scholarly journals Understanding Antibiotic Use for Pig Farming in Thailand: A Qualitative Study

2020 ◽  
Author(s):  
Angkana Lekagul ◽  
Viroj Tangcharoensathien ◽  
Marco Liverani ◽  
Anne Mills ◽  
Jonathan Rushton ◽  
...  
Keyword(s):  
Health Professionals ◽  
Professional Training ◽  
Central Government ◽  
Animal Health ◽  
Antibiotic Use ◽  
Economic Incentives ◽  
Antibiotic Prescribing ◽  
Pig Production ◽  
Factors Influencing ◽  
Pig Farming

Abstract Background: Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is driven by antibiotic use. Understanding factors influencing antibiotic use is essential to design and implement effective interventions to reduce unnecessary antibiotic use and AMR. This study aims to explore the practices and views of the key actors associated with the use of antibiotics for pig farming in Thailand, from local farmers to officers in central government institutions. Methods: A total of 31 in-depth interviews were conducted with pig farmers (n=13), drug retailers (n=5), veterinarians (n=7), and government officers (n=3) and representatives of health professional councils (n=2). Direct observations were conducted in pig farms. Thematic analysis based on practices, views and interests of actors regarding antibiotic use in pig production in Thailand. Results: There are various factors influencing the use of antibiotics. The factors may trigger greater antibiotic use including lack of knowledge and awareness about antibiotics and AMR, economic incentives, and loose regulatory frameworks. Farmers considered that antibiotics are necessary to maintain animal health, prevent and control diseases, and ensure economic gains, so using antibiotics was considered a worthwhile investment in pigs. There was limited information about antibiotic use in the curriculum and lack of clinical practice guidelines for health professionals. Veterinarians faced challenges in diagnosis and lacked antibiotic prescribing guidelines. Pharmaceutical companies applied market promotion strategies to increase sales; and used professionals as mediators with farmers. There was no control of antibiotic sale and prescription via the regulatory environment. The national policy on AMR could be facilitating factor to optimise use of antibiotics but its influence was weak relative to other influences which favoured antibiotic use. Conclusions: Our study highlights the need to improve antibiotic use in pig production in Thailand. Access to veterinary services and reliable information about animal health needs to be improved among farmers. Innovative low-cost investment in biosecurity could improve farm management and decrease reliance on antibiotics. Developing professional training and clinical guidelines, and establishing a code of conduct, are needed to improve practices in antibiotic prescription and sale amongst health professionals and industry.

scholarly journals Understanding antibiotic use for pig farming in Thailand: a qualitative study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Angkana Lekagul ◽  
Viroj Tangcharoensathien ◽  
Marco Liverani ◽  
Anne Mills ◽  
Jonathan Rushton ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Professional Training ◽  
Central Government ◽  
Animal Health ◽  
Code Of Conduct ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Regulatory Oversight ◽  
Pig Farming ◽  
Livestock Sector

Abstract Background Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is promoted by multiple drivers, including antibiotic use in the livestock sector. Thus, understanding factors influencing antibiotic use in livestock production is essential to the design and implementation of effective interventions to reduce AMR. This qualitative study aimed to explore the experiences and views of the key actors associated with the use of antibiotics for pig farming in Thailand, from local farmers to officers in central government institutions. Methods A total of 31 in-depth interviews were conducted with different categories of actors: pig farmers (n = 13), drug retailers (n = 5), veterinarians (n = 7), government officers (n = 3) and representatives of animal and human health associations (n = 2). Themes emerging from the interviews were identified and explored using thematic analysis. In addition, direct observations were conducted in the pig farms. Results The findings highlight the multi-faceted nature of the views and practices that may contribute to misuse or overuse of antibiotics in the study locations, including misconceptions about the nature of antibiotics and AMR (particularly among smallholders), lack of facilities and financial means to establish an antibiotic-free farm, lack of sufficient training on AMR and antibiotic prescribing for veterinarians, the profit motive of pharmaceutical companies and their ties to farm consultants, and lack of sufficient regulatory oversight. Conclusions Our study indicates a clear need to improve antibiotic use for pig production in Thailand. Farmers need better access to veterinary services and reliable information about animal health needs and antibiotics. Innovative investments in biosecurity could improve farm management and decrease reliance on antibiotics, although the cost of these interventions should be low to ensure wide uptake in the livestock sector. Lastly, further development of professional training and clinical guidelines, and the establishment of a code of conduct, would help improve antibiotic dispensing practices.

scholarly journals Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

Antibiotics ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 2 ◽  
Author(s):  
Annie Wilkinson ◽  
Ayako Ebata ◽  
Hayley MacGregor
Keyword(s):  
Animal Health ◽  
Drug Distribution ◽  
Antibiotic Use ◽  
Evidence Base ◽  
Antibiotic Prescribing ◽  
System Quality ◽  
Middle Income ◽  
Targeted Interventions ◽  
Middle Income Countries ◽  
Healthcare Settings

