Expert consensus regarding drivers of antimicrobial stewardship in companion animal veterinary practice: a Delphi study
Expert consensus regarding drivers of antimicrobial stewardship in companion animal veterinary practice: a Delphi study
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DOI：
10.1136/vr.104639
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发表时间：
2018-06-01
影响因子：
2.2
通讯作者：
Flowers, Paul
中科院分区：
文献类型：
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作者：
Currie, Kay;King, Caroline;Flowers, Paul
抗菌素耐药性（AMR）是人类和动物医疗保健专业人员面临的全球性挑战;有效应对这一威胁需要采用“一种健康”的抗菌素管理（AMS）方法，以保留重要的抗生素用于紧急临床需求。然而，目前对伴侣动物兽医实践中有效AMS行为的障碍和促进因素的理解有限。我们对来自英国兽医政策制定者、大学学者和专业机构领导人的16名国家认可的专家进行了德尔菲研究。这项德尔菲研究旨在确定专家认为有助于AMR并构成AMS重要方面的兽医行为。德尔菲调查结果分析表明，行为的感知层次，最有影响力的抗生素处方行为和与客户的互动。其他被认为重要的兽医行为涉及与兽医同事的互动;感染控制实践;以及使用诊断测试来确认感染。确定了这些行为领域内AMS的主要障碍和推动因素。建议采取具体干预措施，消除重要的障碍和促进因素。据作者所知，这是第一项在国家层面就伴侣动物兽医实践中与AMR和AMS相关的“行为”（兽医实践方面）应成为目标达成专家共识的研究。
Antimicrobial resistance (AMR) is a global challenge facing both human and animal healthcare professionals; an effective response to this threat requires a 'One-Health' approach to antimicrobial stewardship (AMS) to preserve important antibiotics for urgent clinical need. However, understanding of barriers and enablers to effective AMS behaviour in companion animal veterinary practice is currently limited. We conducted a Delphi study of 16 nationally recognised experts from UK-based veterinary policymakers, university academics and leaders of professional bodies. This Delphi study sought to identify veterinary behaviours which experts believe contribute to AMR and form vital aspects of AMS. Analysis of Delphi findings indicated a perceived hierarchy of behaviours, the most influential being antibiotic prescribing behaviours and interactions with clients. Other veterinary behaviours perceived as being important related to interactions with veterinary colleagues; infection control practices; and the use of diagnostic tests to confirm infection. Key barriers and enablers to AMS within each of these behavioural domains were identified. Specific interventions to address important barriers and enablers are recommended. To the authors' knowledge, this is the first study to establish expert consensus at a national level about which 'behaviours' (aspects of veterinarian practice) should be targeted in relation to AMR and AMS in companion animal veterinary practice.