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Nyokabi NS, Phelan L, Lindahl JF, Berg S, Muunda E, Mihret A, Wood JLN, Moore HL. Exploring veterinary students' awareness and perception of zoonoses risks, infection control practices, and biosecurity measures in Ethiopia. Front Vet Sci 2024; 11:1385849. [PMID: 39044741 PMCID: PMC11263103 DOI: 10.3389/fvets.2024.1385849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
Universities and colleges are often regarded as playing a key role in educating veterinarians and animal health workers who advise farmers on herd health and animal husbandry. However, to date, studies examining veterinary students' knowledge of zoonotic diseases of public health importance and the source of this knowledge, as well as their preparedness to respond to these diseases, have focused on the Global North rather than the Global South. This study takes Ethiopia as a case study in exploring veterinary medicine students' knowledge of zoonosis risks, infection control practices and biosecurity measures, recognizing that it is imperative to reconcile national-level veterinary education curricula with emerging global trends, such as One Health-focused training. This training advocates for a collaborative, interdisciplinary response at local, national, and international levels to the adverse impact of zoonotic diseases on animal health and productivity, and human and environmental health. Data for this study were collected through a pre-tested online questionnaire administered to 154 veterinary students from several universities in Ethiopia. The findings of this study suggest veterinary students were aware of the public health risks posed by zoonoses and the important role that collaboration between the disciplines of human and animal health can play in addressing zoonoses and emerging health risks. However, students demonstrated poor knowledge of the need to adopt infection control measures (ICPs) and biosecurity measures to reduce occupational risks and prevent within and between herd transmission of infection. Moreover, students' vaccination rates against zoonotic diseases associated with occupational risks, such as rabies, were low. The results of this study suggest that there are currently gaps in Ethiopia's veterinary curriculum and that enhancing veterinary students' access to information regarding infection control practices and biosecurity measures could contribute to reducing their future occupational exposure to zoonoses. This study highlights the policy implications of the current veterinary medicine curriculum in Ethiopia and the scope for aligning the curriculum with important global initiatives, such as One Health-focused training.
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Affiliation(s)
- Ndungu S. Nyokabi
- Institute for Global Prosperity, University College London, London, United Kingdom
| | - Lisette Phelan
- School of Geography, University of Leeds, Leeds, United Kingdom
- Environmental Economics and Natural Resources Group, Wageningen University and Research, Wageningen, Netherlands
| | - Johanna F Lindahl
- International Livestock Research Institute (ILRI), Nairobi, Kenya
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Stefan Berg
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Emmanuel Muunda
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Adane Mihret
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - James L. N. Wood
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Henrietta L. Moore
- Institute for Global Prosperity, University College London, London, United Kingdom
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Agrawal I, Varga C. Assessing and comparing disease prevention knowledge, attitudes, and practices among veterinarians in Illinois, United States of America. Prev Vet Med 2024; 228:106223. [PMID: 38749312 DOI: 10.1016/j.prevetmed.2024.106223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 04/27/2024] [Accepted: 05/03/2024] [Indexed: 06/11/2024]
Abstract
Veterinarians play an essential role in safeguarding and promoting animal and human health by timely reporting of notifiable diseases to animal and public health agencies and by educating animal owners on effective disease prevention measures. Moreover, clinical veterinarians can prevent the transmission and spread of zoonotic diseases by adopting effective biosecurity practices in their clinics. An online questionnaire was administered between October and November 2021 to veterinarians registered with the Illinois State Veterinary Medical Association. Veterinarians were surveyed on their disease risk perception, biosecurity practices, and disease reporting knowledge. In total, 104 veterinarians (64 % females and 46 % males) completed the questionnaire, of whom 88 % were veterinarians working in clinical practice (88 % companion animals and 12 % bovine or swine), while 12 % were employed in non-clinical settings. The disease-reporting knowledge score was higher for veterinarians with biosecurity training (IRR: 1.35; 95 % CI: 1.47-1.75). Compared to large animal veterinarians, companion animal veterinarians had lower odds of having biosecurity training (OR=0.68; 95 % CI=0.02-0.28) and were less familiar with current biosecurity guidelines (OR=0.12; 95 % CI = 0.03-0.51). Veterinarians familiar with biosecurity guidelines had a higher probability (OR=4.4; 95 % CI: 1.21-16.28) of perceiving biosecurity practices as practical while working with animals. Conversely, veterinarians who perceived that they could transmit diseases to animals had lower odds (OR: 0.42; 95 % CI: 0.20-0.91) of wearing protective clothing while dealing with confirmed cases of zoonotic diseases. Based on our study results, a gap in disease-reporting knowledge was identified among companion animal veterinarians. Biosecurity training improved the disease-reporting knowledge of veterinarians, suggesting that providing continuing education for veterinarians would be beneficial to disease reporting. A disconnect between disease risk perception and biosecurity practices was identified and further studies are needed to understand this discrepancy to design effective education programs.
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Affiliation(s)
- Isha Agrawal
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, IL, USA
| | - Csaba Varga
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign, IL, USA; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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Dias MC, Alpizar-Jara R, Lavrador C, Marques C, Broens EM, Duarte EL. Companion Animal Owners' Knowledge, Attitudes and Perceptions Regarding Antibiotic Use in Portugal. Antibiotics (Basel) 2024; 13:533. [PMID: 38927199 PMCID: PMC11201214 DOI: 10.3390/antibiotics13060533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
While multiple studies have focused on the motivations surrounding antibiotic prescription among veterinarians, little is known about companion animal owners' knowledge, attitude and perception (KAP) regarding the topic. A nationwide survey directed toward Portuguese dog and cat owners was conducted online and at veterinary practices to characterize their KAP regarding antibiotics. After database curation, a total of 423 valid submissions were considered. Although 97.9% of respondents stated that they knew what an antibiotic was, 23.5% and 19.2% answered that they were used to treat viral and fungal infections, respectively. Antimicrobial effectiveness was favored over cost when 87.7% of owners agreed they would prefer to spend more money to identify the appropriate antibiotic. Around 87% of respondents recognized antibiotic resistance as a significant health problem and 74.6% strongly agreed/somewhat agreed that antibiotic use in pets may contribute to resistance development. However, only 25.3% recognized that this could promote resistance dissemination, showing little awareness of the interconnection between human and animal health. Moreover, 55.6% of respondents were neutral when asked whether antibiotics used in veterinary medicine were also important for humans. These findings suggest that communication between veterinarians and pet owners can still be improved to further clarify the impact that antibiotic use has in pets from a One-Health perspective, also enabling antimicrobial stewardship interventions.
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Affiliation(s)
- Margarida Correia Dias
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
| | - Russell Alpizar-Jara
- Department of Mathematics, School of Science and Technology & CIMA Research Centre in Mathematics and Applications, Universidade de Évora, 7004-516 Évora, Portugal
| | - Catarina Lavrador
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
| | - Cátia Marques
- Faculty of Veterinary Medicine, Lusófona University, 376 Campo Grande, 1749-024 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), CECAV—Animal and Veterinary Research Centre, University of Trás-os-Montes and Alto Douro, Quinta de Prados, 5000-801 Vila Real, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Genevet, Diagnostic Laboratory and ECVM Satellite Training Center, 1495-191 Carnaxide, Portugal
| | - Els M. Broens
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Elsa L. Duarte
- Department of Veterinary Medicine, School of Science and Technology, Universidade de Évora, 7004-516 Évora, Portugal; (C.L.)
- MED–Mediterranean Institute for Agriculture, Environment and Development & CHANGE–Global Change and Sustainability Institute, Universidade de Évora, 7004-516 Évora, Portugal
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Mugwaneza D, Rwagasore E, El-Khatib Z, Dukuziyaturemye P, Omolo J, Nsekuye O, Rwunganira S, Manzi M. Factors Associated with Inappropriate Use of Antibiotics Among Animal Health Professionals in Selected Districts of Rwanda, 2021. J Epidemiol Glob Health 2024; 14:265-273. [PMID: 38407719 PMCID: PMC11176279 DOI: 10.1007/s44197-024-00192-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Antibiotic resistance is a global health concern. Humans can acquire antibiotic resistance through human-to-human transmission, from the environment, via the food chain, and through the contact with animals. The National Action Plan on antimicrobial resistance 2020-2024 highlights the prudent use of antibiotics in veterinary activities as the key element in keeping antibiotics effective. We determined the factors associated with misuse of antibiotics among animal health professionals in Rwanda. METHODS This was a cross-sectional study that enrolled animal health field professionals from five districts, where stratified random sampling was used to select one district by each province of Rwanda. Structured questions were used during face-to-face interviews. The misuse of antibiotics was defined as the use of antibiotics for reasons other than treatment, the non-completion of required courses, or the use of a high dose (i.e., an overdose) of antibiotics. We collected socio-demographic data of respondents, as well as elementary knowledge and perceptions on veterinary antibiotics and antibiotic resistance. A backward stepwise logistic regression model was used to identify the factors that were predictive of the inappropriate use of antibiotics. RESULTS There were 256 respondents to the survey. Of those, 198 were male and 58 were female. Almost three quarters of respondents (n = 174/256; 68%) reported the misuse of antibiotics at least once in the previous 12 months. The final logistic regression analysis identified the following factors to be predictive of antibiotics misuse: aged ≤ 24 years (aOR 0.92; 95% CI [0.88, 0.96]; p < 0.001); low trust in veterinary antibiotics available in the local market (aOR 8.45; 95% CI [4.18, 17.07]; p < 0.01), insufficient knowledge about basic understanding of antibiotics and antibiotic resistance (aOR 2.78; 95% CI [1.38, 5.58], p < 0.01) and not acquiring any continuing education (aOR 1.97; 95% CI [1.02, 4.19]; p = 0.04). CONCLUSIONS This study identified inadequate perceptions of proper antibiotic use among animal health professionals. There is a need for continuous education on appropriate antibiotic use among animal health professionals to lessen the negative impact of antibiotic resistance on public health security.
