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Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study
The veterinary prescription of antibiotics in low- and middle-income countries (LMIC) remains largely undocumented. In Bhutan, however, the national veterinary service keeps records of their activities and prescriptions, which offer an opportunity to establish a benchmark to assess the use of these...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194083/ https://www.ncbi.nlm.nih.gov/pubmed/34124215 http://dx.doi.org/10.3389/fvets.2021.641488 |
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author | Villanueva-Cabezas, Juan Pablo Rinzin, Karma Dorjee, Sithar Tshewang, Pema Namgyel, Ugyen Sharma, Puspa Maya Stevenson, Mark A. McVernon, Jodie |
author_facet | Villanueva-Cabezas, Juan Pablo Rinzin, Karma Dorjee, Sithar Tshewang, Pema Namgyel, Ugyen Sharma, Puspa Maya Stevenson, Mark A. McVernon, Jodie |
author_sort | Villanueva-Cabezas, Juan Pablo |
collection | PubMed |
description | The veterinary prescription of antibiotics in low- and middle-income countries (LMIC) remains largely undocumented. In Bhutan, however, the national veterinary service keeps records of their activities and prescriptions, which offer an opportunity to establish a benchmark to assess the use of these agents in this and other LMIC. A cross-sectional retrospective study was designed and 2,266 handwritten veterinary records from 2017 were sampled from 23 animal health premises (AHPs) to estimate individual and an overall proportion of consultations that resulted in an antibiotic prescription. The frequency of antibiotic prescription per species, type of AHP, and according to WHO's AWaRe index and OIE list of priority antimicrobials were also explored. It was estimated that 31% (95% confidence interval: 29–33%; intracluster correlation: 0.03) of the veterinary consultations resulted in an antibiotic prescription. The incidence of antibiotic prescription was highest in consultations of poultry across AHP. Across species, diarrhea and wounds were frequently treated with broad-spectrum antibiotics including sulfonamides, tetracyclines, trimethoprim + sulfa, and penicillin. Between 45% and 70% antibiotics prescribed correspond to AWaRe's access group and up to 25% to AWaRe's watch group. Over 70% of antibiotics dispensed in veterinary consultations for any species correspond to the OIE's veterinary critically important antimicrobial agents. Overall, the study demonstrated positive features of veterinary antimicrobial stewardship in Bhutan, given the conservative proportion of consultation that results in this type of prescription and the type of antibiotic prescribed. Although the veterinary service closely follows the Bhutanese Standard Treatment Guidelines, the prescription of antibiotics to key species should be closely monitored. Our study suggests that further improvements of antibiotic stewardship can be achieved through standardisation of antibiotic prescription to some species, a revision of the guidelines toward reducing the prescription of antibiotics of high relevance for human medicine, and by including details of clinical investigation, use of tests, and treatment outcomes in veterinary consultation records. |
format | Online Article Text |
id | pubmed-8194083 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81940832021-06-12 Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study Villanueva-Cabezas, Juan Pablo Rinzin, Karma Dorjee, Sithar Tshewang, Pema Namgyel, Ugyen Sharma, Puspa Maya Stevenson, Mark A. McVernon, Jodie Front Vet Sci Veterinary Science The veterinary prescription of antibiotics in low- and middle-income countries (LMIC) remains largely undocumented. In Bhutan, however, the national veterinary service keeps records of their activities and prescriptions, which offer an opportunity to establish a benchmark to assess the use of these agents in this and other LMIC. A cross-sectional retrospective study was designed and 2,266 handwritten veterinary records from 2017 were sampled from 23 animal health premises (AHPs) to estimate individual and an overall proportion of consultations that resulted in an antibiotic prescription. The frequency of antibiotic prescription per species, type of AHP, and according to WHO's AWaRe index and OIE list of priority antimicrobials were also explored. It was estimated that 31% (95% confidence interval: 29–33%; intracluster correlation: 0.03) of the veterinary consultations resulted in an antibiotic prescription. The incidence of antibiotic prescription was highest in consultations of poultry across AHP. Across species, diarrhea and wounds were frequently treated with broad-spectrum antibiotics including sulfonamides, tetracyclines, trimethoprim + sulfa, and penicillin. Between 45% and 70% antibiotics prescribed correspond to AWaRe's access group and up to 25% to AWaRe's watch group. Over 70% of antibiotics dispensed in veterinary consultations for any species correspond to the OIE's veterinary critically important antimicrobial agents. Overall, the study demonstrated positive features of veterinary antimicrobial stewardship in Bhutan, given the conservative proportion of consultation that results in this type of prescription and the type of antibiotic prescribed. Although the veterinary service closely follows the Bhutanese Standard Treatment Guidelines, the prescription of antibiotics to key species should be closely monitored. Our study suggests that further improvements of antibiotic stewardship can be achieved through standardisation of antibiotic prescription to some species, a revision of the guidelines toward reducing the prescription of antibiotics of high relevance for human medicine, and by including details of clinical investigation, use of tests, and treatment outcomes in veterinary consultation records. Frontiers Media S.A. 2021-05-28 /pmc/articles/PMC8194083/ /pubmed/34124215 http://dx.doi.org/10.3389/fvets.2021.641488 Text en Copyright © 2021 Villanueva-Cabezas, Rinzin, Dorjee, Tshewang, Namgyel, Sharma, Stevenson and McVernon. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Veterinary Science Villanueva-Cabezas, Juan Pablo Rinzin, Karma Dorjee, Sithar Tshewang, Pema Namgyel, Ugyen Sharma, Puspa Maya Stevenson, Mark A. McVernon, Jodie Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title | Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title_full | Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title_fullStr | Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title_full_unstemmed | Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title_short | Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study |
title_sort | antibiotic prescription in veterinary consultations in bhutan: a retrospective cross-sectional study |
topic | Veterinary Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194083/ https://www.ncbi.nlm.nih.gov/pubmed/34124215 http://dx.doi.org/10.3389/fvets.2021.641488 |
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