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印度宠物从业者关于抗菌药物的态度、意见及工作偏好调查

Attitude, Opinions, and Working Preferences Survey among Pet Practitioners Relating to Antimicrobials in India.

作者信息

Grakh Kushal, Mittal Dinesh, Kumar Tarun, Thakur Swati, Panwar Diksha, Singh Lokender, Kumar Manesh, Jindal Naresh

机构信息

Department of Veterinary Public Health and Epidemiology, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar 125004, India.

Department of Veterinary Clinical Complex (VCC), Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar 125004, India.

出版信息

Antibiotics (Basel). 2022 Sep 22;11(10):1289. doi: 10.3390/antibiotics11101289.

DOI:10.3390/antibiotics11101289
PMID:36289947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9599001/
Abstract

The indiscriminate usage and overuse of antimicrobials in pets or companion animals are underlying causes of antimicrobial resistance (AMR). Despite the multi-faceted global challenge presented by antimicrobial resistance, very few studies have appraised pet practitioners' factors, such as written policy on antimicrobials, dose rate prescribed, use of critically important antimicrobials, and antimicrobial prescription in clean surgical procedures, which can contribute to AMR. In the present study, an online cross-sectional survey among randomly selected pet practitioners ( = 104) of various Indian provinces and union territories was conducted using a questionnaire comprising 33 closed-ended questions on different parameters, viz., the dosage regimen and level of compliance towards guidelines of the World Health Organization (WHO), other relevant veterinary associations, and their opinion while prescribing antimicrobials. Almost every practitioner of the 104 respondents had revealed the difficulties with owner compliance; i.e., incomplete course of the antibiotics, inappropriate follow-ups, and improper care of the sick animals. The majority of practitioners (95%) reported self-prescription of antimicrobials by the owner before presenting the pet(s) to the veterinary clinic, whereas more than half of the respondents (64%) revealed unavailability of antibiogram facilities. Furthermore, a large number (76%) of practitioners stated empirical treatment based on their experience as the main criteria for antimicrobial choice in the absence of timely results from the laboratory. Although non-necessitated use of antimicrobials in clean surgical procedures has been claimed, surprisingly, the majority of pet practitioners (97%) reported their use to reduce the post-operative complications. The use of the highest priority, critically important antimicrobials (HPCIA) listed by the WHO for humans, particularly quinolones and third-generation cephalosporin, also has been reported for different infections. The treatment durations were nearly as per the recommended guidelines issued by the Danish Small Animal Veterinary Association (DSAVA) for different ailments. Analysis using chi-square tests exhibited a significant correlation between less experienced veterinarians (less than 5 years) and prescription of antimicrobials restricted for critically important infections in human medicine. However, there seems to be no association between the experience of the practitioner and the further studied parameters, namely, antimicrobial regimen prescription, weighing the animals before prescription, dose rate calculation, and antimicrobial selection and use after clean surgical operations. The findings suggest periodic awareness campaigns among practitioners regarding the implementation of the official guidelines, the need for systematic surveillance of AMR, awareness among pet owners about antimicrobial resistance, and the importance of rational use of antimicrobials on their pets.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ee6/9599001/9cae9b14eb84/antibiotics-11-01289-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ee6/9599001/9cae9b14eb84/antibiotics-11-01289-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ee6/9599001/9cae9b14eb84/antibiotics-11-01289-g001.jpg
摘要

宠物或伴侣动物中抗菌药物的滥用和过度使用是抗菌药物耐药性(AMR)的根本原因。尽管抗菌药物耐药性带来了多方面的全球挑战,但很少有研究评估宠物从业者的一些因素,如抗菌药物书面政策、规定的剂量率、重要抗菌药物的使用以及清洁手术程序中的抗菌药物处方,这些因素可能导致抗菌药物耐药性。在本研究中,使用一份包含33个关于不同参数的封闭式问题的问卷,对印度各邦和联邦属地随机抽取的104名宠物从业者进行了在线横断面调查,这些参数包括给药方案以及对世界卫生组织(WHO)、其他相关兽医协会指南的遵守程度,以及他们在开具抗菌药物时的意见。在104名受访者中,几乎每位从业者都提到了主人依从性方面的困难,即抗生素疗程不完整、随访不当以及对患病动物护理不当。大多数从业者(95%)报告称,主人在将宠物送到兽医诊所之前会自行开具抗菌药物,而超过一半的受访者(64%)表示没有药敏试验设施。此外,大量从业者(76%)表示,在实验室未能及时给出结果的情况下,根据经验进行经验性治疗是选择抗菌药物的主要标准。尽管有人声称在清洁手术程序中不必要使用抗菌药物,但令人惊讶的是,大多数宠物从业者(97%)报告称使用抗菌药物是为了减少术后并发症。也有报告称,针对不同感染使用了世界卫生组织列出的人类最高优先级、重要抗菌药物(HPCIA),特别是喹诺酮类和第三代头孢菌素。治疗持续时间几乎符合丹麦小动物兽医协会(DSAVA)针对不同疾病发布的推荐指南。使用卡方检验进行分析显示,经验不足(少于5年)的兽医与开具用于治疗人类重要感染的受限抗菌药物之间存在显著相关性。然而,从业者的经验与进一步研究的参数之间似乎没有关联,这些参数包括抗菌药物方案处方、处方前对动物称重、剂量率计算以及清洁手术后抗菌药物的选择和使用。研究结果表明,应定期对从业者开展宣传活动,内容包括官方指南的实施、对抗菌药物耐药性进行系统监测的必要性、提高宠物主人对抗菌药物耐药性的认识以及合理使用宠物抗菌药物的重要性。

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