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Affiliation(s)
| | | | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | | | - Jared Omolo
- Centers for Disease Control and Prevention (CDC), Kigali, Rwanda
| | | | | | - Maximillian Manzi
- Rwanda Agriculture and Animal Resources Development Board, Kigali, Rwanda
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Best CM, Bard AM, Rees GM, Reyher KK. Validation, visibility, vagueness and variation: A qualitative assessment of existing veterinary guidelines for antimicrobial use in cattle and sheep in the UK. PLoS One 2023; 18:e0294733. [PMID: 38032877 PMCID: PMC10688698 DOI: 10.1371/journal.pone.0294733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Antimicrobials are essential in veterinary medicine to treat and control bacterial disease in animals. Their prudent use in food-producing animals has been encouraged to reduce the development and spread of antimicrobial resistance. National and international guidelines for responsible antimicrobial use have been developed as tools to guide and rationalise antimicrobial prescribing decisions by veterinarians and usage decisions by farmers. Yet, there is little understanding of whether these existing guidelines are fit for purpose. Accordingly, this study rigorously assessed 128 veterinary guidelines for antimicrobial use in ruminants in the UK, following established qualitative methodologies. Findings revealed four pertinent themes: validation of the veterinarian as the prescriber, visibility of responsible use realities, vagueness in interpretation and variation in directing behaviour. These themes encompassed the roles and responsibilities of the veterinarian and the realities of prescribing scenarios, alongside concerns relating to the specificity within and variation between guidelines. Resultant recommendations to inform and support the future development of guidelines include establishing species-specific and disease-specific guidelines, expanding guidelines to include disease prevention measures, including definitions to resolve vagueness and promoting congruence in interpretation, encouraging the development of practice-level guidelines to endorse collaboration and ownership, and fostering active working between stakeholders to align priorities and messaging.
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Affiliation(s)
- Caroline M. Best
- University of Bristol Veterinary School, Langford, Bristol, United Kingdom
| | - Alison M. Bard
- University of Bristol Veterinary School, Langford, Bristol, United Kingdom
- Department of Life Sciences, Aberystwyth University, Aberystwyth, Ceredigion, United Kingdom
| | - Gwen M. Rees
- Department of Life Sciences, Aberystwyth University, Aberystwyth, Ceredigion, United Kingdom
| | - Kristen K. Reyher
- University of Bristol Veterinary School, Langford, Bristol, United Kingdom
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Ryan CA, McNeal CD, Credille BC. Ceftiofur use and antimicrobial stewardship in the horse. Equine Vet J 2023; 55:944-961. [PMID: 36733237 DOI: 10.1111/evj.13930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
Equine practitioners require recommendations that support antimicrobial stewardship and avoid generating resistance to medically important antibiotics. This review examines current inadequacies in antimicrobial stewardship standards within the veterinary community, related to antimicrobial categorisation and prescribing practices. Resistance to cephalosporin antibiotics in horses is also described. Properties of cephalosporin antibiotics are outlined and equine-specific studies of ceftiofur, a third-generation cephalosporin antibiotic with medical importance, are detailed. Readers are provided with recommendations that encourage appropriate use of ceftiofur, citing the evidence available in horses.
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Affiliation(s)
- Clare A Ryan
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
| | - Christina D McNeal
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
| | - Brenton C Credille
- Department of Population Health, University of Georgia, Athens, Georgia, USA
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Sun R, Cummings KJ, Beukema A, Hinckley-Boltax AL, Korich JA, Cazer CL. Veterinary Students' Knowledge and Awareness of Antimicrobial Stewardship before and after Clinical Rotations. JOURNAL OF VETERINARY MEDICAL EDUCATION 2023:e20220125. [PMID: 37104468 DOI: 10.3138/jvme-2022-0125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Given the global threat of antimicrobial resistance, it is imperative that veterinary graduates are effective antimicrobial stewards. Veterinary students learn the principles of antimicrobial stewardship explicitly, through pre-clinical coursework, and implicitly, through the cases they each encounter on clinical rotations. We aimed to understand the influence of pre-clinical versus clinical learning on veterinary students' knowledge and awareness of antimicrobial concepts to guide efforts to improve instruction in these areas. To assess knowledge acquisition and to explore student perceptions of antimicrobial stewardship, a standardized online survey was administered to Cornell University veterinary students at two timepoints: in August 2020 before clinical rotations (N = 26 complete responses and N = 24 partial responses) and again in May 2021 after their clinical rotations (N = 17 complete responses and N = 6 partial responses). Overall and section-specific confidence and knowledge scores were calculated, using pairwise deletion for incomplete responses. Students generally had low confidence in antimicrobial topics and correctly answered only half of knowledge questions correctly; they performed the best on antimicrobial resistance knowledge questions. There were no significant differences in knowledge or confidence after clinical rotations. On average, students had only read one antimicrobial stewardship guideline. Students reported that human health care providers contributed more to antimicrobial resistance than veterinarians. In conclusion, graduating veterinary students at our institution have significant knowledge gaps in critical principles that are essential to become antimicrobial stewards. Explicit instruction in antimicrobial stewardship is necessary in the pre-clinical and clinical coursework, and the practical use of antimicrobial stewardship guidelines should be emphasized.
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Affiliation(s)
- Ruinan Sun
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Kevin J Cummings
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Andrea Beukema
- Educational Support Services, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Ariana L Hinckley-Boltax
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, Grafton, MA USA
| | - Jodi A Korich
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY USA
| | - Casey L Cazer
- Department of Population Medicine & Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA. Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY USA
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Primeau CA, McWhirter JE, Carson C, McEwen SA, Parmley EJ. Exploring medical and veterinary student perceptions and communication preferences related to antimicrobial resistance in Ontario, Canada using qualitative methods. BMC Public Health 2023; 23:483. [PMID: 36915074 PMCID: PMC10012462 DOI: 10.1186/s12889-023-15193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 02/02/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) threatens our ability to treat and prevent infectious diseases worldwide. A significant driver of AMR is antimicrobial use (AMU) in human and veterinary medicine. Therefore, education and awareness of AMR among antimicrobial prescribers is critical. Human and animal health professionals play important roles in the AMR issue, both as contributors to the emergence of AMR, and as potential developers and implementers of effective solutions. Studies have shown that engaging stakeholders prior to developing communication materials can increase relevance, awareness, and dissemination of research findings and communication materials. As future antimicrobial prescribers, medical and veterinary students' perspectives on AMR, as well as their preferences for future communication materials, are important. The first objective of this study was to explore medical and veterinary student perceptions and understanding of factors associated with emergence and spread of AMR. The second objective was to identify key messages, knowledge translation and transfer (KTT) methods, and dissemination strategies for communication of AMR information to these groups. METHODS Beginning in November 2018, focus groups were conducted with medical and veterinary students in Ontario, Canada. A semi-structured format, using standardized open-ended questions and follow-up probing questions was followed. Thematic analysis was used to identify and analyze patterns within the data. RESULTS Analyses showed that students believed AMR to be an important global issue and identified AMU in food-producing animals and human medicine as the main drivers of AMR. Students also highlighted the need to address society's reliance on antimicrobials and the importance of collaboration between different sectors to effectively reduce the emergence and transmission of AMR. When assessing different communication materials, students felt that although infographics provide easily digestible information, other KTT materials such as fact sheets are better at providing more information without overwhelming the target audiences (e.g., professional or general public). CONCLUSION Overall, the study participants felt that AMR is an important issue and emphasized the need to develop different KTT tools for different audiences. This research will help inform the development of future communication materials, and support development of AMR-KTT tools tailored to the needs of different student and professional groups.
