Representative, scalable, and sustainable surveillance methodologies to track companion animal antimicrobial use

项目摘要 抗菌剂对医学至关重要，但抗菌剂的问题 耐药性(AMR)威胁着这些有价值药物的有效性。广泛使用 抗生素是AMR的主要驱动力。在人类和动物健康环境中，这使得 感染很难治疗，有时甚至是不可能的。追踪抗菌药物的使用情况 (AU)是抗击AMR的一项基本战略。没有系统的，持续的国家- 或州级项目，在美国追踪猫狗的AU。量测 AU的使用受到了在内部访问处方数据的后勤挑战的阻碍 在许多不同的兽医电子健康记录(EHR)系统中。兽医 医学缺乏标准的诊断编码，因为这样的编码既不需要用于计费，也不需要 疾病报告。通常是患者遭遇的细节(例如，诊断、适应症 处方)仅记录在电子病历的自由文本字段中，而不是轻松地记录在 可搜索字段。克服数据收集障碍的方法是至关重要的 在抗击AMR的斗争中需要。 该项目的总体目标是优化长期战略，以 从同伴动物实践中收集和报告AU数据，以了解 为抗菌药物提供基本的处方行为和可操作的靶点 管家职务(AS)跟踪AU的两种实用、可扩展和可持续的方法 将利用配套的动物兽医实践。其中包括使用point 流行率调查(PPS)和伴生动物兽医监测网 (CAVSNET)。疾病控制和预防中心已经使用PPS来 建立非盟在人力医院和长期护理方面的基线国家措施 设置。该项目将建立关于非盟在转诊和治疗中患病率的国家估计。 在兽医教学中开展全国PPS小动物全科实践 医院以及全科和转诊的做法。CAVSNET是一种安全的被动监视 用于长期跟踪同伴动物健康、疾病和治疗的系统。 CAVSNET将在例行基础上直接从EHR系统收集AU数据。有了这些 两个相辅相成的方式，我们将全面构建非盟的国家图景 在狗和猫身上。

Project Summary Antimicrobials are critical for medicine, but the problem of antimicrobial resistance (AMR) threatens the effectiveness of these valuable drugs. Widespread use of antibiotics is the main driver of AMR. In human and animal health settings, this makes infections difficult, and sometimes impossible, to treat. Tracking of antimicrobial use (AU) is an essential strategy to combat AMR. There are no systematic, ongoing national- or state-level programs to track AU in dogs and cats in the United States. Measurement of AU is hampered by logistical challenges of accessing prescribing data within and across the many diverse veterinary electronic health record (EHR) systems. Veterinary medicine lacks standard diagnostic coding, as such codes are not required for billing nor disease reporting. Often the details of the patient encounter (e.g., diagnosis, indication for prescriptions) are recorded only in free-text fields of the EHR rather than in easily searchable fields. Methodologies that overcome obstacles to data collection are a critical need in the fight against AMR. The overarching goal of this project is to optimize long-term strategies for collecting and reporting AU data from companion animal practices to understand baseline prescribing behaviors and provide actionable targets for antimicrobial stewardship (AS). Two practical, scalable, and sustainable approaches to track AU in companion animal veterinary practices will be utilized. These include the use of point prevalence surveys (PPS) and the Companion Animal Veterinary Surveillance Network (CAVSNET). PPS have been used by the Centers for Disease Control and Prevention to establish baseline national measures of AU in human hospital and long-term care settings. This project will establish national estimates of AU prevalence in referral and small animal general practices by conducting national PPS in veterinary teaching hospitals and general and referral practices. CAVSNET is a secure passive surveillance system for long-term tracking of companion animal health, disease, and treatment. CAVSNET will gather AU data on a routine basis directly from EHR systems. With these two complementary approaches, we will build a comprehensive national picture of AU in dogs and cats.