Facultad de Medicina Veterinaria y Zootecnia, Universidad Central del Ecuador, Quito 170103, Ecuador; Department of Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
School of Psychology, Faculty of Health and Medical Sciences, Stag Hill Campus, University of Surrey, GU2 7XH Guildford, United Kingdom.
Prev Vet Med. 2023 Apr;213:105858. doi: 10.1016/j.prevetmed.2023.105858. Epub 2023 Jan 23.
Understanding antibiotic prescription patterns and non-clinical factors influencing antibiotic use is essential for implementing strategies to promote appropriate antibiotic use. There is, however, limited research exploring these issues with Ecuadorian veterinarians. Therefore, a questionnaire was developed and applied cross-sectionally to veterinarians (n = 173) from two professional organizations to explore the antibiotic prescription patterns and non-clinical factors (e.g., attitudes and perceptions) influencing antibiotic use, and to identify strategies to reduce antibiotic use. The response rate was 78.4%. Responses were compared between veterinarians working mainly on cattle and poultry farms using Mann-Whitney U tests. The most important attitudes, beliefs and perceptions towards antimicrobial resistance (AMR) and antibiotic use were identified with the Relative Importance Index (RII). Veterinarians showed high awareness of AMR and its implications for public health, as well as the necessity of reducing antibiotic use. However, some veterinarians appear to underestimate the potential contribution of veterinary antibiotic use on AMR in humans. Veterinarians self-reported high prescription (> 20%) of antibiotics for cattle and poultry that are critically important for human medicine, such as 3rd and 4th generation cephalosporins, polymyxins and quinolones. Further, antibiotic therapy was not tailored to disease type. Cattle and poultry veterinarians perceived similar barriers to increasing antibiotic stewardship including: poor biosecurity measures, animal confinement, low feed quality, farmers' behaviors (such as stopping antibiotic treatment, storing antibiotics on farms, buying antibiotics in veterinary supply stores), and sales agents' roles as non-professional prescribers of antibiotics. Overall, veterinarians were broadly supportive (>90%) of most strategies to promote appropriate antibiotic use. They saw more merit in improving biosecurity of farms and implementing educational programs for farmers and veterinarians. This study provides insight into the complexity of antibiotic use on Ecuadorian farms and the need for holistic strategies in a One Health context, to achieve antibiotic stewardship.
了解抗生素处方模式和影响抗生素使用的非临床因素对于实施促进合理使用抗生素的策略至关重要。然而，关于厄瓜多尔兽医的相关研究有限。因此，开发了一份问卷，并在两个专业组织中对兽医（n=173）进行了横断面调查，以探讨影响抗生素使用的抗生素处方模式和非临床因素（例如态度和看法），并确定减少抗生素使用的策略。回应率为 78.4%。使用曼-惠特尼 U 检验比较了主要在牛和家禽养殖场工作的兽医之间的回答。使用相对重要性指数（RII）确定了对抗生素耐药性（AMR）和抗生素使用最重要的态度、信念和看法。兽医对 AMR 及其对公共卫生的影响以及减少抗生素使用的必要性有很高的认识。然而，一些兽医似乎低估了兽医抗生素使用对人类 AMR 的潜在贡献。兽医自我报告对牛和家禽的抗生素处方率较高（>20%），这些抗生素对人类医学至关重要，如第三代和第四代头孢菌素、多黏菌素和喹诺酮类药物。此外，抗生素治疗并未根据疾病类型进行调整。牛和家禽兽医认为，增加抗生素管理的障碍相似，包括：生物安全措施差、动物圈养、饲料质量低、农民行为（如停止抗生素治疗、在农场储存抗生素、在兽医供应店购买抗生素）以及销售代理作为非专业抗生素开方者的角色。总体而言，兽医普遍支持（>90%）促进合理使用抗生素的大多数策略。他们认为改善农场的生物安全和为农民和兽医实施教育计划更有价值。这项研究深入了解了厄瓜多尔农场抗生素使用的复杂性以及在一个“同一健康”背景下实施全面策略以实现抗生素管理的必要性。
