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2.
Artigo em Alemão | MEDLINE | ID: mdl-31434114

RESUMO

OBJECTIVE: Pain management during veterinary procedures is a significant component of animal welfare and has legal as well as ethical implications. Even though regional intravenous anaesthesia (RIVA) is an accepted method for painful procedures involving the distal digits of sheep, this anaesthetic technique is rarely applied in the field. The primary goal was to investigate the feasibility, safety and efficacy of RIVA in sheep. A secondary goal was to examine whether the anaesthetic procedure can be improved by combining RIVA with sedation and whether these methods have a positive effect on the postoperative wellbeing of the animals. METHODS: A total of 36 Meat Merino sheep with contagious interdigital dermatitis and 12 healthy control sheep were used. Behaviour was observed during treatment of the lame sheep using various pain management protocols and during routine claw trimming of the healthy sheep, and all the sheep were observed after the procedures. The observed behaviours were assessed using scores and the scores compared among the animals of the 4 study groups (RIVA, sedation with xylazine hydrochloride + RIVA, placebo, control). RESULTS: RIVA was successfully conducted in sheep. Local reactions at the application sight and in the tourniquet area in 2 animals resolved completely. A significant reduction in defensive movements during the painful procedure confirmed the efficacy of RIVA. Stress-associated behaviours, including head shaking and idle chewing, occurred with a similar frequency in RIVA and placebo animals, leading to the conclusion that stress levels due to the handling in dorsal recumbency were comparable between these 2 groups. Sedation reduced the frequency of pain- and stress-associated behaviours, including guarding, favouring limbs, vocalisation, idle chewing and bruxism. Xylazine hydrochloride-RIVA animals displayed better weight-bearing in the affected limb, better food uptake and ruminated more postoperatively than sheep from the other study groups. CONCLUSION: RIVA in sheep is straightforward, safe and effective. Additional sedation reduces the stress and pain response. This pain and stress management has a positive effect on the postoperative wellbeing of sheep.


Assuntos
Anestésicos Intravenosos , Casco e Garras/fisiopatologia , Manejo da Dor , Doenças dos Ovinos/tratamento farmacológico , Carneiro Doméstico , Administração Intravenosa/veterinária , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/uso terapêutico , Bem-Estar do Animal , Animais , Dermatite/cirurgia , Dermatite/veterinária , Feminino , Casco e Garras/cirurgia , Manejo da Dor/métodos , Manejo da Dor/veterinária , Dor Pós-Operatória/tratamento farmacológico , Ovinos , Doenças dos Ovinos/cirurgia , Drogas Veterinárias/administração & dosagem , Drogas Veterinárias/uso terapêutico
4.
Parasite ; 26: 26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31041897

RESUMO

Six benzoylphenyl ureas are currently used in formulations approved as veterinary medicines: diflubenzuron for fly control mainly on cattle, lice and blowfly strike control on sheep, and lice control on farmed salmonids; lufenuron for flea control on dogs and cats and for lice control on farmed salmonids; triflumuron for lice and blowfly strike control on sheep; fluazuron for tick control on cattle; teflubenzuron for lice control on farmed salmon; and novaluron for fly and tick control on cattle and for flea control on dogs. Resistance to diflubenzuron and triflumuron has already been reported for sheep body lice and blowflies, and to fluazuron in cattle ticks. These and other minor veterinary usages, as well as the current status of resistance, are reviewed and perspectives for future opportunities are discussed based on unexplored potentials and threats posed by future resistance development.


Assuntos
Antiparasitários/uso terapêutico , Resistência a Medicamentos , Doenças Parasitárias em Animais/tratamento farmacológico , Drogas Veterinárias/uso terapêutico , Animais , Antiparasitários/química , Benzamidas/uso terapêutico , Diflubenzuron/uso terapêutico , Drogas Veterinárias/química
5.
Trop Anim Health Prod ; 51(7): 2011-2018, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31054060