This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing contexts. All intervention studies were from human healthcare settings, none were from animal health. Only one context study examined antibiotic use in animal health. The evidence base is uneven, with the strongest evidence on knowledge and stewardship interventions. The review found that multiplex interventions that combine different strategies to influence behaviour tend to have a higher success rate than interventions based on single strategies. Evidence on prescribing contexts highlights interacting influences including health system quality, education, perceptions of patient demand, bureaucratic processes, profit, competition, and cultures of care. Most interventions took place within one health setting. Very few studies targeted interventions across different kinds of providers and settings. Interventions in hospitals were the most commonly evaluated. There is much less evidence on private and informal private providers who play a major role in drug distribution in LMICs. There were no interventions involving drug detailers or the pharmaceutical companies despite their prominent role in the contextual studies.

scholarly journals Risk Factors for Antibiotic Treatment of Pigs Between Birth and Slaughter – A Longitudinal Study

2020 ◽  
Author(s):  
Elke Burow ◽  
Anja Rostalski ◽  
Jürgen Harlizius ◽  
Céline Simoneit ◽  
Bernd-Alois Tenhagen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Antibiotic Treatment ◽  
Animal Health ◽  
Antibiotic Use ◽  
Housing System ◽  
Pig Production ◽  
Production Type ◽  
Increased Risk ◽  
Production Stages

Abstract Background: Recently, we found an association between antibiotic treatment and antibiotic resistance in fecal Escherichia coli from rearing pigs during their life. In this study, our aim was to investigate potential risk factors for antibiotic treatment at different production stages of these pigs.Results: In a longitudinal study, antibiotic use was recorded in commercial pig production chains, starting in 29 breeding herds. Information on housing system and management, management of animals and feeding, animal health and performance was surveyed in the herds. In total 55, 57 and 66 variables were evaluated for the production stages suckling, weaning and fattening. In descriptive and univariable analyses seven to eight variables per production stage were associated with antibiotic use. In multivariable analyses, rodent control carried out by a company was associated with an increased risk of antibiotic treatment (odds ratio (OR), 6.86, confidence limits, CL, 1.12 – 41.83, p = 0.023) at suckling. At weaning, production type (farrow-to-finish vs. movement of pigs to another farm after suckling or weaning; OR 0.15, CL 0.02 – 0.89, p = 0.023) was associated with the risk of antibiotic treatment. During the fattening stage, animals were treated more often when the number of weaned piglets per sow and year increased (additional piglet: OR 2.5, CL 0.6 – 29.6, p = 0.0172).Conclusions: Different risk factors were associated with an increased risk of antibiotic treatment in the individual production stages. Therefore, focus on specific measures, especially at suckling and weaning, when most antibiotics are used, is needed. Further research on key factors driving antibiotic use and the causative pathogens that require treatment is necessary in pig production.

scholarly journals The efficiency of pig farming inputs in Minahasa Regency of North Sulawesi

2020 ◽  
Vol 46 (1) ◽  
pp. 84-90
Author(s):  
N. M. Santa ◽  
M. A. V. Manese ◽  
P. O. V. Waleleng
Keyword(s):  
Random Sampling ◽  
Sampling Method ◽  
Total Sample ◽  
Marginal Product ◽  
Pig Production ◽  
North Sulawesi ◽  
Factors Influencing ◽  
Pig Farming ◽  
Random Method ◽  
Douglas Production Function

The purpose of this study was to analyze the factors influencing the production and the efficiency of pig farming input in Minahasa Regency of North Sulawesi Province. The location was determined using the multistage random sampling method, determining regency, districts, and village, which have the highest pig population in North Sulawesi Province, so that Minahasa Regency, and four selected Districts (Sonder, Kakas, Tombulu and Tombariri), then 2 villages/district were taken. The sample was determined using a simple random method by taking 25 farmers in each district so that the total sample was 100 pig farmers, then the data was taken in January-July 2019. Variables measured were the number of pig production, the number of sows, the number of piglets, the number of feed (corn, concentrate, rice bran) and the number of labor. Data were analyzed using the Cobb-Douglas production function model with multiple linear regression and marginal product values calculations. The results showed that the efficiency of pig farming inputs was larger than one, meaning it was inefficient. This condition is still possible to increase pig production by increasing the number of sows, the number of piglets, the number of feed (corn, bran, concentrate), and the number of labor.

scholarly journals Antibiotic use practices of veterinarians and para-veterinarians and the implications for antibiotic stewardship in Nigeria