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Affiliation(s)
- Courtney A Primeau
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, N1G 2W1, Guelph, ON, Canada. .,Centre for Food-borne, Environmental and Zoonotic Infectious Disease, Public Health Agency of Canada, N1H 7M7, Guelph, ON, Canada.
| | - Jennifer E McWhirter
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, N1G 2W1, Guelph, ON, Canada
| | - Carolee Carson
- Centre for Food-borne, Environmental and Zoonotic Infectious Disease, Public Health Agency of Canada, N1H 7M7, Guelph, ON, Canada
| | - Scott A McEwen
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, N1G 2W1, Guelph, ON, Canada
| | - E Jane Parmley
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, N1G 2W1, Guelph, ON, Canada
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Attitudes towards Use of High-Importance Antimicrobials—A Cross-Sectional Study of Australian Veterinarians. Antibiotics (Basel) 2022; 11:antibiotics11111589. [DOI: 10.3390/antibiotics11111589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022] Open
Abstract
The timely implementation of antimicrobial stewardship interventions could delay or prevent the development of higher levels of antimicrobial resistance in the future. In food-producing animals in Australia, high-importance antimicrobials, as rated by the Australian Strategic and Technical Advisory Group (ASTAG), include virginiamycin and third-generation cephalosporins (in individual pigs or cattle). The use of high-importance antimicrobials in companion animals is more widespread and less regulated. There is no national antimicrobial use surveillance system for animals in Australia. Consequently, there is a gap in the knowledge about reasonable use across all sectors of veterinary practice. This study explored attitudes towards the use in veterinary medicine of antimicrobials with high importance to human health, and determined levels of agreement about the introduction of restrictions or other conditions on this use. An online survey was distributed via social media and email from June to December 2020 to veterinarians working in Australia. Of the 278 respondents working in clinical practice, 49% had heard of the ASTAG rating system, and 22% used a traffic light system for antimicrobial importance in their practice. Overall, 61% of participants disagreed that veterinarians should be able to prescribe high-importance antimicrobials without restrictions. If there were to be restrictions, there was most agreement amongst all respondents for only restricting high-importance antimicrobials (73%). There is a need for education, guidance, and practical support for veterinarians for prescribing high-importance antimicrobials alongside any restrictions.
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Maruve SA, Essack SY. Knowledge, attitudes, and practices of veterinarians on antibiotic use and resistance and its containment in South Africa. J S Afr Vet Assoc 2022; 93:99-108. [DOI: 10.36303/jsava.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- SA Maruve
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal,
South Africa
| | - SY Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal,
South Africa
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Horvat O, Petrović AT, Paut Kusturica M, Bukumirić D, Jovančević B, Kovačević Z. Survey of the Knowledge, Attitudes and Practice towards Antibiotic Use among Prospective Antibiotic Prescribers in Serbia. Antibiotics (Basel) 2022; 11:antibiotics11081084. [PMID: 36009952 PMCID: PMC9405044 DOI: 10.3390/antibiotics11081084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The complex issue of antibacterial resistance (ABR) requires actions taken with the One Health approach, involving both human and veterinarian medicine. It can spread from animals to humans through the food chain or through direct contact. Health profession students, as the future antibiotic providers, can greatly impact antibiotic-related issues in the future. The study was conducted to evaluate knowledge, attitudes and practice of future antibiotic prescribers in relation to judicious use of antibiotics. This cross-sectional, questionnaire-based study was performed on 400 students of health professions who were allowed to prescribe antibiotics of the University of Novi Sad, Serbia. Students of medicine and students of dentistry showed a significantly higher knowledge score compared to students of veterinary medicine (p = 0.001). Multivariate regression identified predictors of adequate antibiotic knowledge: being a female student (B = 0.571; p = 0.020), higher grade average (B = 1.204; p = 0.001), students of medicine (B = 0.802; p = 0.006) and dentistry (B = 0.769; p = 0.026), and students who used a complete package of antibiotics during the last infection (B = 0.974; p = 0.001) or for the period recommended by the doctor (B = 1.964; p = 0.001). Out of the total sample, self-medication was reported among 42.8% of students. The identified predictors of self-medication were: more frequent (B = 0.587; p = 0.001) and irregular (B = 0.719; p = 0.007) antibiotic use, taking antibiotics until symptoms disappeared (B = 2.142; p = 0.001) or until the bottle was finished (B = 1.010; p = 0.001) during the last infection. It seems prudent to reevaluate the educational curricula regarding antibiotic use and ABR of prospective prescribers in Serbia.
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Affiliation(s)
- Olga Horvat
- Faculty of Medicine, Department of Pharmacology Toxicology and Clinical Pharmacology, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Ana Tomas Petrović
- Faculty of Medicine, Department of Pharmacology Toxicology and Clinical Pharmacology, University of Novi Sad, 21000 Novi Sad, Serbia
- Correspondence:
| | - Milica Paut Kusturica
- Faculty of Medicine, Department of Pharmacology Toxicology and Clinical Pharmacology, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Dragica Bukumirić
- Institute of Public Health “Dr Milan Jovanovic Batut”, 11000 Belgrade, Serbia
| | - Bojana Jovančević
- Faculty of Medicine, Department of Pharmacology Toxicology and Clinical Pharmacology, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Zorana Kovačević
- Faculty of Agriculture, Department of Veterinary Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
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Cadena MM, Kelman T, Pitesky M, Dutch RS, Tell LA. Assessing Backyard Poultry versus Small Animal Knowledge of Veterinary Students regarding Husbandry, Prescription Drug Use, and Antimicrobial Resistance. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:531-536. [PMID: 34375165 DOI: 10.3138/jvme-2021-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
As backyard poultry (BYP) ownership has increased in the US, the demand for veterinarians who treat BYP has also increased. However, veterinarians who treat BYP remain scarce and are mostly small animal veterinarians and exotic animal practitioners who have limited training in food animal regulatory practices. To gauge whether veterinary students are interested in learning more about BYP and what BYP topics to include in an online training program for veterinary students, a BYP knowledge assessment was conducted. Pre-clinical veterinary students were asked to self-rate their level of knowledge on various topics for both small animal practice and BYP using Likert-type ordinal scales. Wilcoxon signed-rank tests of those Likert data showed significant differences (p < .01 at α = .05) between self-assessed knowledge of poultry and small animal medicine for all surveyed topics. Specifically, veterinary students ranked themselves as less knowledgeable on poultry concepts than on small animal medicine concepts. Nevertheless, students expressed interest in an online training program for treating BYP and drug residue avoidance in BYP, despite having chosen future career tracks that are not exclusively poultry. Specific topics students expressed interest in with respect to BYP training included anatomy, husbandry, prescribing medications, treatment options, food safety, antimicrobial resistance, and extra-label drug use.
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Smith SI, Kwaga JK, Ngulukun SS, Adedeji A, Jolaiya TF, Ajayi A, Kabir J. Antibiotic prescription practices amongst veterinarians in Nigeria. Res Vet Sci 2022; 152:219-227. [DOI: 10.1016/j.rvsc.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/19/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
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14
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Torres MC, Vieira TR, Cardoso MRI, Siqueira FM, Borba MR. Perception of poultry veterinarians on the use of antimicrobials and antimicrobial resistance in egg production. Poult Sci 2022; 101:101987. [PMID: 35841632 PMCID: PMC9293647 DOI: 10.1016/j.psj.2022.101987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to describe the perception of veterinarians who work with commercial laying hens in the state of Rio Grande do Sul, Brazil, regarding the use of antibiotics and their possible impacts on animal, human, and environmental health. A descriptive epidemiological study was carried out through face-to-face or web conferencing interviews with the veterinarians that provide technical assistance at commercial laying hen operations. A standardized and structured questionnaire was developed based on the literature and expert opinion, which contained 1 opened and 40 closed questions. Conventional non-probabilistic sampling was used, based on an initial list of 15 veterinarians registered in the Poultry Production Association of Rio Grande do Sul, followed by the snowball technique. The acquisition of 26 contacts of veterinarians was accomplished, and 16 were interviewed. Through the answers obtained it was possible to verify that the interviewees' understanding regarding both the antibiotic resistance impact and the decision-making about the use of antibiotics seem to be linked to their practical experiences. Besides that, according to the veterinarians, farmers can acquire and administer the antimicrobials on their farms. Moreover, both farm storage and administration of lower doses of antibiotics than the recommended one could be contributing factors to resistant bacteria selection. Furthermore, controversially, the professionals believed that resistant bacteria can be transmitted to humans from eggs, but they said that there are no bacteria in eggs. Therefore, the veterinarians´ practices can be improved considering national and international guidelines on antimicrobial resistance to minimize the development of resistance. Finally, it is expected that the present results will contribute to a more complex discussion about antimicrobial resistance, helping to formulate public policies in the egg production industry.
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Affiliation(s)
- Mariana C Torres
- Department of Preventive Veterinary Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil; Postgraduate Program in Veterinary Science, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil
| | - Tatiana R Vieira
- Department of Preventive Veterinary Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil
| | - Marisa R I Cardoso
- Department of Preventive Veterinary Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil
| | - Franciele M Siqueira
- Postgraduate Program in Veterinary Science, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil; Department of Veterinary Clinical Pathology, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil.
| | - Mauro R Borba
- Department of Preventive Veterinary Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul CEP: 91540-000, Brazil
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Hayes JF. Fighting Back against Antimicrobial Resistance with Comprehensive Policy and Education: A Narrative Review. Antibiotics (Basel) 2022; 11:antibiotics11050644. [PMID: 35625288 PMCID: PMC9137785 DOI: 10.3390/antibiotics11050644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Globally, antimicrobial resistance has emerged as a significant threat. A comprehensive plan is required to combat antimicrobial resistance. There have been national and international efforts to address this global health problem, but much work remains. Enhanced funding and regulations to support antimicrobial stewardship policy and program development, reforms to incentivize drug development to treat resistant pathogens, and efforts to strengthen One Health programs are areas for collaboration and innovation. Finally, implementation of educational interventions for trainees encompassing these key areas along with training on policy and leadership development is critical to enable sustainability of these efforts to fight back against antimicrobial resistance.