RESUMO

African animal trypanosomiasis (AAT) continues to inflict heavy losses on livestock production especially cattle in terms of decreased production and productivity in Uganda. AAT is a disease complex caused by tsetse fly-transmitted Trypanosoma brucei brucei, Trypanosoma brucei rhodesiense, Trypanosoma congolense, and Trypanosoma vivax. The disease is most important in cattle but also known to cause serious losses in pigs, camels, goats, and sheep. Several control measures including live bait technology, mass treatment of cattle with trypanocidal drugs, and deployment of tsetse traps have been used in the past 10 years, but the problem still persists in some areas. This necessitated an exploration of the factors associated with continued trypanosome infections in cattle, which are also known reservoirs for the zoonotic trypanosomiasis. A structured questionnaire was administered to 286 animal owners from 20 villages purposively selected from Lira, Kole, and Alebtong districts of Lango subregion to obtain information on the factors associated with persistence of infection. Over 50% of the respondents reported trypanosomiasis as a major challenge to their livestock. Land ownership (P = 0.029), type of livestock kept (P = 0.000), disease control strategy employed (P = 0.000), source of drugs (P = 0.046), and drug preparation (P = 0.017) were associated with persistent AAT infection. We recommend continued farmer sensitization on the threat of AAT and the available prevention and control options. The use of isometamidium chloride for prophylaxis against trypanosomiasis is highly recommended. There is also a need to foster qualified private veterinary drug supply in the region.


Assuntos
Controle de Doenças Transmissíveis/métodos , Gado , Tripanossomicidas/uso terapêutico , Tripanossomíase Africana/veterinária , Animais , Bovinos , Estudos Transversais , Fazendas , Propriedade , Fenantridinas/uso terapêutico , Tripanossomicidas/provisão & distribução , Trypanosoma , Tripanossomíase Africana/epidemiologia , Uganda/epidemiologia , Drogas Veterinárias/provisão & distribução , Drogas Veterinárias/uso terapêutico
6.
Vet Anaesth Analg ; 46(2): 151-162, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30737017

RESUMO

OBJECTIVE: To provide an overview of pain and analgesia in rabbits with the aim of developing a more accurate understanding of these topics. To illustrate and discuss the areas that have advanced in recent years and those that still require further research. DATABASES USED: Three key subject resources were used: Web of Science, Medline and CAB Abstracts. Search terms were rabbits, lagomorphs, laboratory animals, pet, pain, surgical procedures, ovariohysterectomy, orchiectomy, castration, analgesia, opioids, and non-steroidal anti-inflammatory drugs. References from books and articles relevant to the topics were also included. CONCLUSIONS: Rabbit medicine has improved over the last 20 years, but the literature suggests that pain management in this species is still inadequate and veterinary professionals believe their knowledge of pain and analgesia in this species is limited. Assessment and quantification of pain in rabbits can be challenging in a clinical environment not only because, as a prey species, rabbits tend to hide signs of pain but also because there are no validated methods to assess pain, except the Rabbit Grimace Scale, which is based on only one rabbit breed. Current consensus is that perioperative multimodal analgesia is the best practice. However, it is not widely used in rabbits. In rabbits, analgesia protocols and dosages reported in the literature are often poorly researched and do not result in complete pain amelioration with the return of normal. The present literature on rabbit pain and analgesia presents gaps either due to unexplored areas or insufficient findings. Further research should focus on these areas with the aim of improving the welfare of rabbits within a veterinary clinic.


Assuntos
Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Dor Pós-Operatória/veterinária , Coelhos/cirurgia , Animais , Castração/veterinária , Feminino , Masculino , Manejo da Dor/veterinária , Medição da Dor/veterinária , Dor Pós-Operatória/tratamento farmacológico , Drogas Veterinárias/uso terapêutico
7.
JAMA Netw Open ; 2(1): e186950, 2019 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-30646207

