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影响印度阿萨姆邦兽医抗生素处方行为及对抗菌素耐药性理解的因素

Factors Influencing Antibiotic Prescribing Behavior and Understanding of Antimicrobial Resistance Among Veterinarians in Assam, India.

作者信息

Eltholth Mahmoud, Govindaraj Gurrappanaidu, Das Banani, Shanabhoga M B, Swamy H M, Thomas Abin, Cole Jennifer, Shome Bibek R, Holmes Mark A, Moran Dominic

机构信息

Global Academy of Agriculture and Food Security, The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Edinburgh, United Kingdom.

Hygiene and Preventive Medicine Department, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt.

出版信息

Front Vet Sci. 2022 Apr 26;9:864813. doi: 10.3389/fvets.2022.864813. eCollection 2022.

Abstract

This study investigates factors influencing veterinarians' antibiotic prescribing behaviors and their understanding of antimicrobial resistance (AMR). The study used a telephone survey of 50 veterinarians conducted in five districts in Assam state, India. The survey sought information on the most prevalent animal diseases, veterinarians' awareness of potential preventive measures, including factors determining antimicrobial prescribing; the types of antimicrobials used for different health conditions in different species, and possible options to reduce antimicrobial use (AMU). The majority (86%) of respondents worked for the government, 98% reported having no written policy for the use of veterinary health products, and 58% have no on-site diagnostic facilities. Ceftriaxone, Enrofloxacin, and Oxytetracycline were the antibiotics (ABX) most frequently prescribed, by 76, 68, and 54% of veterinarians, respectively. These ABX were prescribed mainly for respiratory health problems and mastitis in cattle, and gastrointestinal infections in buffaloes, sheep, goat, and pigs. Severity of clinical symptoms, economic status of the livestock owner, and withdrawal period for ABX were ranked as very important factors for giving ABX. Less than two thirds (64%) were aware of the government ban for Colistin and only 2% were aware of a national plan for AMR. This study highlighted that ABX prescription is mostly based on tentative diagnosis given the lack of diagnostic facilities in most veterinary clinics. There is a need to enhance veterinary healthcare and to improve communication between policy makers and field veterinarians and, importantly, a need to disseminate clear prescribing guidelines on prudent AMU.

摘要

本研究调查了影响兽医抗生素处方行为及其对抗菌素耐药性(AMR)理解的因素。该研究对印度阿萨姆邦五个地区的50名兽医进行了电话调查。调查旨在获取有关最常见动物疾病的信息、兽医对潜在预防措施的认识,包括决定抗菌药物处方的因素;不同物种在不同健康状况下使用的抗菌药物类型,以及减少抗菌药物使用(AMU)的可能选择。大多数(86%)受访者为政府工作,98%的受访者表示没有关于使用兽医保健产品的书面政策,58%的受访者没有现场诊断设施。头孢曲松、恩诺沙星和土霉素是最常被处方的抗生素,分别有76%、68%和54%的兽医使用。这些抗生素主要用于治疗牛的呼吸道健康问题和乳腺炎,以及水牛、绵羊、山羊和猪的胃肠道感染。临床症状的严重程度、牲畜所有者的经济状况以及抗生素的停药期被列为开具抗生素的非常重要的因素。不到三分之二(64%)的人知道政府禁止使用黏菌素,只有2%的人知道国家抗菌素耐药性计划。这项研究强调,由于大多数兽医诊所缺乏诊断设施,抗生素处方大多基于初步诊断。有必要加强兽医保健,改善政策制定者与现场兽医之间的沟通,重要的是,有必要传播关于谨慎使用抗菌药物的明确处方指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bc3/9087579/fadfbe5b0840/fvets-09-864813-g0001.jpg

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