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Affiliation(s)
- Justin F Hayes
- Department of Medicine, Division of Infectious Diseases, Banner University Medical Center-Tucson and South, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA
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16
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Assessing Knowledge, Beliefs, and Behaviors around Antibiotic Usage and Antibiotic Resistance among UK Veterinary Students: A Multi-Site, Cross-Sectional Survey. Antibiotics (Basel) 2022; 11:antibiotics11020256. [PMID: 35203857 PMCID: PMC8868437 DOI: 10.3390/antibiotics11020256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 01/21/2023] Open
Abstract
Antimicrobial resistance (AMR) is a profound threat to human and animal health. Antimicrobial prescribing behaviours are influenced by psychological factors such as knowledge, beliefs, and emotions. As future antimicrobial prescribers, it is important to understand beliefs about AMR and stewardship among veterinary (vet) students. This cross-sectional online survey assessed vet students’ self-reported behavior, knowledge, and beliefs in specific relation to antibiotic resistance (ABR) and antibiotic usage. Participants were early years (first- and second-year; n = 460) and later-years (third- and fourth-year; n = 113) undergraduate vet students from three UK universities. Self-reported antibiotic-related behaviors were responsible among most students. Knowledge about ABR and stewardship was moderate among early years students and good among later years students. Vet students typically believed that vets had less responsibility for both causing and preventing ABR than other groups (animal owners, human medics, and the public). This study offers evidence that vet students (along with other groups) tend to lay greater responsibility for ABR/AMR outside of their own profession, which may impact their future prescribing behaviors. It is vital that AMR and antimicrobial stewardship are embedded across veterinary curricula, and that the One Health nature of the challenge posed by AMR is emphasized to encourage shared responsibility across all stakeholder groups, thereby helping to reduce ‘other-blaming’ for AMR.
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17
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Sobierajski T, Mazińska B, Chajęcka-Wierzchowska W, Śmiałek M, Hryniewicz W. Antimicrobial and Antibiotic Resistance from the Perspective of Polish Veterinary Students: An Inter-University Study. Antibiotics (Basel) 2022; 11:antibiotics11010115. [PMID: 35052992 PMCID: PMC8772817 DOI: 10.3390/antibiotics11010115] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/07/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022] Open
Abstract
The phenomenon of antibiotic resistance is a global problem that affects the use of antibiotics by humans and animal husbandry. One of the primary reasons for the growing phenomenon of antibiotic resistance is the over-prescription of antibiotics by doctors in human medicine and the overuse of antibiotics in industrial animal farming. Adequate education of veterinary medical students on the use of antibiotics in animal husbandry may reduce antibiotic resistance. For this reason, a survey was conducted among students at four primary research and didactic centers teaching veterinary medicine in Poland. The survey aimed to find out the knowledge and attitude of students towards the use of antibiotics and antibiotic resistance. The survey was conducted in May/June 2021. Four hundred and sixty-seven students participated in the study. The study positively verified that antibiotics and antibiotic resistance knowledge increase with successive years of veterinary studies/education. For most students (82.2%), antibiotic resistance is a significant problem, but only 58.7% believe it is global, and one in three respondents heard about the One Health approach.
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Affiliation(s)
- Tomasz Sobierajski
- Faculty of Applied Social Sciences and Resocialization, Warsaw University, Krakowskie Przedmieście 26/28, 00-927 Warsaw, Poland
- Correspondence:
| | - Beata Mazińska
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Chełmska 30/34, 00-725 Warsaw, Poland; (B.M.); (W.H.)
| | - Wioleta Chajęcka-Wierzchowska
- Department of Industrial and Food Microbiology, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Plac Cieszyński 1, 10-726 Olsztyn, Poland;
| | - Marcin Śmiałek
- Department of Poultry Diseases, Faculty of Veterinary Medicine, University of Warmia and Mazury, 10-719 Olsztyn, Poland;
| | - Waleria Hryniewicz
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Chełmska 30/34, 00-725 Warsaw, Poland; (B.M.); (W.H.)
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18
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Knowledge and perceptions of Australian postgraduate veterinary students prior to formal education of antimicrobial use and antimicrobial resistance. One Health 2022; 14:100366. [PMID: 35005181 PMCID: PMC8719013 DOI: 10.1016/j.onehlt.2021.100366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/31/2022] Open
Abstract
Antimicrobial resistance (AMR) is widely perceived as a threat to human and animal health and a significant One Health issue with extensive and complex factors contributing to its occurrence and spread. Previous studies have surveyed human and animal health professionals to determine their perceptions regarding AMR and antimicrobial use (AMU). There are limited studies exploring the understanding of veterinary students despite their critical role as future antimicrobial prescribers. A cross-sectional survey was administered to an entire cohort of Doctor of Veterinary Medicine Year 2 (DVM2) students (n = 136) to investigate their knowledge and perceptions regarding AMR and AMU prior to formal education on this issue. Ninety students (66.2% of the cohort) completed the survey. There was overwhelming agreement regarding the immediacy of the problem, with 84.4% of students indicating that ‘We must take action on AMR’. Despite more than 94.4% of students correctly defining AMR, specific knowledge regarding AMR impact, contributory causes to AMR and strategies to solve the challenge of AMR was variable. Most students perceived livestock producers to have a significant role in the perpetuation of AMR due to AMU for prophylaxis (71.1% substantial/moderate contribution) and treatment (56.7% substantial/moderate contribution). Over a third of respondents (37.8%) were unsure if AMR could spread from animals to humans. Respondents perceived that various groups (dentists, doctors, veterinarians, professional organisations) are all important in ameliorating the issue of AMR. The implementation of restrictive measures to reduce veterinary prescription of antimicrobials was viewed as less important than strategies involving education, hygiene, surveillance, and guideline development/availability. To encourage the development of good antimicrobial stewardship (AMS) practices, professional veterinary education needs to foster an understanding of the scientific, behavioural and social issues that contribute to AMR and inappropriate AMU, as well as prescribers' personal contribution to AMR perpetuation and amelioration. Reports on perceptions of postgraduate veterinary students regarding factors responsible for AMR prior to formal instruction in a DVM program Students were unsure about routes of transfer of AMR between humans and animals, and antimicrobial use for routine veterinary procedures Students had high agreement that antimicrobial use in livestock contributed to AMR Students, like qualified veterinarians, do not like the concept of government restricting their ability to prescribe antimicrobials
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19
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Thursky KA, Hardefeldt LY, Rajkhowa A, Ierano C, Bishop J, Hawes L, Biezen R, Saha SK, Dowson L, Bailey KE, Scarborough R, Little SB, Gotterson F, Hur B, Khanina A, Urbancic K, Crabb HK, Richards S, Sri A, James R, Kong DCM, Marshall C, Mazza D, Peel T, Stuart RL, Manski-Nankervis JA, Friedman ND, Bennett N, Schulz T, Billman-Jacobe H, Buono E, Worth L, Bull A, Richards M, Ayton D, Gilkerson JR, Browning GF, Buising KL. Antimicrobial stewardship in Australia: the role of qualitative research in programme development. JAC Antimicrob Resist 2021; 3:dlab166. [PMID: 34806005 PMCID: PMC8600289 DOI: 10.1093/jacamr/dlab166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial stewardship (AMS) in Australia is supported by a number of factors, including enabling national policies, sectoral clinical governance frameworks and surveillance programmes, clinician-led educational initiatives and health services research. A One Health research programme undertaken by the National Centre for Antimicrobial Stewardship (NCAS) in Australia has combined antimicrobial prescribing surveillance with qualitative research focused on developing antimicrobial use-related situational analyses and scoping AMS implementation options across healthcare settings, including metropolitan hospitals, regional and rural hospitals, aged care homes, general practice clinics and companion animal and agricultural veterinary practices. Qualitative research involving clinicians across these diverse settings in Australia has contributed to improved understanding of contextual factors that influence antimicrobial prescribing, and barriers and facilitators of AMS implementation. This body of research has been underpinned by a commitment to supplementing 'big data' on antimicrobial prescribing practices, where available, with knowledge of the sociocultural, technical, environmental and other factors that shape prescribing behaviours. NCAS provided a unique opportunity for exchange and cross-pollination across the human and animal health programme domains. It has facilitated synergistic approaches to AMS research and education, and implementation of resources and stewardship activities. The NCAS programme aimed to synergistically combine quantitative and qualitative approaches to AMS research. In this article, we describe the qualitative findings of the first 5 years.