RESUMO

Importance: Veterinarians are a subset of opioid prescribers. Objective: To assess the quantity and trends in prescribing and dispensing of several different opioids in the past 11 years in a large veterinary hospital in Philadelphia, Pennsylvania. Design, Setting, and Participants: This cross-sectional study inventoried all opioid tablets and/or patches dispensed or prescribed by veterinarians practicing in a multispecialty academic veterinary teaching hospital in Philadelphia for small animals and species, such as rabbits, birds, and reptiles, from January 1, 2007, through December 31, 2017. Prescribing data were obtained from all veterinarians who wrote a prescription for opioids by reviewing detailed pharmacy records of controlled substances for the study period. Data included all opioids dispensed, or prescribed to animals (patients) undergoing evaluation at the center or being followed up as outpatients by the veterinarians in the hospital. Statewide veterinarian prescribing data were used for comparison. Data were analyzed from December 24, 2017, through May 15, 2018. Main Outcomes and Measures: The trend in administration and prescribing of 4 specific opioid analgesics (codeine sulfate, hydrocodone bitartrate, and tramadol hydrochloride tablets as well as fentanyl citrate patch) during the 11-year study period. The individual opioids were converted to morphine milligram equivalents (MME) for comparison. Results: The study included 134 veterinarians (70.9% women) with 366 468 patient visits. During the study period, the hospital veterinarians prescribed 105 183 689 tablets of tramadol, 97 547 tablets of hydrocodone, 38 939 tablets of codeine, and 3153 fentanyl patches to dogs (73.0%), cats (22.5%), and exotic animals (4.5%). Overall, MME use increased 41.2%, whereas visits increased by 12.8%. The comparison data for Pennsylvania revealed a predominance of hydrocodone use (688 340 tablets prescribed), although data were not available for comparison with tramadol because it is a Schedule IV drug. Conclusions and Relevance: Results of this study suggest that the large, increasing volume of opioids prescribed at 1 veterinary teaching hospital highlights concerns parallel to those about excessive opioid prescribing in humans. The extent to which these data may represent similar volumes of prescriptions from the general veterinary practices and hospitals across the United States is suggested by the accompanying Pennsylvania state data. These findings highlight an opportunity to assess the risk of veterinarian opioid prescriptions to safeguard public health.


Assuntos
Analgésicos Opioides/uso terapêutico , Sobremedicalização , Padrões de Prática Médica/estatística & dados numéricos , Uso Indevido de Medicamentos sob Prescrição/prevenção & controle , Médicos Veterinários/estatística & dados numéricos , Analgésicos Opioides/classificação , Animais , Revisão de Uso de Medicamentos , Feminino , Hospitais Veterinários/estatística & dados numéricos , Humanos , Masculino , Sobremedicalização/prevenção & controle , Sobremedicalização/estatística & dados numéricos , Estados Unidos , Drogas Veterinárias/uso terapêutico
8.
Vet Rec ; 184(5): 153, 2019 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-30413673

RESUMO

Prescription veterinary medicine (PVM) use in the UK is an area of increasing focus for the veterinary profession. While many studies measure antimicrobial use on dairy farms, none report the quantity of antimicrobials stored on farms, nor the ways in which they are stored. The majority of PVM treatments occur in the absence of the prescribing veterinarian, yet there is an identifiable knowledge gap surrounding PVM use and farmer decision making. To provide an evidence base for future work on PVM use, data were collected from 27 dairy farms in England and Wales in Autumn 2016. The number of different PVMs stored on farms ranged from 9 to 35, with antimicrobials being the most common therapeutic group stored. Injectable antimicrobials comprised the greatest weight of active ingredient found, while intramammary antimicrobials were the most frequent unit of medicine stored. Antimicrobials classed by the European Medicines Agency as critically important to human health were present on most farms, and the presence of expired medicines and medicines not licensed for use in dairy cattle was also common. The medicine resources available to farmers are likely to influence their treatment decisions; therefore, evidence of the PVM stored on farms can help inform understanding of medicine use.


Assuntos
Indústria de Laticínios , Armazenamento de Medicamentos/métodos , Armazenamento de Medicamentos/estatística & dados numéricos , Fazendas , Medicamentos sob Prescrição , Drogas Veterinárias , Adolescente , Adulto , Animais , Antibacterianos/uso terapêutico , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Estudos Transversais , Fazendeiros/psicologia , Fazendeiros/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Medicamentos sob Prescrição/uso terapêutico , Reino Unido , Drogas Veterinárias/uso terapêutico , Adulto Jovem
9.
Med Anthropol ; 38(3): 295-310, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30526055

RESUMO

Widespread use of antibiotics is of concern due to the selection for resistant bacterial strains, which render life-saving antimicrobials ineffective. Smallholders in rural Guatemala rely on human antibiotics to treat their poultry, and in this article, I aim to understand why they do so. I incorporate Ethnographic Decision Modeling (EDM) to understand treatment behaviors. Results indicate that access and affordability in opportunity costs are barriers to seeking veterinary medicines for poultry. Access to veterinary medicine and education campaigns on poultry health are necessary to support the appropriate use of antimicrobials for backyard poultry.