2021 ◽  
Vol 92 ◽  
Author(s):  
Adah Ogwuche ◽  
Abel B. Ekiri ◽  
Isabella Endacott ◽  
Beatty-Viv Maikai ◽  
Enokela S. Idoga ◽  
...  
Keyword(s):  
Health Professionals ◽  
Fungal Pathogens ◽  
Online Survey ◽  
Susceptibility Testing ◽  
Animal Health ◽  
Antibiotic Use ◽  
Intervention Strategies ◽  
Descriptive Statistics ◽  
Relevant Regulation ◽  
Almost All

The aim of this study was to describe the antibiotic use practices of veterinarians and para-veterinarians in Nigeria. An online survey was distributed during November through December 2018 via email and phone to veterinarians and para-veterinarians to collect information on antibiotic use practices. Data were downloaded into Excel and descriptive statistics were presented and analysed. The survey was completed by 390 respondents. Almost all respondents (98.5%, 384/390) recommended the use of antibiotics to treat animal patients, and of these, 93.2% (358/384) were veterinarians and 6.8% (26/384) were para-veterinarians. Most respondents reported commonly recommending the use of oxytetracycline (82.6%, 317/384), tylosin (44.5%, 171/384) and gentamycin (43.8%, 168/384). A third (32.0%, 122/384) of respondents did not undertake antimicrobial susceptibility testing (AST) prior to antibiotic treatment. At least 60% of the respondents recommended the use of antibiotics for the treatment of non-bacterial pathogens, including viral, helminth and fungal pathogens. Over 55% (217/390) were not aware of government-issued guidelines on antibiotic use in animals, although of those aware, 69% (74/107) utilised the guidelines. Across all respondents, the majority believed legislation or regulation by government can influence the use of antibiotics by animal health professionals. The study highlights areas that can be targeted as part of intervention strategies to promote antimicrobial stewardship by animal health professionals in Nigeria, including the need for increased use of AST as a tool for supporting disease management, increased awareness of appropriate antibiotic use and greater dissemination of antibiotic use guidelines and enforcement of relevant regulation by government authorities.

scholarly journals Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aleksandra J. Borek ◽  
Anne Campbell ◽  
Elle Dent ◽  
Michael Moore ◽  
Christopher C. Butler ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Focus Groups ◽  
Health Professionals ◽  
Skills Training ◽  
Antibiotic Use ◽  
Behavioural Intervention ◽  
Antibiotic Prescribing ◽  
Evidence Based ◽  
Think Aloud

Abstract Background Trials show that antimicrobial stewardship (AMS) strategies, including communication skills training, point-of-care C-reactive protein testing (POC-CRPT) and delayed prescriptions, help optimise antibiotic prescribing and use in primary care. However, the use of these strategies in general practice is limited and inconsistent. We aimed to develop an intervention to enhance uptake and implementation of these strategies in primary care. Methods We drew on the Person-Based Approach to develop an implementation intervention in two stages. (1) Planning and design: We defined the problem in behavioural terms drawing on existing literature and conducting primary qualitative research (nine focus groups) in high-prescribing general practices. We identified ‘guiding principles’ with intervention objectives and key features and developed logic models representing intended mechanisms of action. (2) Developing the intervention: We created prototype intervention materials and discussed and refined these with input from 13 health professionals and 14 citizens in two sets of design workshops. We further refined the intervention materials following think-aloud interviews with 22 health professionals. Results Focus groups highlighted uncertainties about how strategies could be used. Health professionals in the workshops suggested having practice champions, brief summaries of each AMS strategy and evidence supporting the AMS strategies, and they and citizens gave examples of helpful communication strategies/phrases. Think-aloud interviews helped clarify and shorten the text and user journey of the intervention materials. The intervention comprised components to support practice-level implementation: antibiotic champions, practice meetings with slides provided, and an ‘implementation support’ website section, and components to support individual-level uptake: website sections on each AMS strategy (with evidence, instructions, links to electronic resources) and material resources (patient leaflets, POC-CRPT equipment, clinician handouts). Conclusions We used a systematic, user-focussed process of developing a behavioural intervention, illustrating how it can be used in an implementation context. This resulted in a multicomponent intervention to facilitate practice-wide implementation of evidence-based strategies which now requires implementing and evaluating. Focusing on supporting the uptake and implementation of evidence-based strategies to optimise antibiotic use in general practice is critical to further support appropriate antibiotic use and mitigate antimicrobial resistance.

