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 感染难以治疗，有时甚至无法治疗。 (AU)是对抗AMR的重要战略。没有系统的，持续的国家- 或州一级的项目来追踪美国猫狗体内的Au。测量 Au的研究受到访问内部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。兽医 医学缺乏标准的诊断编码，因为这些代码不需要用于计费， 疾病报告。通常患者遭遇的细节（例如，诊断、适应症 对于处方）仅记录在EHR的自由文本字段中，而不是轻松 可搜索字段。克服数据收集障碍的方法是一个关键的 在对抗AMR的斗争中。 该项目的首要目标是优化长期战略， 从伴侣动物实践中收集和报告Au数据，以了解 基线处方行为，并为抗菌药物提供可操作的目标 管理（AS）。两种实用的、可扩展的和可持续的方法来跟踪Au， 将使用伴侣动物兽医实践。其中包括使用Point 流行率调查（PPS）和伴侣动物兽医监测网络 （CAVSNET）. PPS已被疾病控制和预防中心用于 建立人类医院和长期护理中Au基线国家测量 设置.该项目将建立转诊中Au患病率的国家估计值， 在兽医教学中开展全国性PPS的小动物综合实践 医院、综合医院和转诊医院。CAVSNET是一种安全的被动监视 长期跟踪伴侣动物健康、疾病和治疗的系统。 CAVSNET将定期直接从EHR系统收集Au数据。与这些 通过两种互补的方法，我们将构建一个全面的Au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.