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Affiliation(s)
- Karin A Thursky
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia
- Guidance Group, Royal Melbourne Hospital, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne and Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia
| | - Laura Y Hardefeldt
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Arjun Rajkhowa
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Courtney Ierano
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Jaclyn Bishop
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Pharmacy Department, Ballarat Health Services, 1 Drummond Street North, Ballarat, Victoria 3353, Australia
| | - Lesley Hawes
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
| | - Ruby Biezen
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
- Department of General Practice, University of Melbourne, 780 Elizabeth Street, Melbourne, Victoria 3010, Australia
| | - Sajal K Saha
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
| | - Leslie Dowson
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Kirsten E Bailey
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Ri Scarborough
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Stephen B Little
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Fiona Gotterson
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Brian Hur
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Anna Khanina
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne and Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia
| | - Karen Urbancic
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Helen K Crabb
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Suzanna Richards
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Anna Sri
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Rodney James
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Guidance Group, Royal Melbourne Hospital, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - David C M Kong
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Pharmacy Department, Ballarat Health Services, 1 Drummond Street North, Ballarat, Victoria 3353, Australia
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Caroline Marshall
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Danielle Mazza
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia
| | - Trisha Peel
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, The Alfred and Central Clinical School, Burnet Institute, Monash University and Alfred Health, 85 Commercial Road, Monash University, Melbourne, Victoria 3004, Australia
| | - Rhonda L Stuart
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Departments of Infectious Diseases and Infection Control and Epidemiology, Monash Medical Centre, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Jo-Anne Manski-Nankervis
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of General Practice, University of Melbourne, 780 Elizabeth Street, Melbourne, Victoria 3010, Australia
| | - N Deborah Friedman
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, University Hospital Geelong, Barwon Health, Bellerine Street, Geelong, Victoria 3220, Australia
| | - Noleen Bennett
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Guidance Group, Royal Melbourne Hospital, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- VICNISS Coordinating Centre, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Thomas Schulz
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia
| | - Helen Billman-Jacobe
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Evette Buono
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- New South Wales Clinical Excellence Commission, 1 Reserve Road, St Leonards, New South Wales 2065, Australia
| | - Leon Worth
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne and Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia
| | - Ann Bull
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- VICNISS Coordinating Centre, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Michael Richards
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia
- VICNISS Coordinating Centre, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
| | - Darshini Ayton
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia
| | - James R Gilkerson
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Glenn F Browning
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Asia-Pacific Centre for Animal Health, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Corner Park Drive and Flemington Road, Building 400, Parkville, Victoria 3010, Australia
| | - Kirsty L Buising
- NHMRC National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Department of Infectious Diseases, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne Health, 300 Grattan Street, Parkville, Victoria 3050, Australia
- Guidance Group, Royal Melbourne Hospital, Melbourne Health, 792 Elizabeth Street, Melbourne, Victoria 3000, Australia
- Peter Doherty Institute of Infection and Immunity, 792 Elizabeth Street, Melbourne Victoria, 3000, Australia
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20
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Tompson AC, Mateus ALP, Brodbelt DC, Chandler CIR. Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts. Front Vet Sci 2021; 8:719547. [PMID: 34692805 PMCID: PMC8531418 DOI: 10.3389/fvets.2021.719547] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022] Open
Abstract
Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.
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Affiliation(s)
- Alice C Tompson
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana L P Mateus
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Dave C Brodbelt
- VEEPH Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
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21
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Antibiotic prescription practices and opinions regarding antimicrobial resistance among veterinarians in Kentucky, USA. PLoS One 2021; 16:e0249653. [PMID: 33857198 PMCID: PMC8049335 DOI: 10.1371/journal.pone.0249653] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background Inappropriate antimicrobial use (AMU) is a global concern. Opinions of veterinarians regarding AMU and its role in the development of antimicrobial resistance (AMR) may influence their prescription practices. It is important to understand these opinions, prescription practices and their potential impact on the development of AMR in order to guide efforts to curb the problem. Therefore, the objective of this study was to investigate the antimicrobial prescription practices and opinions of veterinarians in Kentucky regarding AMU and AMR. Methods This cross-sectional study used a 30-question survey questionnaire administered to veterinarians who were members of the Kentucky Veterinary Medical Association. Survey responses from 101 participants were included in the study. Descriptive statistics were computed and associations between categorical variables assessed using Chi-square or Fisher’s exact tests. Firth logistic models were used to investigate predictors of “Compliance with prescription policies” and “Cost of antimicrobial affects prescription decisions”. Results Almost all (93%) respondents indicated that improper AMU contributed to selection for AMR. A total of 52% of the respondents believed that antimicrobials were appropriately prescribed, while the remaining 48% believed that antimicrobials were inappropriately prescribed. Significant predictors of compliance with prescription policies were availability of prescription policy at the veterinary facility (Odds Ratio (OR) = 4.2; p<0.001) and over-prescription (OR = 0.35; p = 0.025). Similarly, significant predictors of cost of antimicrobials affecting prescription decisions were lack of post-graduate training (OR = 8.3; p = 0.008) and practice type, with large animal practices having significantly lower odds of the outcome (OR = 0.09; p = 0.004) than small animal practices. Conclusion Most veterinarians indicated that improper AMU contributed to selection for AMR. Since the odds of compliance with prescription policies were 4-times higher among veterinarians working at facilities that had prescription policies compared to those at facilities that didn’t, more veterinary facilities should be encouraged to adopt prescription policies to help improve compliance and reduce AMR. Veterinarians would also benefit from continued professional education to help improve prescription practices, antimicrobial stewardship and curb AMR.
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Towards a Better and Harmonized Education in Antimicrobial Stewardship in European Veterinary Curricula. Antibiotics (Basel) 2021; 10:antibiotics10040364. [PMID: 33808353 PMCID: PMC8067070 DOI: 10.3390/antibiotics10040364] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
Education in antimicrobial stewardship (AMS) in veterinary medicine is essential to foster responsible antimicrobial use and control of antimicrobial resistance (AMR) in animals. AMS is listed by the EU and international organizations among the basic 'Day One Competences' required of veterinary students upon graduation. Our aim was to evaluate the quality of education of European veterinary students in AMS. We distributed a 27-item survey addressing the perceptions of preparedness and acquired skills on key topics related to AMS to final-year veterinary students in Europe. We collected 3423 complete answers from 89 veterinary schools in 30 countries. Selection of treatment strategies and awareness of emerging AMR problems were markedly different between countries. Overall, only one in four students was familiar with guidelines for antimicrobial use. The students perceived a medium-high impact of veterinary antimicrobial use on AMR in humans. Notably, 75% of the students felt the need for improved teaching on AMS, half of which also demanded more teaching on general antimicrobial therapy. Our results highlight several possible strategies to improve the quality of education, ranging from a better link between clinical rotations and the theory taught in pre-clinical modules, to a more effective introduction into best practices for antimicrobial use.
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Llanos-Soto SG, Vezeau N, Wemette M, Bulut E, Greiner Safi A, Moroni P, Shapiro MA, Ivanek R. Survey of perceptions and attitudes of an international group of veterinarians regarding antibiotic use and resistance on dairy cattle farms. Prev Vet Med 2021; 188:105253. [PMID: 33524793 PMCID: PMC10957290 DOI: 10.1016/j.prevetmed.2020.105253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023]
Abstract
Veterinarians are the main source of information for farmers regarding the responsible use of antibiotics in farm animals and how to reduce the risk of antibiotic resistance. Consequently, understanding how veterinarians perceive their clients' and colleagues' antibiotic use and their own beliefs about the development of antibiotic resistance is essential to determining areas in which antibiotic use practices can be improved to minimize the emergence of antibiotic resistance. An international cross-sectional study was carried out using a questionnaire designed to elucidate perceptions, attitudes, and concerns of dairy veterinarians regarding antibiotic use and the emergence of antibiotic resistance in dairy farming. The questionnaire was initially administered to veterinarians attending the International Bovine Mastitis Conference in Milano, Italy, 2018, followed by veterinarian members of the National Mastitis Council, and all conference registrants. A total of 71 participants from 21 countries participated in the survey, the majority were from the United States and member countries of the European Union. Logistic regression analysis was conducted to identify predictors of veterinarians' level of concern about the development of antibiotic resistance on their clients' farms. Associations were described with odds ratios (ORs) and the associated 95 % confidence intervals (95 % CIs). Free text responses where participants shared their views on the reason for overprescribing antibiotics by veterinarians were analyzed using thematic analysis. Participants perceived that nearly half of their clients overuse or inappropriately use antibiotics, and nearly half of their colleagues overprescribe or inappropriately prescribe antibiotics. After controlling for other factors, the odds of veterinarians being concerned about antibiotic resistance on dairy farms they served decreased by a factor of 0.91 for each additional year of participants' experience working with dairy cattle (OR = 0.91, 95 % CI = 0.84-0.99). Participants concerned about antibiotic resistance on clients' dairy farms were also more likely to consider better adherence to drug labelling as important for reducing farmers' antibiotic use (OR = 6.86, 95 % CI = 1.21-38.93). Thematic analysis revealed four themes surrounding the perceived reasons for veterinarians' overprescribing of antibiotics: (i) knowledge, (ii) attitudes, (iii) barriers, and (iv) rules and regulations. The study findings will aid in the development of strategies to improve antibiotic use in dairy farming and educational initiatives looking to enhance the communication between veterinarians and farmers about judicious use of antibiotics.
