PDF(Pubmed)
Abstract：
An interrupted time-series study design was implemented to evaluate the impact of antibiotic stewardship interventions on antibiotic prescribing among veterinarians. A total of 41 veterinarians were enrolled in Canada and Israel and their prescribing data between 2019 and 2021 were obtained. As an intervention, veterinarians periodically received three feedback reports comprising feedback on the participants\' antibiotic prescribing and prescribing guidelines. A change in the level and trend of antibiotic prescribing after the administration of the intervention was compared using a multi-level generalized linear mixed-effect negative-binomial model. After the receipt of the first (incidence rate ratios [IRR] = 0.88; 95% confidence interval (CI): 0.79, 0.98), and second (IRR = 0.85; 95% CI: 0.75, 0.97) feedback reports, there was a reduced prescribing rate of total antibiotic when other parameters were held constant. This decline was more pronounced among Israeli veterinarians compared to Canadian veterinarians. When other parameters were held constant, the prescribing of critical antibiotics by Canadian veterinarians decreased by a factor of 0.39 compared to that of Israeli veterinarians. Evidently, antibiotic stewardship interventions can improve antibiotic prescribing in a veterinary setting. The strategy to sustain the effect of feedback reports and the determinants of differences between the two cohorts should be further explored.
摘要：
实施了中断的时间序列研究设计，以评估抗生素管理干预措施对兽医抗生素处方的影响。在加拿大和以色列共招募了41名兽医，并获得了他们在2019年至2021年之间的处方数据。作为一种干预,兽医定期收到三份反馈报告，包括对参与者的抗生素处方和处方指南的反馈。使用多级广义线性混合效应负二项模型比较了干预后抗生素处方水平和趋势的变化。在收到第一个（发病率比率[IRR]=0.88;95％置信区间（CI）：0.79，0.98）后，和第二份(IRR=0.85；95%CI：0.75，0.97)反馈报告，当其他参数保持不变时,总抗生素的处方率降低.与加拿大兽医相比，以色列兽医的这种下降更为明显。当其他参数保持不变时，与以色列兽医相比,加拿大兽医对关键抗生素的处方减少了0.39倍.显然,抗生素管理干预措施可以改善兽医环境中的抗生素处方。应进一步探索维持反馈报告效果的策略以及两个队列之间差异的决定因素。
