Vernaccini Matilde, De Marchi Lucia, Briganti Angela, Lippi Ilaria, Marchetti Veronica, Meucci Valentina, Intorre Luigi
Veterinary Teaching Hospital, Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy.
Antibiotics (Basel). 2024 Sep 27;13(10):927. doi: 10.3390/antibiotics13100927.
Monitoring antimicrobial use is crucial for understanding current prescribing practices. Such information helps in establishing stewardship programs for effectively using antimicrobials and combating resistance to them. This study describes how antimicrobials are prescribed at the Veterinary Teaching Hospital of the University of Pisa and compares how the internal medicine and intensive care units differ in their usage of antimicrobials. The study involved cats that were presented in the units in 2021 and 2022. Antimicrobial prescriptions were obtained via the hospital's management software (OCIROE). In a population of 1164 non-surgical cats with 397 antimicrobials prescribed, the most prescribed ones were amoxicillin-clavulanic acid in the internal medicine unit and ampicillin in the intensive care unit. Twenty-five percent of all antimicrobials were Highest-Priority Critically Important Antimicrobials or Antimicrobial Advice Ad Hoc Expert Group Category B. The oral route was the main route of administration in the internal medicine unit, while parenteral was the most common route used in the intensive care unit. Most antimicrobials were prescribed to treat pathologic conditions affecting the urinary (39%), gastroenteric (21%), respiratory (13%), and integumentary (12%) systems. A diagnosis, accurate dosage, and the use of species-approved medications were recorded in the antimicrobial prescriptions. However, only 11% of these prescriptions were supported by antimicrobial susceptibility tests. These results suggest room for improvement, particularly in increasing the use of antimicrobial susceptibility testing to ensure more targeted antimicrobial therapy. Given the importance of antimicrobial resistance and the One Health approach, the study also highlights the need to consider the broader impact of antimicrobial use in animals, including the potential contribution to resistance in bacteria that affect both animal and human health.
监测抗菌药物的使用对于了解当前的处方实践至关重要。此类信息有助于建立管理计划，以有效使用抗菌药物并对抗其耐药性。本研究描述了比萨大学兽医教学医院抗菌药物的处方方式，并比较了内科和重症监护病房在抗菌药物使用方面的差异。该研究涉及2021年和2022年在这些科室就诊的猫。抗菌药物处方通过医院的管理软件（OCIROE）获取。在1164只非手术猫的群体中，开出了397份抗菌药物处方，内科开出最多的是阿莫西林-克拉维酸，重症监护病房开出最多的是氨苄西林。所有抗菌药物中有25%是最高优先级的 critically important抗菌药物或抗菌药物临时专家建议小组B类。口服途径是内科的主要给药途径，而肠外途径是重症监护病房最常用的途径。大多数抗菌药物被开用于治疗影响泌尿（39%）、胃肠（21%）、呼吸（13%）和皮肤（12%）系统的病理状况。抗菌药物处方中记录了诊断、准确剂量和使用物种批准的药物。然而，这些处方中只有11%有抗菌药物敏感性测试的支持。这些结果表明仍有改进空间，特别是在增加抗菌药物敏感性测试的使用以确保更有针对性的抗菌治疗方面。鉴于抗菌药物耐药性的重要性和“同一健康”方法，该研究还强调需要考虑动物抗菌药物使用的更广泛影响，包括对影响动物和人类健康的细菌耐药性的潜在贡献。