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Affiliation(s)
- Sebastian G Llanos-Soto
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.
| | - Neil Vezeau
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Michelle Wemette
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Ece Bulut
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Amelia Greiner Safi
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA; Department of Communication, College of Agriculture and Life Sciences, Ithaca, NY, 14853, USA
| | - Paolo Moroni
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA; Università degli Studi di Milano, Dipartimento di Medicina Veterinaria, Milan, Italy
| | - Michael A Shapiro
- Department of Communication, College of Agriculture and Life Sciences, Ithaca, NY, 14853, USA
| | - Renata Ivanek
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
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Stein MR, Evason MD, Stull JW, McClure JT, Weese JS. Knowledge, attitudes and influencers of North American dog-owners surrounding antimicrobials and antimicrobial stewardship. J Small Anim Pract 2021; 62:442-449. [PMID: 33594676 DOI: 10.1111/jsap.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To quantify the individual influences of antimicrobial cost, method of administration and drug importance in human medicine on dog-owner antimicrobial preference, and determine knowledge, attitudes and influencers of dog-owners surrounding antimicrobials and antimicrobial stewardship. MATERIALS AND METHODS Data were collected through an online survey targeting three dog-owner participant groups. These consisted of individuals residing in: (1) Canada, (2) USA and (3) any country recruited through an educational social media site. USA and Canadian participants were financially compensated. Conjoint analysis was used to quantify the influence of antimicrobial cost, method of administration and drug importance in human medicine. Descriptive and analytical statistics were used for data evaluation. RESULTS A total of 809 surveys were completed. Antimicrobial cost accounted for 47% of dog-owner preferences, followed by method of administration (31%) and drug importance in human medicine (22%). All groups preferred lower cost drugs that were administered once by injection. Participants were more likely to prefer drugs considered "very important" in human medicine, except for the social media participants, who preferred drugs that were "not at all important." Most respondents (86%) reported antimicrobial resistance as important in human medicine and 29% believed antimicrobial use in pets posed a risk for antimicrobial resistance in humans. Participants recruited through social media, and those in the highest education category, were significantly more likely to report antimicrobial use in pets as a risk to people. CLINICAL SIGNIFICANCE Cost was the most important factor in dog-owner antimicrobial preferences. There is a need for dog-owner antimicrobial stewardship education.
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Affiliation(s)
- M R Stein
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - M D Evason
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada.,Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - J W Stull
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - J T McClure
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada
| | - J S Weese
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Centre for Public Health and Zoonoses, University of Guelph, Guelph, Ontario, Canada
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Galarce N, Arriagada G, Sánchez F, Venegas V, Cornejo J, Lapierre L. Antimicrobial Use in Companion Animals: Assessing Veterinarians' Prescription Patterns through the First National Survey in Chile. Animals (Basel) 2021; 11:348. [PMID: 33573203 PMCID: PMC7912091 DOI: 10.3390/ani11020348] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/17/2022] Open
Abstract
Although the relationship between the use of antimicrobials and the development of resistant bacteria is well established, information about the use of antimicrobials in companion animals has been poorly described, which represents a risk to public health. The aim of this study was to describe the antimicrobial prescription patterns of Chilean companion animal veterinarians. A nationally distributed survey targeted at companion animal veterinarians was designed. The survey included questions about the veterinarian's demographics, bacterial diseases treated, prescribed antimicrobials, and the use of laboratory diagnostic tools. Three hundred twenty-three responses were collected, most of the respondents were female (59.4%). The most frequently reported bacterial diseases were pyoderma (17.2%), followed by otitis and abscesses (7.4%). The antimicrobials most used corresponded with critically or highly important drugs for veterinary and human use, including β-lactams (65.3%), quinolones (36.2%) and tetracyclines (23.2%). Only 15% of the veterinarians reported the use of laboratory diagnostic tests, although 67% declared they were aware of the official antimicrobial classification schemes. Our results describe for the first time the usage of antimicrobials by veterinarian practitioners in Chile to treat different diseases in companion animals. The data presented here provide a baseline that could help to promote the implementation of clinical guidelines and regulations in order to improve current treatments.
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Affiliation(s)
- Nicolás Galarce
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile; (N.G.); (F.S.); (J.C.)
- Núcleo Una Salud—FAVET, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile
| | - Gabriel Arriagada
- Instituto de Ciencias Agroalimentarias, Animales y Ambientales—ICA3, Universidad de O’Higgins, San Fernando 3070000, Chile;
| | - Fernando Sánchez
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile; (N.G.); (F.S.); (J.C.)
- Núcleo Una Salud—FAVET, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile
| | - Vladimir Venegas
- Escuela de Pregrado, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile;
| | - Javiera Cornejo
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile; (N.G.); (F.S.); (J.C.)
- Núcleo Una Salud—FAVET, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile
| | - Lisette Lapierre
- Departamento de Medicina Preventiva Animal, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile; (N.G.); (F.S.); (J.C.)
- Núcleo Una Salud—FAVET, Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago 8820000, Chile
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Samuels R, Qekwana DN, Oguttu JW, Odoi A. Antibiotic prescription practices and attitudes towards the use of antimicrobials among veterinarians in the City of Tshwane, South Africa. PeerJ 2021; 9:e10144. [PMID: 33520429 PMCID: PMC7811296 DOI: 10.7717/peerj.10144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/20/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Understanding the prescription practices and attitudes of veterinarians towards antimicrobial resistance (AMR) is crucial in guiding efforts to curb AMR. This study investigated prescription practices and attitudes towards AMR among veterinarians in the City of Tshwane, South Africa. METHODS Out of the 83 veterinarians invited to participate in the study, 54 signed the consent form and completed the questionnaire. Percentages and 95% confidence intervals of all categorical variables were computed. A multinomial logistic model was used to identify predictors of the veterinarians' view towards antimicrobial use. RESULTS The majority (88%) of respondents indicated that improper use of antimicrobials contributed to selection for AMR. Veterinarians relied on clinical signs and symptoms (88%, 48/54) to decide whether to prescribe antimicrobials or not. However, the choice of antimicrobials depended on the cost of antibiotics (77.2%), route of administration (81.5%), and risk of potential adverse reactions (79.6%; 43/54). Many (61.5%) veterinarians were of the view that often antimicrobials are appropriately prescribed and 88.7% agreed that improper use of antimicrobials contributed to selection for antimicrobial resistant organisms. Compared to females, males were significantly more likely (Relative Risk Ratio (RRR) = 9.0; P = 0.0069) to agree rather than to "neither agree nor disagree" that their colleagues over-prescribed antimicrobials. CONCLUSIONS The decisions to prescribe antimicrobials by the veterinarians depended on clinical presentation of the patient, while the choice of antimicrobial depended on cost, route of administration, and risk of potential adverse reactions. Most veterinarians were of the view that antimicrobials were prescribed judiciously.
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Affiliation(s)
- Ronita Samuels
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA
| | - Daniel Nenene Qekwana
- Section of Veterinary Public Health, Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - James W. Oguttu
- Department of Agriculture and Animal Health, College of Agriculture & Environmental Sciences, University of South Africa, Johannesburg, South Africa
| | - Agricola Odoi
- Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA
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Rahaman MR, Milazzo A, Marshall H, Chaber AL, Bi P. Q fever vaccination: Australian animal science and veterinary students' One Health perspectives on Q fever prevention. Hum Vaccin Immunother 2020; 17:1374-1381. [PMID: 33180660 DOI: 10.1080/21645515.2020.1829900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Unvaccinated animal science and veterinary students are at risk of Q fever, a vaccine-preventable zoonotic disease transmitted from animals to humans. We investigated students' perspectives on Q fever prevention using a One Health approach combining animal, human and environmental health. Animal science and veterinary students enrolled at the University of Adelaide in 2019 were invited to participate in an online survey to explore their perceptions about Q fever and prevention strategies. We undertook descriptive analysis and logistic regression. Overall, 46% of students reported little to no knowledge of Q fever. Over three-quarters of students reported transmission of Q fever via aerosol inhalation and animal culling, whilst other modes including sexual transmission between humans (7%) was poorly identified. The majority of students reported exposure to cattle, sheep and goats. Of those who reported vaccination status, 5% veterinary and 61% animal science students were unvaccinated for Q fever. Challenges concerning vaccination included cost, time and access to healthcare with strategies aimed at promoting awareness, improving healthcare access and subsidized and mass vaccination. Knowledge of Q fever among respondents, particularly about disease transmission was suboptimal. As a key principle to One Health approach, adherence to biosecurity guidelines during contact with animals could potentially reduce zoonoses including Q fever transmission. Improving access to Q fever vaccine for unvaccinated students is a priority. Findings underscore that university policy for Q fever vaccination needs to consider subsidized vaccination for both animal science and veterinary students.
