Ljungquist Ditte, Andersson Anna-Maria, Johansson Emelia, Tham Johan, Toresson Linda
Department of Translational Medicine, Lund University, Lund, Sweden.
IVC Evidensia, Bristol, United Kingdom.
Front Vet Sci. 2024 Dec 18;11:1506106. doi: 10.3389/fvets.2024.1506106. eCollection 2024.
Canine gastroenteritis (CGE) is a common cause for seeking veterinary care in companion animal medicine and an area where antibiotics have been reported to be widely used. Therefore, creating relevant benchmarks for antibiotic use in CGE is important when implementing and analyzing antibiotic stewardship interventions. The aim of this paper was to describe the level and temporal trend of systemic antibiotic use for CGE in Sweden between 2020 and 2023.
This was an observational multicenter cohort study. Retrospective data from 93,641 CGE consultations was extracted from the electronic health record and analyzed. All CGE consultations were included irrespective of age, breed, severity of disease and level of care. To evaluate the data, 100 medical records of CGE consultations were also manually reviewed using a predefined study protocol.
The overall level of systemic antibiotic use in Swedish dogs diagnosed with gastroenteritis was 5.7% during the study period, with aminopenicillins being the most abundantly used antibiotics (60.2%). The yearly level of antibiotic use in CGE declined from 8.1% in 2020 to 3.9% in 2023, with a statistically significant annual percentage change (APC) of -21.3% (95% CI, -22.8 to -19.7). Concurrently, the annual all-cause mortality decreased for all CGE consultations. Higher levels of antibiotic use were seen in hospitalized CGE (21.7% compared to 2.1% for non-hospitalized CGE, OR 13.1, 95% CI: 12.3-14.0, < 0.001) and hemorrhagic diarrhetic CGE (21.0% compared to 5.5% for non-hemorrhagic diarrhetic CGE, OR 4.6, 95% CI: 4.2-4.9, < 0.001).
This study revealed a low level and a significantly declining trend of antibiotic use in canine gastroenteritis in Sweden, implicating a high level of awareness and compliance to antibiotic guidelines among Swedish veterinarians. During the same period, the all-cause mortality rates decreased significantly for all CGE consultations, implicating that this level of antibiotic use do not compromise patient safety. Benefiting from automatic surveillance, we hereby provide important benchmarks which should encourage more prudent use of antibiotics in CGE internationally.
犬胃肠炎（CGE）是伴侣动物医学中寻求兽医护理的常见原因，且据报道抗生素在该领域被广泛使用。因此，在实施和分析抗生素管理干预措施时，为CGE中的抗生素使用建立相关基准很重要。本文旨在描述2020年至2023年瑞典CGE全身用抗生素的使用水平和时间趋势。
这是一项观察性多中心队列研究。从电子健康记录中提取并分析了93641例CGE会诊的回顾性数据。所有CGE会诊均被纳入，无论年龄、品种、疾病严重程度和护理水平如何。为评估数据，还使用预定义的研究方案对100份CGE会诊的病历进行了人工审核。
在研究期间，瑞典被诊断患有胃肠炎的犬全身用抗生素的总体使用水平为5.7%，氨基青霉素是使用最广泛的抗生素（60.2%）。CGE中抗生素的年使用水平从2020年的8.1%降至2023年的3.9%，年度百分比变化（APC）具有统计学意义，为-21.3%（95%CI，-22.8至-19.7）。同时，所有CGE会诊的全因死亡率均有所下降。住院CGE的抗生素使用水平较高（21.7%，而非住院CGE为2.1%，OR 13.1，95%CI：12.3 - 14.0，<0.001），出血性腹泻CGE也是如此（21.0%，而非出血性腹泻CGE为5.5%，OR 4.6，95%CI：4.2 - 4.9，<0.001）。
本研究揭示了瑞典犬胃肠炎中抗生素使用水平较低且呈显著下降趋势，这表明瑞典兽医对抗生素指南的认识和依从性较高。在此期间，所有CGE会诊的全因死亡率均显著下降，这意味着这种抗生素使用水平不会危及患者安全。受益于自动监测，我们在此提供了重要基准，应能鼓励国际上在CGE中更谨慎地使用抗生素。