Assuntos
Criação de Animais Domésticos , Antibacterianos/uso terapêutico , Prescrição Inadequada/veterinária , Aves Domésticas , Drogas Veterinárias/uso terapêutico , Animais , Antropologia Médica , Guatemala/etnologia , Humanos
10.
Vet Rec ; 184(5): 154, 2019 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-30455188

RESUMO

The aim of this systematic review is to describe and assess the quality of the existing evidence base concerning factors that influence the compliance of cat and dog owners to pharmaceutical and specifically polypharmacy treatment recommendations. PubMed, CAB Abstracts and Google were searched to identify relevant literature and search results were filtered according to predetermined inclusion and exclusion criteria. Standardised data extraction and critical appraisal were carried out on each included study, and a Centre for Evidence-Based Medicine level of evidence grading was applied. Of the 8589 studies, eight studies were included in the review. Majority (five of eight) of the included studies were examining compliance with short-term antimicrobial therapies and none examined polypharmacy. Multiple definitions of compliance, methods of measurement and different factors potentially affecting compliance were used. Factors reported to have affected compliance in at least one study were dosing regimen, discussion of dosing regimen in light of owners' circumstances, consultation time, disease, month of consultation/treatment, physical risk, social risk and method of administration. The evidence available regarding factors affecting client compliance with pharmaceutical treatment recommendations in cats and dogs is scarce and of poor quality.


Assuntos
Doenças do Gato/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Propriedade , Drogas Veterinárias/uso terapêutico , Animais , Gatos , Cães , Humanos , Polimedicação , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Parasit Vectors ; 11(1): 581, 2018 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-30400923

RESUMO

BACKGROUND: Veterinary clinic transaction records from the USA were examined to determine dog owner purchase patterns for three prescription ectoparasiticides. In-clinic purchases of formulations of fluralaner (with 12-week duration per dose) were compared with dog owner purchases of afoxolaner and spinosad (both with 4 week duration per dose) in a population of 231,565 dogs over a 12 month period. Prior studies in human and animal medicine have suggested that patients more closely adhere to prescriber dosing recommendations when they receive a longer-duration medication. RESULTS: Veterinary clinic transaction records were examined for the period June 2014 through March 2017 using records from approximately 650 veterinary clinics. Ectoparasiticide purchase patterns were compared for two products (afoxalaner and spinosad) with monthly dosing and one product (fluralaner) with an extended (12 week) dosing interval. The average dog owner who obtained fluralaner purchased significantly more months of flea/tick protection (5.7 months) over the 12-month study period than the average dog owner that selected either afoxolaner (4.6 months) or spinosad (3.3 months). The proportion of dog owners who obtained only one dose of ectoparasiticide per 12-month period was 42% for fluralaner, 30% for afoxolaner and 37% for spinosad. The proportion of dog owners who obtained 2 doses or less per 12-month period was 67% for fluralaner, 52% for afoxoalaner and 67% for spinosad. Owners that obtained fluralaner were significantly more likely to obtain 7.0-12.0 months of flea and tick protection and significantly less likely to purchase 1.0-6.9 months compared with dog owners who purchased afoxolaner or spinosad. CONCLUSIONS: Dog owners who obtained a flea and tick medication with a longer duration of action acquired significantly more months of protection in a year than dog owners who obtained shorter duration (1 month) products. Dog owners were better able to adhere to veterinary recommendations on ectoparasites control with a longer-acting flea/tick medication.