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Affiliation(s)
- Md R Rahaman
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Adriana Milazzo
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Helen Marshall
- Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, Australia.,Department of Pediatrics, Women's and Children's Health Network, Adelaide, Australia
| | - Anne-Lise Chaber
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, Australia
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28
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Letters to the Editor. J Am Vet Med Assoc 2020; 257:692-695. [DOI: 10.2460/javma.257.7.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kovacevic Z, Blagojevic B, Suran J, Horvat O. Mapping knowledge and comprehension of antimicrobial stewardship and biosecurity among veterinary students. PLoS One 2020; 15:e0235866. [PMID: 32813747 PMCID: PMC7446898 DOI: 10.1371/journal.pone.0235866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/24/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES As an important public health concern, antimicrobial resistance (AMR) is related to lack of knowledge among healthcare professionals. Since the Global Action Plan on AMR highlights the importance of training all healthcare professionals, it is essential to focus our attention on the education related to judicious antimicrobial use. The current study was the first attempt in southeastern Europe to quantify the knowledge about antimicrobial usage and biosecurity measure among veterinary students. METHODS This questionnaire-based study was performed between April and May of 2019 on 213 veterinary students of the University of Novi Sad, Serbia and the University of Zagreb, Croatia. RESULTS Veterinary students appeared to be little aware of antimicrobial use in veterinary medicine contribution to overall AMR since only 56.8% have chosen strong contribution as the answer. Of the students surveyed, only 22.1%/35.7% of them strongly agreed/agreed that the amount of teaching time for pharmacology was about right. Students who denied having good knowledge of the pharmacology of antimicrobials showed higher knowledge about systemic use of antimicrobials in different clinical scenarios (p = 0.002). High importance of some antimicrobials for human medicine was not recognized by surveyed students. Only 8.5% of them identified gentamicin correctly, as first-line therapy. Students expected to graduate later were more likely to identify the importance of rating antimicrobials correctly than those who thought they would graduate earlier (p = 0.002). More than half of students gave correct answer at scenario regarding a dog with recurrent pyoderma by choosing culture and susceptibility (C & S) testing. Our students who think they will graduate sooner have higher knowledge level on C & S testing sample submission for range of clinical scenarios (p = 0.004). Moreover, appropriate use of PPE (personal protective equipment) procedure and biosecurity measure were reported for two thirds of our students in case of only for two clinical scenarios. CONCLUSION This study reveals that among veterinary students from Croatia and Serbia improved undergraduate education is needed on the AMR with emphasis on antimicrobial stewardship (AMS) and appropriate biosecurity.
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Affiliation(s)
- Zorana Kovacevic
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
- * E-mail:
| | - Bojan Blagojevic
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Jelena Suran
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Olga Horvat
- Department of Pharmacology Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Fasina FO, LeRoux-Pullen L, Smith P, Debusho LK, Shittu A, Jajere SM, Adebowale O, Odetokun I, Agbaje M, Fasina MM, Fasanmi OG, van Dyk D, Abubakar MS, Onakpa MM, Ali MG, Yousuf HS, Elmgboul WE, Sirdar MM. Knowledge, Attitudes, and Perceptions Associated With Antimicrobial Stewardship Among Veterinary Students: A Multi-Country Survey From Nigeria, South Africa, and Sudan. Front Public Health 2020; 8:517964. [PMID: 33194938 PMCID: PMC7609782 DOI: 10.3389/fpubh.2020.517964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 09/15/2020] [Indexed: 02/05/2023] Open
Abstract
In African countries, antimicrobial resistance (AMR) issue remains pertinent. Despite this, little efforts have been made to assess the future veterinary prescribers on their knowledge, attitudes and practices (KAP) related to antimicrobial usage. This multi-country survey attempts to explore the KAP of future veterinarians on stewardship of antimicrobial and identify knowledge gaps. Eight veterinary schools participated from Nigeria, Sudan and South Africa. Data regarding perceptions and knowledge were analyzed using Chi-square χ2 test, Spearman's (Rho) Rank order correlation and factor analysis using principal component factoring extraction method. Fifty-two percent of the study participants were final year veterinary students, respectively, and majority (77.2%) had no previous knowledge of biomedical sciences. Majority age were 22-27 years (24.7 ± 2.8) 79% and multiple career fields post-graduation were preferred. Overall, poor perceptions and knowledge of antimicrobial stewardship were observed with variations among countries and only 36.3% (n = 123) of the students were confident in their ability to choose the ideal antimicrobial agents for a specific patient/group of animals. The majority of the final year students were confident of their knowledge regarding AMR (68%), making of Gram staining (69.2%) and in choosing the most ideal route for administering a specific antimicrobial (74.7%). The final year students had significantly (p < 0.05) higher confidence level for knowledge compared with the pre-final year students. Tetracyclines, penicillins, and sulphonamides represent the three most abused veterinary antimicrobials with similar ranking across countries. South African (69.7 ± 20.5) and Sudanese (68.1 ± 15.4) had significantly (p < 0.0001) higher mean scores compared to the Nigerian students (44.3 ± 6.8) in the student's ability to correctly match some specific antimicrobials against their classes but Nigerian students performed better in ranking antimicrobials. This survey revealed poor to average knowledge of antimicrobial stewardship among veterinary students with significant knowledge gaps across the countries. It is recommended that the relevant regulatory and standardization authorities should make concerted efforts and interventions to regularly review curricula to ensure the delivery of targeted formative and normative training, and improved lectures on antimicrobial usage and stewardship in order to improve the awareness and behaviors of future prescribers. The identified knowledge gaps of veterinary medical students on antimicrobial stewardship must be bridge to safeguard the future.
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Affiliation(s)
- Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases, Food and Agriculture Organisation of the United Nations, Dar es Salaam, Tanzania
- Department of Veterinary Tropical Disease, University of Pretoria, Pretoria, South Africa
- *Correspondence: Folorunso O. Fasina
| | - Lerica LeRoux-Pullen
- Department of Paraclinical Sciences, University of Pretoria, Pretoria, South Africa
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
| | - Peter Smith
- Department of Production Animal Studies, University of Pretoria, Pretoria, South Africa
| | - Legesse K. Debusho
- Department of Statistics, College of Science, Engineering and Technology, University of South Africa, Johannesburg, South Africa
| | - Aminu Shittu
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Saleh M. Jajere
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Seri Kembangan, Malaysia
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria
| | - Oluwawemimo Adebowale
- Department of Veterinary Public Health and Reproduction, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Nigeria
| | - Ismail Odetokun
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Michael Agbaje
- Department of Veterinary Microbiology and Parasitology, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta, Nigeria
| | - Modupe M. Fasina
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Olubunmi G. Fasanmi
- Department of Animal Health, Federal College of Animal Health and Production Technology, Ibadan, Nigeria
| | - Deborah van Dyk
- Department of Production Animal Studies, University of Pretoria, Pretoria, South Africa
| | - Mohammed S. Abubakar
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Monday M. Onakpa
- Department of Veterinary Pharmacology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Masaad G. Ali
- Faculty of Veterinary Medicine, University of Khartoum, Khartoum, Sudan
| | - Hozaifa S. Yousuf
- Faculty of Veterinary Medicine, University of Albutana, Albutana, Sudan
| | | | - Mohammed M. Sirdar
- Department of Production Animal Studies, University of Pretoria, Pretoria, South Africa
- Onderstepoort Veterinary Research, Agricultural Research Council, Pretoria, South Africa
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Stevens NT, Bruen C, Boland F, Pawlikowska T, Fitzpatrick F, Humphreys H. Is online case-based learning effective in helping undergraduate medical students choose the appropriate antibiotics to treat important infections? JAC Antimicrob Resist 2019; 1:dlz081. [PMID: 34222954 PMCID: PMC8210328 DOI: 10.1093/jacamr/dlz081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/01/2019] [Accepted: 11/07/2019] [Indexed: 11/15/2022] Open
Abstract
Background Medical students are frequently confused about indication for and choice of antibiotic. We developed an online learning resource that focused on antibiotic stewardship and important infections where medical students could practise their antibiotic decision-making skills safely. Methods The resource was made available to third-year undergraduate medical students via their virtual learning environment. It covered the theory and fundamentals of antibiotic stewardship and five clinical cases covering important infections. We assessed the number of attempts taken to achieve the required level of understanding to pass each activity and surveyed a selection of students for their feedback. Results Of 310 students, over 80% engaged with the theory-based components, with an average score exceeding 90% (range 93.4%–99.7%). Eighty-three percent (258/310) engaged with the first two cases (Clostridioides difficile infection and pyelonephritis) but only 61% (189/310) of students completed the fifth case on bacterial meningitis. Only 49.4% (153/310) of students completed all five cases, with 48% (73/153) of these achieving ≥90% on their first attempt of the associated quizzes. Fifty-nine percent (23/39) agreed or strongly agreed that the quality of the learning resource was excellent. Seventy-two percent (28/39) agreed or strongly agreed that the objectives of the resource were relevant to their needs as undergraduate medical students. Only 33% (13/39) reported the resource would change their practice. Conclusions Student feedback was positive but engagement with the cases needs improvement. Highlighting the utility of case-based technology-enhanced learning as a safe place to practise antibiotic decision-making skills among students may improve this.
