Becker Stuart D, Hughes David M
Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom.
Pathobiology and Population Sciences, The Royal Veterinary College, Hertfordshire, United Kingdom.
Front Vet Sci. 2024 Feb 19;11:1358535. doi: 10.3389/fvets.2024.1358535. eCollection 2024.
Various factors including body weight-associated treatment cost may influence the probability of dispensing antibiotics to dogs in first-opinion practice, but their effect on specific drug choice remains unclear.
Multiple membership regression modeling was used to investigate the probability of dispensing 12 different antibiotics to dogs of different weights in the context of various disease presentations, using anonymized data obtained from electronic health records of 18 clinics between 2020 and 2022. Data from 14,259 dogs were analyzed.
Treatment choice varied significantly with animal weight. Higher body weight was associated with an increased likelihood of dispensing lower cost antimicrobials such as amoxicillin and trimethoprim sulfonamide, while use of higher cost antimicrobials such as cefovecin was strongly biased to smaller animals. However, these effects were limited when restricted treatment options were available for the target condition.
This work demonstrates that anticipated financial costs may result in different treatment choices for canine patients depending on their body weight. Further work is needed to understand the impact of financial pressures on veterinarians' treatment choices, and the implications for the optimization of antimicrobial stewardship in first opinion practice.
包括与体重相关的治疗成本在内的各种因素可能会影响在初诊医疗中给狗使用抗生素的可能性,但其对具体药物选择的影响仍不明确。
利用2020年至2022年期间从18家诊所的电子健康记录中获取的匿名数据,采用多重成员回归模型研究在各种疾病表现情况下,给不同体重的狗使用12种不同抗生素的可能性。对14259只狗的数据进行了分析。
治疗选择因动物体重而有显著差异。体重较高与使用成本较低的抗菌药物(如阿莫西林和甲氧苄啶磺胺)的可能性增加相关,而使用成本较高的抗菌药物(如头孢维星)则强烈倾向于体型较小的动物。然而,当针对目标病症的治疗选择有限时,这些影响是有限的。
这项研究表明,预期的财务成本可能会导致根据犬类患者的体重做出不同的治疗选择。需要进一步开展工作,以了解财务压力对兽医治疗选择的影响,以及对初诊医疗中抗菌药物管理优化的影响。