国际专家就在动物中使用高重要度抗菌剂达成共识--德尔菲研究

IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES
Anna Sri , Kirsten E. Bailey , Ri Scarborough , James R. Gilkerson , Karin Thursky , Glenn F. Browning , Laura Y. Hardefeldt
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引用次数: 0

摘要

在澳大利亚,澳大利亚抗菌药耐药性战略和技术咨询组对抗菌药进行了重要性评级。重要性高的抗菌药是指那些对治疗或预防人类感染至关重要的抗菌药,在这种情况下,几乎没有或根本没有替代治疗方法。在这项研究中,我们采用德尔菲法(Delphi)建立共识的程序,咨询了人类健康和动物健康领域的专家,以确定在哪些情况下,对人类健康具有高度重要性的抗菌药物可用于澳大利亚的动物。我们使用了三轮在线调查。在随后的每一轮调查中,我们都会向参与者提供小组答复,以促进意见的统一。80%或以上的受访者对某个问题选择了相同的选项,即为达成共识。到第三轮结束时,已就八个项目达成共识。其中包括:如果培养和药敏试验表明,病菌对可用于治疗该病例的中低级抗菌药物具有耐药性,则应适当使用高重要性抗菌药物。如果为动物开具任何高重要性抗菌药物处方,与会者还一致认为,必须在病历中记录明确的使用指征和选择抗菌药物的理由,以及剂量、给药途径、持续时间和复查病情及相关抗菌药物治疗的时间点。还需要进一步开展工作,以确定在使用未注册用于动物的高活性抗菌药物时应通知哪个特定组织。德尔菲过程对于促进具有广泛卫生背景和经验的国际专家达成共识非常有价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reaching consensus amongst international experts on the use of high importance-rated antimicrobials in animals – a Delphi study

In Australia, antimicrobials are given an importance rating by the Australian Strategic and Technical Advisory Group on antimicrobial resistance. High importance antimicrobials are those essential for the treatment or prevention of infections in humans, where there are few or no treatment alternatives. In this study we consulted with experts from across human and animal health using the Delphi consensus-building process to establish the circumstances under which antimicrobials with high importance to human health could be used in animals in Australia. We used three rounds of online surveys. Group responses were provided to participants in each subsequent round to facilitate convergence of opinion. Consensus was defined as 80 % or more of respondents selecting the same option for a question. By the end of the third round, consensus was achieved on eight items. This included the use of high importance antimicrobials being appropriate if culture and sensitivity testing indicated the organism was resistant to low- and medium-rated antimicrobials that could be used to treat the case. If any high-importance antimicrobials are prescribed for animals there was also agreement that a clear indication for this use and justification for antimicrobial choice must be recorded in the medical history, along with the dose rate, route of administration, the duration and the time point for review of the condition and associated antimicrobial therapy.

Appropriateness of use of high importance antimicrobials in critically ill animals where culture and sensitivity results are not available is still undefined. Further work is also required to establish which particular organisation should be notified of the use of high importance antimicrobials not registered for use in animals. The Delphi process was valuable in facilitating consensus amongst international experts from a broad range of health backgrounds and experience.

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来源期刊
One Health
One Health Medicine-Infectious Diseases
CiteScore
8.10
自引率
4.00%
发文量
95
审稿时长
18 weeks
期刊介绍: One Health - a Gold Open Access journal. The mission of One Health is to provide a platform for rapid communication of high quality scientific knowledge on inter- and intra-species pathogen transmission, bringing together leading experts in virology, bacteriology, parasitology, mycology, vectors and vector-borne diseases, tropical health, veterinary sciences, pathology, immunology, food safety, mathematical modelling, epidemiology, public health research and emergency preparedness. As a Gold Open Access journal, a fee is payable on acceptance of the paper. Please see the Guide for Authors for more information. Submissions to the following categories are welcome: Virology, Bacteriology, Parasitology, Mycology, Vectors and vector-borne diseases, Co-infections and co-morbidities, Disease spatial surveillance, Modelling, Tropical Health, Discovery, Ecosystem Health, Public Health.
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