Assuntos
Infestações por Pulgas/veterinária , Adesão à Medicação , Propriedade/estatística & dados numéricos , Registros , Drogas Veterinárias/uso terapêutico , Medicina Veterinária , Animais , Doenças do Cão/tratamento farmacológico , Doenças do Cão/epidemiologia , Cães , Combinação de Medicamentos , Infestações por Pulgas/tratamento farmacológico , Hospitais Veterinários , Humanos , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Isoxazóis/administração & dosagem , Isoxazóis/uso terapêutico , Macrolídeos/administração & dosagem , Macrolídeos/uso terapêutico , Naftalenos/administração & dosagem , Naftalenos/uso terapêutico , Medicamentos sob Prescrição/administração & dosagem , Medicamentos sob Prescrição/uso terapêutico , Sifonápteros/efeitos dos fármacos , Carrapatos/efeitos dos fármacos , Estados Unidos
14.
Trop Anim Health Prod ; 50(7): 1683-1699, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29732489

RESUMO

This study's aim is to inventory antibiotics used in cattle in North-East Benin and assess risk practices that could be the cause of both food chain contamination by antibiotic residues and selection of antibiotic-resistant bacteria in animals and humans. A survey was conducted among 98 cattle breeders in the districts of Banikoara, Kandi, Bembereke, and Kalale in North Benin. Semi-structured interviews were conducted, covering breeder status, breeding system, and antibiotic use. Multiple correspondence analysis and hierarchical classification analysis were conducted to establish a breeder typology. Breeders mainly belonged to the Fulani ethnic group (71.4 ± 8.9%) and almost all of them received "no formal education" (96.9 ± 3.4%). Cattle herds were mainly composed of a single breed, the Borgou (76.4 ± 8.1%) or the Fulani Zebu (16.0 ± 7.0%). Some herds were mixed. Antibiotics groups used in cattle breeding were tetracyclines, beta-lactams, sulfonamides, aminoglycosides, and macrolides, used by respectively 100%, 69.4 ± 9.1%, 56.1 ± 9.8%, 44.9 ± 9.8%, and 34.7 ± 9.4% of breeders. These drugs were purchased in local markets (59.0 ± 15.4%) and veterinary pharmacy (41.0 ± 15.4%). They were mainly used against respiratory diseases, lameness, mastitis, omphalitis and neonatal enteritis, and skin diseases. Only 49.0 ± 9.9% of breeders seek veterinary services to treat animals and 92.9 ± 5.1% of them did not respect antibiotic withdrawal times. These practices suggest that both contamination of bovine meat with antibiotic residues and selection of resistant bacteria are to be expected, resulting in adverse health effects on consumers.


Assuntos
Criação de Animais Domésticos/métodos , Antibacterianos/uso terapêutico , Bovinos , Drogas Veterinárias/uso terapêutico , Animais , Antibacterianos/farmacologia , Bactérias , Benin/epidemiologia , Cruzamento , Feminino , Cadeia Alimentar , Geografia , Humanos , Carne , Gestão de Riscos , Especificidade da Espécie , Inquéritos e Questionários , Drogas Veterinárias/farmacologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-29744041

RESUMO

Background: Antimicrobial resistance (AMR) has been identified as one of the major threats to global health, food security and development today. While there has been considerable attention about the use and misuse of antibiotics amongst human populations in both research and policy environments, there is no definitive estimate of the extent of misuse of antibiotics in the veterinary sector and its contribution to AMR in humans. In this study, we explored the drivers ofirrational usage of verterinary antibiotics in the dairy farming sector in peri-urban India. Methods and materials: The study was conducted in the peri-urban belts of Ludhiana, Guwahati and Bangalore. A total of 54 interviews (formal and non-formal) were carried out across these three sites. Theme guides were developed to explore different drivers of veterinary antimicrobial use. Data was audio recorded and transcribed. Analysis of the coded data set was carried out using AtlasTi. Version 7. Themes emerged inductively from the set of codes. Results: Findings were presented based on concept of 'levels of analyses'. Emergent themes were categorised as individual, health systems, and policy level drivers. Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers and easily available antibiotics, dispensed without appropriate prescriptions contributed to easy access to antibiotics, and were identified to be the possible drivers contributing to the non-prescribed and self-administered use of antibiotics in the dairy farms. Conclusions: Smallholding dairy farmers operated within very small margins of profits. The paucity of formal veterinary services at the community level, coupled with easy availability of antibiotics and the need to ensure profits and minimise losses, promoted non-prescribed antibiotic consumption. It is essential that these local drivers of irrational antibiotic use are understood in order to develop interventions and policies that seek to reduce antibiotic misuse.


