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[瑞士马兽医抗生素使用情况调查]

[Survey on the use of antibiotics among Swiss equine veterinarians].

作者信息

Kunz T, Torgerson P R, Schoster A

机构信息

Pferdeklinik, Vetsuisse-Fakultät, Universität Zürich.

Abteilung Epidemiologie, Vetsuisse-Fakultät , Universität Zürich.

出版信息

Schweiz Arch Tierheilkd. 2023 Feb;165(2):105-0. doi: 10.17236/sat00384.

Abstract

The aim of this study was to evaluate the current use of antibiotics by Swiss equine veterinarians and to compare the results with a similar study from 2013 before the introduction of the web tool Antibiotic Scout. The survey was sent to equine veterinarians according to the member database of the Swiss Veterinary Association (GST, SVS). The demographic data of the respondents and their antibiotics usage were collected. In addition, six different case scenarios were presented with questions to their potential antibiotic usage, active substance/preparation and the dosing scheme. The dosage provided was compared with the dosage information approved by Swissmedic in the information for healthcare professionals and the recommendations of the antibiotic scout. A backward logistic regression analysis was performed to assess the association between different aspects of antibiotic use and demographic data. The response rate was 94/739 (13 %), 22 of the 94 (23 %) had also participated in the 2013 study. 47/94 (50 %) of the respondents obtained their information from the antibiotic scout. The respondents indicated that they used an antibiotic in 16 %-88 % depending on the case scenario. Neither 3rd nor 4th generation cephalosporins or fluoroquinolones were used in the case scenarios. Dihydrostreptomycin was indicated as a possible antibiotic in a case scenario by 14/94 (15 %) of the respondents. Respondents who had already taken part in the 2013 survey used dihydrostreptomycin significantly more frequently (7/22, 32 % vs. 7/72, 10 %; p = 0,047). 29/81 (36 %) had underdosed compared to the prescribing information and 38/81 (47 %) compared to the antibiotic scout; neither was associated with demographic data. The use of non-equine-licensed antimicrobial products was directly related to the number of veterinarians in the practice (p = 0,007) and to the percentage of horses (p = 0,02). No association between demographics and peri-operative antibiotic use >24h (17/44, 39 %) was detected. The antibiotic prescribing habits of Swiss equine veterinarians have improved over the last 10 years. The antibiotic use decreased compared to the study of Schwechler et al. in 2013 by 0-16 % depending on the case scenario. The use of 3rd and 4th generation cephalosporins was reduced by 4 % and fluoroquinolones by 7 %. Underdosing according to scientific recommendations was reduced by 32 %. Furthermore, there is a need for additional information regarding the indication for antimicrobial use and the adequate use of perioperative antibiotics.

摘要

本研究的目的是评估瑞士马兽医目前对抗生素的使用情况,并将结果与2013年在网络工具“抗生素 Scout”推出之前进行的一项类似研究进行比较。根据瑞士兽医协会(GST,SVS)的会员数据库,向马兽医发送了调查问卷。收集了受访者的人口统计学数据及其抗生素使用情况。此外,还提出了六种不同的病例场景,并询问他们潜在的抗生素使用情况、活性物质/制剂和给药方案。将提供的剂量与瑞士药品监管局在医疗专业人员信息中批准的剂量信息以及抗生素 Scout 的建议进行比较。进行了向后逻辑回归分析,以评估抗生素使用的不同方面与人口统计学数据之间的关联。回复率为94/739(13%),94名受访者中有22名(23%)也参与了2013年的研究。47/94(50%)的受访者从抗生素 Scout 获得信息。受访者表示,根据病例场景,他们使用抗生素的比例在16%至88%之间。在病例场景中,第三代和第四代头孢菌素或氟喹诺酮类药物均未被使用。14/94(15%)的受访者指出双氢链霉素是病例场景中一种可能的抗生素。已经参加2013年调查的受访者使用双氢链霉素的频率明显更高(7/22,32%对7/72,10%;p = 0.047)。与处方信息相比,29/81(36%)的剂量不足,与抗生素 Scout 相比,38/81(47%)的剂量不足;两者均与人口统计学数据无关。使用非马用许可抗菌产品与诊所中的兽医数量直接相关(p = 0.007),与马匹的百分比也直接相关(p = 0.02)。未检测到人口统计学与术后抗生素使用>24小时(17/44,39%)之间的关联。在过去10年中,瑞士马兽医的抗生素处方习惯有所改善。与Schwechler等人2013年的研究相比,根据病例场景,抗生素使用减少了0%至16%。第三代和第四代头孢菌素的使用减少了4%,氟喹诺酮类药物的使用减少了7%。根据科学建议的剂量不足情况减少了32%。此外,还需要关于抗菌药物使用指征和围手术期抗生素合理使用的更多信息。

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