Förskrivning av antibiotika till hund vid veterinärhögskolan i Nantes, Frankrike

Sammanfattning: The purpose of this retrospective study was to investigate the prescription of antibiotics to dogs at the small animal clinic at Ecole Nationale Vétérinaire, Nantes, France. The purpose was also to compare the possible prescription patterns in France with those seen in a similar study by Petersson (2003) at the small animal clinic at the Swedish University of Agricultural Sciences, Uppsala. Antibiotics are very important in veterinary medicine and are used both to treat infections and to prevent them. The use of antibiotics however is not without complications and the risk of developing antimicrobial resistance is of most concern. Resistance has been shown to exist against all currently known antibiotics and potentially all pathogenic bacteria could develop resistance to one or more antibiotics. This study analysed the case records for all dogs presented to the small animal clinic at Ecole Nationale Vétérinaire, Nantes, France during October 2001 and March 2002 to identify patients which were treated with systemic antibiotics. For these cases the antibiotic used, classified according to the ATCvet system, and the indication for use was noted. A total of 292 cases (146 per month) resulted in administration of systemic antibiotics. Substances from seven ATCvet groups and a product containing a combination of metronidazole and spiramycin were prescribed during October 2001. During March 2002 antibiotics from only five ATCvet groups and again the combination of metronidazole and spiramycin were prescribed. During both October 2001 and March 2002 β-lactams accounted for about three quarters of all antibiotics prescribed, which is roughly the same as in the Swedish study (Peterson, 2003). The relative proportions of aminopenicillins and cefalosporins were equivocal during October 2001 and March 2002. The proportion of β-lactam antibiotics containing amoxicillin potentiated with clavulanic acid was one-seventh during October 2001 and one fifth during March 2002. The main reason given for administering β-lactam antibiotics was for prophylactic use, primarily peri- and post-operatively. Cefalosporins were also commonly used for problems in cutis or subcutis . Apart from β-lactam antibiotics the combination metronidazole and spiramycin was the antibiotic prescribed most frequently. The difference in the number of prescriptions in October 2001 compared with March 2002 is, however, large. During October 2001 the combination metronidazole and spiramycin represent just over ten percent of the total prescriptions whereas during March 2002 it makes up no less than twenty percent. Any reason for this divergence in the prescription is not known. The main use of the metronidazole and spiramycin combination is prophylactic, either at a plain dental descaling or at surgical operations, mainly various dental procedures. The predominant prophylactic use of antibiotics is notable. Especially since the Swedish Veterinary Associations antibiotic policy for dog and cat medical care (Bergvall, 2002) stress that antibiotics should only be used prophylactically peri- and post-operatively where the risk of infection is either great or could be devastating for the individual. In many of the occasions where antibiotics have been used prophylactically in this study are however, minor surgical operations such as standard castrations. Even if it is not confirmed this work indicates that the prescription of systemic antibiotics at the small animal clinic at Ecole Nationale Vétérinaire, Nantes, France is less stringent than what is the case at the small animal clinic at the Swedish University of Agricultural Sciences, Uppsala. Established however is the fact that at the small animal clinic at Ecole Nationale Vétérinaire, Nantes, France antibiotics are generally prescribed with a broader activity than at the small animal clinic at the Swedish University of Agricultural Sciences, Uppsala.