Testing for resistance: Point-of-care testing as a communicational tool in antibiotic prescribing

2018 ◽  
Vol 14 (3) ◽  
pp. 229-240
Author(s):  
Johanna Lindell
Keyword(s):  
Point Of Care ◽  
Rapid Test ◽  
Antibiotic Use ◽  
Treatment Recommendation ◽  
Antibiotic Prescribing ◽  
Communicative Practices ◽  
Effective Strategies ◽  
Reactive Protein ◽  
Point Of Care Test ◽  
Test Result

As antibiotic resistance becomes a growing health emergency, effective strategies are needed to reduce inappropriate antibiotic use. In this article, one such strategy – communicative practices associated with the C-reactive protein point-of care test – is investigated. Building on a collection of 31 videorecorded consultations from Danish primary care, and using conversation analysis, this study finds that the rapid test can be used throughout the consultation to incrementally build the case for a nonantibiotic treatment recommendation, both when the test result is forecast and reported. The study also finds that the format of reports of elevated results differs from that of ‘normal’ results, resulting in a subtle shift of authority from doctor to test.

A retrospective audit of antibiotic prescriptions in a Lebanese Hospital

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Mohamad Ibrahim ◽  
Zeinab Bazzi
Keyword(s):  
Epidemiological Data ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Team Approach ◽  
Strong Correlations ◽  
Prescribing Practices ◽  
Antimicrobial Drugs ◽  
Stewardship Program ◽  
Retrospective Audit ◽  
Attending Physician

Despite the frequent alarms that have been published about the adverse effects of antibiotic use and misuse, physicians prescribe to patients approximately fifty percent of unnecessary antimicrobials. In an attempt to decrease the emergence of antimicrobial resistance and increase awareness, a team approach is required to address this prescribing phenomenon in a feasible manner. A retrospective study was done at a one-hundred-forty-bed hospital with a representative sample size of 368 patients. Patient data was collected and analyzed by a stewardship team. The overall antibiotic inappropriate rate was 45.8%, which is relatively high and consistent with the findings of other studies mentioned in the literature. This study aimed to provide baseline epidemiological data on the use of antibiotics in a Lebanese hospital and has revealed several notable patterns of antibiotic prescribing practices among Lebanese physicians such as the use of antimicrobial drugs example penicillin was consistently high. Strong correlations were identified between the type of attending physician and antibiotic appropriateness. These findings will be important in constructing an antimicrobial stewardship program to reduce antibiotic misuse.

scholarly journals 229. Hospitalists Antimicrobial Scorecard Improves Antibiotic Prescribing at a Community Teaching Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S116-S116
Author(s):  
Julia Sessa ◽  
Helen Jacoby ◽  
Bruce Blain ◽  
Lisa Avery
Keyword(s):  
Patient Care ◽  
Teaching Hospital ◽  
Antimicrobial Stewardship ◽  
Rank Order ◽  
Antibiotic Use ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Full Time ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Measuring antimicrobial consumption data is a foundation of antimicrobial stewardship programs. There is data to support antimicrobial scorecard utilization to improve antibiotic use in the outpatient setting. There is a lack of data on the impact of an antimicrobial scorecard for hospitalists. Our objective was to improve antibiotic prescribing amongst the hospitalist service through the development of an antimicrobial scorecard. Methods Conducted in a 451-bed teaching hospital amongst 22 full time hospitalists. The antimicrobial scorecard for 2019 was distributed in two phases. In October 2019, baseline antibiotic prescribing data (January – September 2019) was distributed. In January 2020, a second scorecard was distributed (October – December 2019) to assess the impact of the scorecard. The scorecard distributed via e-mail to physicians included: Antibiotic days of therapy/1,000 patient care days (corrected for attending census), route of antibiotic prescribing (% intravenous (IV) vs % oral (PO)) and percentage of patients prescribed piperacillin-tazobactam (PT) for greater than 3 days. Hospitalists received their data in rank order amongst their peers. Along with the antimicrobial scorecard, recommendations from the antimicrobial stewardship team were included for hospitalists to improve their antibiotic prescribing for these initiatives. Hospitalists demographics (years of practice and gender) were collected. Descriptive statistics were utilized to analyze pre and post data. Results Sixteen (16) out of 22 (73%) hospitalists improved their antibiotic prescribing from pre- to post-scorecard (χ 2(1)=3.68, p = 0.055). The median antibiotic days of therapy/1,000 patient care days decreased from 661 pre-scorecard to 618 post-scorecard (p = 0.043). The median PT use greater than 3 days also decreased significantly, from 18% pre-scorecard to 11% post-scorecard (p = 0.0025). There was no change in % of IV antibiotic prescribing and no correlation between years of experience or gender to antibiotic prescribing. Conclusion Providing antimicrobial scorecards to our hospitalist service resulted in a significant decrease in antibiotic days of therapy/1,000 patient care days and PT prescribing beyond 3 days. Disclosures All Authors: No reported disclosures

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