Assuntos
Antibacterianos/uso terapêutico , Fazendas/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Drogas Veterinárias/uso terapêutico , Animais , Bovinos , Indústria de Laticínios/métodos , Coleta de Dados , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Medicina Veterinária/métodos
16.
Dtsch Med Wochenschr ; 143(9): 651-657, 2018 May.
Artigo em Alemão | MEDLINE | ID: mdl-29684932

RESUMO

After a short history of the development of antimicrobial substances and the initially underestimated resistance problem, the paper describes the method of monitoring the use of antibiotics in food animals at farm level. The resulting benchmarking led to a remarkable reduction of the amount of antibiotics used in animals. However, it is also explained that, apart from reducing the use of antibiotics, the rules for "prudent use" of antibiotics have to be complied with. Concluding, a critical analysis of the effectiveness of the current interpretation of the "critically important antimicrobials for human medicine is discussed.


Assuntos
Antibacterianos , Prescrição Inadequada , Drogas Veterinárias , Animais , Animais Domésticos , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Prescrição Inadequada/prevenção & controle , Prescrição Inadequada/veterinária , Drogas Veterinárias/administração & dosagem , Drogas Veterinárias/uso terapêutico
18.
Ceska Slov Farm ; 66(5): 227-232, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29623716

RESUMO

The goal of the present study was to develop a new intramammary combination preparation for veterinary use based on silver citrate, arginine and dexpanthenol for the treatment and prophylaxis of subclinical mastitis in cattle. When creating combined medicines for veterinary use, attention must be paid to the factors that influence their stability in a combined presence, and the composition of drugs, as well as the technology for their preparation should be determined. In the current study, a qualitative and quantitative control of model mixtures of active ingredients, as well as of a silver citrate-based combined preparation was carried out. The following parameters that define intramammary drug stability were studied: clarity, pH, and the quantitative content of the active ingredient. Based on the experimental studies, optimal pH limits for a new preparation were determined ranging from 6.4 to 6.7. Considering the instability of solutions based on silver citrate, studies on the stabilization of the preparation were conducted at the obtained pH values. As the result, we used povidone, which possessed the stabilizing properties. The amount of arginine that provides the optimum pH level for the selected combination of active ingredients was also determined. In conclusion, the optimal composition of an intramammary preparation for veterinary medicine in 10 ml ampoules with a shelf life of 6 months was developed.Key words: silver citrate arginine dexpanthenol intramammary dosage form stability.


Assuntos
Citratos/uso terapêutico , Mastite Bovina/tratamento farmacológico , Prata/uso terapêutico , Drogas Veterinárias/uso terapêutico , Animais , Arginina/uso terapêutico , Bovinos , Estabilidade de Medicamentos , Feminino , Ácido Pantotênico/análogos & derivados , Ácido Pantotênico/uso terapêutico
20.
Clin Microbiol Infect ; 23(11): 793-798, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28882725

RESUMO

BACKGROUND: The use of the term 'antimicrobial stewardship' has grown exponentially in recent years, typically referring to programmes and interventions that aim to optimize antimicrobial use. Although antimicrobial stewardship originated within human healthcare, it is increasingly applied in broader contexts including animal health and One Health. As the use of the term 'antimicrobial stewardship' becomes more common, it is important to consider what antimicrobial stewardship is, as well as what it is not. AIMS: To review the emergence and evolution of the term 'antimicrobial stewardship'. SOURCES: We searched and reviewed existing literature and official documents, which mostly focused on antibiotics. We contacted the authors of the first publications that mentioned antimicrobial stewardship. CONTENT: We describe the historical background behind how antimicrobial stewardship came into use in clinical settings. We discuss challenges emerging from the varied descriptions of antimicrobial stewardship in the literature, including an over-emphasis on individual prescriptions, an under-emphasis on the societal implications of antimicrobial use, and language translation problems. IMPLICATIONS: To help address these challenges, we suggest viewing antimicrobial stewardship as a strategy, a coherent set of actions which promote using antimicrobials responsibly. We stress the continuous need for 'responsible use' to be defined and translated into context-specific and time-specific actions. Furthermore, we present examples of actions that can be undertaken within antimicrobial stewardship across human and animal health.


Assuntos
Gestão de Antimicrobianos , Prescrição Inadequada/prevenção & controle , Animais , Antibacterianos/uso terapêutico , Humanos , Drogas Veterinárias/uso terapêutico
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