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Affiliation(s)
- Niall T Stevens
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, RCSI Education & Research Centre, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - Catherine Bruen
- RCSI Health Professions Education Centre, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland
| | - Fiona Boland
- Data Science Centre, Royal College of Surgeons in Ireland, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland
| | - Teresa Pawlikowska
- RCSI Health Professions Education Centre, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2, Ireland
| | - Fidelma Fitzpatrick
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, RCSI Education & Research Centre, Beaumont Hospital, Beaumont, Dublin 9, Ireland.,Department of Clinical Microbiology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - Hilary Humphreys
- Department of Clinical Microbiology, Royal College of Surgeons in Ireland, RCSI Education & Research Centre, Beaumont Hospital, Beaumont, Dublin 9, Ireland.,Department of Clinical Microbiology, Beaumont Hospital, Beaumont, Dublin 9, Ireland
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Odetokun IA, Akpabio U, Alhaji NB, Biobaku KT, Oloso NO, Ghali-Mohammed I, Biobaku AJ, Adetunji VO, Fasina FO. Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey. Antibiotics (Basel) 2019; 8:antibiotics8040243. [PMID: 31795341 PMCID: PMC6963658 DOI: 10.3390/antibiotics8040243] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 02/05/2023] Open
Abstract
The challenge of antimicrobial resistance (AMR) is grave in developing countries. Antimicrobials are misused yet stakeholders' contribution to antimicrobial stewardship is low. Veterinary students are future prescribers and their knowledge could influence progress in combating AMR; hence, there is a need to assess their knowledge, attitude, and awareness of AMR. A multi-institutional questionnaire was administered to undergraduates in Nigerian veterinary schools. It comprised demographics, own personal antibiotic usage, and knowledge, attitude, and awareness of AMR in humans and animals. Descriptive statistics and logistic regression were used for analyses. Of the 426 respondents, 39.2% reported personal antimicrobial use in the previous six months. Over 60% received knowledge scores lower than average and >87% requested more education on clinical use and prescriptions pre-graduation, monitored dispensing of antimicrobials, conducting AMR research, and confirmed link among human, animal, and environmental health. Less than 25% of respondents were aware of antimicrobial stewardship and global efforts/organizations for AMR. Final year students have 9-fold and 14-fold more satisfactory knowledge on antimicrobials in humans and animals compared with other students, respectively (p = 0.001). Final year students also have more knowledge (13×) and awareness of contributory factors (3×) on AMR (p = 0.001) than other students. Unsatisfactory knowledge on AMR issues exists among veterinary students yet willingness to improve was observed. Identified knowledge, attitude, and gaps in AMR awareness should be targeted by veterinary schools in Nigeria.
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Affiliation(s)
- Ismail A. Odetokun
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin 240272, Kwara State, Nigeria; (I.G.-M.); (A.J.B.)
- Correspondence: ; Tel.: +234-80-3088-6018
| | - Uduak Akpabio
- Department of Veterinary Public Health and Preventive Medicine, Michael Okpara University of Agriculture, Umudike 440109, Abia State, Nigeria;
| | - Nma B. Alhaji
- Public Health and Epidemiology Unit, Niger State Veterinary Hospital, Bosso, Minna 920211, Niger State, Nigeria;
| | - Khalid T. Biobaku
- Department of Veterinary Pharmacology and Toxicology, University of Ilorin, Ilorin 240272, Kwara State, Nigeria;
| | - Nurudeen O. Oloso
- Epidemiology Section, Department of Production Animal Studies, Faculty of Veterinary Science, Onderstepoort Campus 0110, University of Pretoria, Pretoria 0110, South Africa;
| | - Ibraheem Ghali-Mohammed
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin 240272, Kwara State, Nigeria; (I.G.-M.); (A.J.B.)
| | - Asmau J. Biobaku
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin 240272, Kwara State, Nigeria; (I.G.-M.); (A.J.B.)
| | - Victoria O. Adetunji
- Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan 200284, Oyo State, Nigeria;
| | - Folorunso O. Fasina
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, Onderstepoort Campus 0110, University of Pretoria, Pretoria 0110, South Africa;
- Emergency Centre for Transboundary Animal Diseases-Food and Agriculture Organization of the United Nations (ECTAD-FAO), Dar es Salaam 14111, Tanzania
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Norris JM, Zhuo A, Govendir M, Rowbotham SJ, Labbate M, Degeling C, Gilbert GL, Dominey-Howes D, Ward MP. Factors influencing the behaviour and perceptions of Australian veterinarians towards antibiotic use and antimicrobial resistance. PLoS One 2019; 14:e0223534. [PMID: 31600264 PMCID: PMC6786536 DOI: 10.1371/journal.pone.0223534] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 09/23/2019] [Indexed: 11/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global crisis with impacts on the future health and welfare of humans and animals. Determining key factors that influence veterinarians' antimicrobial prescribing behaviours can bridge the gap between prescribing guidelines and clinical usage. Veterinarians practicing in Australia were surveyed on their frequency in prescribing different antibiotics; factors influencing their antibiotic prescribing behaviours; and their perceptions of current drivers of AMR. Antibiotics were prescribed in a third of consultations with key differences in the frequency of use of specific antibiotics by small companion animal (SCA), equine and livestock veterinarians, which broadly aligned with antibiotic registration restrictions in Australia. SCA veterinarians reported prescribing broad-spectrum antibiotics of higher importance to human health more frequently than livestock veterinarians. Factors that were reported as 'strong' or 'moderate' barriers to appropriate antibiotic prescribing were the 1) cost of culture and susceptibility testing and 2) lack of access to rapid and affordable diagnostic tests. Fear of losing clients, colleague pressure, and lack of their own understanding about antibiotics were considered to be 'no' or 'somewhat' of a barrier to appropriate prescribing by respondents. SCA veterinarians placed greater importance on the contribution of antibiotic use in livestock to AMR, than antibiotic use in companion animals. Despite reporting use of fewer, mostly narrow spectrum antibiotics of lower importance to human and animal health, livestock veterinarians were generally more aware of their potential contribution to AMR. This study provides insights into the similarities and differences in SCA, equine and livestock veterinarians practicing in Australia and informs sector-specific strategies to improve antimicrobial stewardship.
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Affiliation(s)
- Jacqueline M. Norris
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- * E-mail:
| | - Annie Zhuo
- School of Geosciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Merran Govendir
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Samantha J. Rowbotham
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Maurizio Labbate
- School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement, Evidence & Values, School of Health and Society - Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Wollongong Antimicrobial Resistance Research Alliance (WARRA), University of Wollongong, Wollongong, New South Wales, Australia
| | - Gwendolyn L. Gilbert
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Dale Dominey-Howes
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- School of Geosciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael P. Ward
- Sydney School of Veterinary Science, The University of Sydney, Sydney, New South Wales, Australia
- Westmead Institute for Medical Research, Sydney, New South Wales, Australia
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Beliefs, Attitudes and Self-Efficacy of Australian Veterinary Students Regarding One Health and Zoonosis Management. Animals (Basel) 2019; 9:ani9080544. [PMID: 31405166 PMCID: PMC6719076 DOI: 10.3390/ani9080544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022] Open
Abstract
Simple Summary The One Health approach provides a model for educating students, trainees and professionals in a systems approach to providing improved patient care and promoting healthy environments that benefit all species. In the present study, we designed an online survey that was communicated to senior veterinary students in a number of Australian veterinary schools. The survey evaluated the willingness of future veterinary graduates to participate positively in zoonoses (diseases transmitted between animals and humans) management through the adoption of the One Health approach in their future career. All respondents were willing to assist physicians in the management of zoonotic cases involving both patients and clients. The veterinary students were equally concerned about ensuring the best care for both animals (patients) and humans (clients). Our results demonstrate that there is strong support for future Australian veterinarians in the field of One Health. Abstract This study aimed to explore the beliefs and attitudes of a group of senior veterinary students regarding One Health and to evaluate their levels of confidence in advising the general public on preventative health issues at the human–animal interface. An online survey was communicated to senior veterinary students who were in their last two years of study. The questionnaire covered beliefs and attitudes, issues concerning the animal–human interface and participants’ confidence in diagnosing zoonoses. In total, 175 students from five Australian veterinary schools/colleges completed the online survey. The majority (96%) of students considered it their duty to promote the One Health approach, but only 36% believed there were sufficient practical frameworks for Australian veterinarian graduates to promote One Health. Interestingly, 81% (142/175) of respondents believed that veterinarians were more knowledgeable than physicians in managing zoonotic cases. Of the final-year students (n = 77), only 39% and 36% were confident in their ability to diagnose zoonoses in common companion animals and production animals, respectively. However, the number of those confident to diagnose zoonoses transmitted from wildlife was notably lower (22% (17/77)). Next-generation Australian veterinarians are keen to embrace their role in interprofessional collaboration; however, training efforts are required to reassure future veterinarians on aspects of zoonoses and One Health.
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Hardefeldt LY. Implementing antimicrobial stewardship programmes in veterinary practices. Vet Rec 2018; 182:688-690. [DOI: 10.1136/vr.k2563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Laura Y. Hardefeldt
- National Centre for Antibiotic Stewardship; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Australia
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