Bérénice Lutz, Claudia Lehner, Kira Schmitt, Barbara Willi, Gertraud Schüpbach, Meike Mevissen, Ruth Peter, Cedric Müntener, Hanspeter Naegeli, Simone Schuller
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Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage and duration) were retrospectively assessed. A justification score was applied to evaluate appropriateness of antimicrobial therapy based on available national and international consensus guidelines.</p><p><strong>Results: </strong>Antimicrobials were prescribed in 65 per cent of dogs with AD, 88 per cent with UTI, 62 per cent with RTI and 90 per cent with WI. The most prescribed antimicrobial classes (monotherapy and combination therapy) were potentiated aminopenicillins (59 per cent), nitroimidazoles (22 per cent), non-potentiated aminopenicillins (16 per cent) and fluoroquinolones (13 per cent). Overall, 38 per cent (95 per cent CI 0.35 to 0.41) of the prescriptions were in accordance with consensus guidelines. In dogs with AD, antimicrobial therapy was associated with the presence of haemorrhagic diarrhoea (P<0.05) and complied in 32 per cent with consensus guidelines, which recommend antimicrobial treatment only when sepsis is suspected. A bacterial aetiology was confirmed via culture and/or sediment examination in 36 per cent of dogs with suspected UTI.</p><p><strong>Conclusions: </strong>Overall, adherence to consensus guidelines was poor both, at university hospitals and private practices. 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引用次数: 14
摘要
背景:抗菌素耐药性是人类和兽医学中日益严重的问题,并与抗菌素的使用密切相关。本研究的目的是描述2016年瑞士选定犬类疾病的抗菌药物处方。方法:在两所大学医院和14家私人诊所就诊的狗急性腹泻(AD);n=371),疑似或确诊尿路感染(UTIs;n=245),呼吸道感染(RTIs;n=274)或伤口感染(WIs;N =175)。回顾性评估临床病史、诊断检查和抗菌药物处方(类别、剂量和持续时间)。根据现有的国家和国际共识指南,应用理由评分来评估抗菌治疗的适宜性。结果:65%的AD犬、88%的UTI犬、62%的RTI犬和90%的WI犬服用了抗菌素。处方最多的抗菌素类别(单一疗法和联合疗法)是增强型氨霉素(59%)、硝基咪唑(22%)、非增强型氨霉素(16%)和氟喹诺酮类药物(13%)。总体而言,38% (95% CI 0.35至0.41)的处方符合共识指南。在患有AD的狗中,抗菌药物治疗与出血性腹泻的存在有关(结论:总体而言,在大学医院和私人诊所,对共识指南的依从性都很差。因此,需要采取抗菌素管理措施来改善谨慎使用。
Antimicrobial prescriptions and adherence to prudent use guidelines for selected canine diseases in Switzerland in 2016.
Background: Antimicrobial resistance is an increasing problem in human and veterinary medicine and is closely linked to the use of antimicrobials. The objective of this study was to describe antimicrobial prescriptions for selected canine diseases in Switzerland during 2016.
Methods: Dogs presented to two university hospitals and 14 private practices for acute diarrhoea (AD; n=371), suspected or confirmed urinary tract infections (UTIs; n=245), respiratory tract infections (RTIs; n=274) or wound infections (WIs; n=175) were included. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage and duration) were retrospectively assessed. A justification score was applied to evaluate appropriateness of antimicrobial therapy based on available national and international consensus guidelines.
Results: Antimicrobials were prescribed in 65 per cent of dogs with AD, 88 per cent with UTI, 62 per cent with RTI and 90 per cent with WI. The most prescribed antimicrobial classes (monotherapy and combination therapy) were potentiated aminopenicillins (59 per cent), nitroimidazoles (22 per cent), non-potentiated aminopenicillins (16 per cent) and fluoroquinolones (13 per cent). Overall, 38 per cent (95 per cent CI 0.35 to 0.41) of the prescriptions were in accordance with consensus guidelines. In dogs with AD, antimicrobial therapy was associated with the presence of haemorrhagic diarrhoea (P<0.05) and complied in 32 per cent with consensus guidelines, which recommend antimicrobial treatment only when sepsis is suspected. A bacterial aetiology was confirmed via culture and/or sediment examination in 36 per cent of dogs with suspected UTI.
Conclusions: Overall, adherence to consensus guidelines was poor both, at university hospitals and private practices. Antimicrobial stewardship measures are therefore needed to improve prudent use.
期刊介绍:
Veterinary Record Open is a journal dedicated to publishing specialist veterinary research across a range of topic areas including those of a more niche and specialist nature to that considered in the weekly Vet Record. Research from all disciplines of veterinary interest will be considered. It is an Open Access journal of the British Veterinary Association.