Comparing antimicrobial exposure based on sales data
Comparing antimicrobial exposure based on sales data
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DOI：
10.1016/j.prevetmed.2012.07.009
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
van Geijlswijk, Ingeborg M.
中科院分区：
文献类型：
--
作者：
Bondt, Nico;Jensen, Vibeke Frokjaer;van Geijlswijk, Ingeborg M.
本文探讨了根据国家总销售数据对各国兽医使用抗菌药物进行有意义比较的可能性。将丹麦和荷兰国家一级的兽医抗菌药物销售数据和动物普查数据与估计的平均剂量信息相结合，首先基于所有物种和生产类型的治疗发生率相同的假设，对平均每只动物每年的平均治疗天数进行模型计算。其次，分别估算了用于肉类生产的动物和乳制品以及其他牛（不包括小牛肉和小牛肉）的暴露量，假设在乳制品和其他牛中零使用，第三，分别假设100%口服和100%肠外给药。随后，将这些模型计算的结果与根据这两个国家国家监测规划中每个动物物种的详细使用数据计算的治疗发生率进行比较，以评估其准确性和相关性。在丹麦和荷兰，虽然计算出的抗菌素暴露量似乎是对所有动物整体暴露量的合理估计，但它与大多数物种的测量暴露量有很大不同。动物物种之间的暴露差异远远高于两国之间的总体差异。例如，丹麦每年9个治疗日的总体模型估计严重高估了家禽的真实使用量（即3天），荷兰每年13个治疗日的总体模型估计严重低估了小牛肉的真实使用量（即66天）。结论是，以总销售数字为基础进行简单的国别比较，会带来严重误解的风险，特别是如果以毫克/公斤表示时，使用更精确的模型计算进行这种比较，考虑到剂量和农场动物人口统计的差异，只能略微降低这种风险。总体模型估计受到动物统计数据的强烈影响，并且对每种动物暴露的真实差异的指示非常不准确。为了适当确定各国之间在抗微生物药物暴露方面的真正差异，绝对有必要掌握有关每种动物使用情况的可靠信息。(C) 2012 Elsevier B.V.版权所有
This paper explores the possibilities of making meaningful comparisons of the veterinary use of antimicrobial agents among countries, based on national total sales data. Veterinary antimicrobial sales data on country level and animal census data in both Denmark and the Netherlands were combined with information about estimated average dosages, to make model calculations of the average number of treatment days per average animal per year, at first based on the assumption that the treatment incidence is the same in all species and production types. Secondly, the exposure in respectively animals for meat production and dairy and other cattle (excluding veal and young beef) was estimated, assuming zero use in the dairy and other cattle, and thirdly by assuming respectively 100% oral and 100% parenteral administration. Subsequently, the outcomes of these model calculations were compared with treatment incidences calculated from detailed use data per animal species from the national surveillance programmes in these two countries, to assess their accuracy and relevancy.In Denmark and in the Netherlands, although the computed antimicrobial exposure would seem to be a reasonable estimation of the exposure for all animals as a whole, it differs significantly from the measured exposure for most species. The differences in exposure among animal species were much higher than the overall difference between the two countries. For example, the overall model estimate of 9 treatment days per year for Denmark is a severe overestimation of the true use in poultry (i.e. 3 days), and the overall model estimate of 13 treatment days per year for the Netherlands is a severe underestimation of the true use in veal calves (i.e. 66 days).The conclusion is that simple country comparisons, based on total sales figures, entail the risk of serious misinterpretations, especially if expressed in mg per kg. The use of more precise model calculations for making such comparisons, taking into account differences in dosages and in farm animal demographics, only slightly reduces this risk. Overall model estimates are strongly influenced by animal demographics and a very inaccurate indication of the true differences in exposure, per animal species. To get an appropriate certainty about the true differences in antimicrobial exposure between countries it is an absolute necessity to have reliable information about the use per animal species. (C) 2012 Elsevier B.V. All rights reserved.