns of antimicrobial prescriptions for sporadic urinary tract infections (UTIs) in dogs in the United States from 2010 through 2019, including times before and after publication of International Society for Companion Animal Infectious Disease (ISCAID) guidelines.
461,244 qualifying visits for sporadic UTIs.
Veterinary electronic medical records of a private corporation consisting of > 1,000 clinics across the United States were examined to identify canine visits for potential sporadic UTI between January 1, 2010, and December 31, 2019. Proportions of antimicrobial prescriptions were graphed by month and year to identify changes in prescription patterns over time. Interrupted time series analysis was performed for the aminopenicillins.
A total of 461,244 qualifying visits were examined, with 389,949 (85%) of these resulting in at least 1 antimicrobial prescription. Over the 10-year period, the proportion of visits resulting in no antimicrobial prescription increased (14% in 2010 to 19.7% in 2019). Proportions of prescriptions for amoxicillin (38% to 48%) and amoxicillin-clavulanic acid (2.5% to 10%) also increased. Log-linear regression supported that changes in proportions of amoxicillin and amoxicillin-clavulanic acid prescriptions occurred following the 2011 ISCAID guidelines publication, with the proportion of amoxicillin prescriptions increasing by 13% per year (95% CI, 12% to 14%; P < 0.01) and the proportion of amoxicillin-clavulanic acid prescriptions increasing by 0.5% per year (95% CI, 0.2% to 0.8%; P < 0.01). Use of fluoroquinolones and third-generation cephalosporins remained constant.
Results suggest that efforts to guide antimicrobial use in veterinary clinical practice are having positive effects in this private veterinary company, though continued efforts are warranted.
描述 2010 年至 2019 年期间美国散发性尿路感染（UTI）犬用抗菌药物处方模式，包括国际伴侣动物传染病学会（ISCAID）指南发布前后的情况。
461244 例符合条件的散发性 UTI 就诊。
对一家由美国 1000 多家诊所组成的私营公司的兽医电子病历进行了检查，以确定 2010 年 1 月 1 日至 2019 年 12 月 31 日期间犬只患散发性 UTI 的就诊情况。按月和年绘制抗菌药物处方比例图，以确定随时间推移处方模式的变化。对氨基青霉素类药物进行了中断时间序列分析。
共检查了 461244 例符合条件的就诊，其中 389949 例（85%）至少开出了 1 种抗菌药物处方。在 10 年期间，未开具抗菌药物处方的就诊比例增加（2010 年为 14%，2019 年为 19.7%）。阿莫西林（38%至 48%）和阿莫西林克拉维酸（2.5%至 10%）的处方比例也有所增加。对数线性回归支持在 2011 年 ISCAID 指南发布后，阿莫西林和阿莫西林克拉维酸处方比例的变化，阿莫西林处方比例每年增加 13%（95%CI，12%至 14%；P <0.01），阿莫西林克拉维酸处方比例每年增加 0.5%（95%CI，0.2%至 0.8%；P <0.01）。氟喹诺酮类和第三代头孢菌素的使用保持不变。
结果表明，在这家私营兽医公司，指导兽医临床实践中抗菌药物使用的努力正在产生积极影响，但仍需继续努力。
