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How Metabolic Diseases Impact the Use of Antimicrobials: A Formal Demonstration in the Field of Veterinary Medicine

机译:代谢性疾病如何影响抗菌素的使用:兽药领域的正式演示

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摘要

Decreasing the use of antimicrobials has become a primary objective for both human and veterinary medicine in many countries. Medical prevention and good nutrition are seen as key parameters for reducing antimicrobial use. However, little consideration has been given to how metabolic diseases may influence the use of antimicrobials in humans and animals through limiting the prevalence and severity of infectious diseases. To quantify this relationship using the example of a common metabolic disease in dairy cows (subclinical ketosis, SCK), we constructed a stochastic model reporting the total quantity of curative antimicrobials for a given population with the prevalence of cows at risk for SCK. We considered the prevalence of SCK, the relative risk of the disease in cases of SCK compared to no SCK and the use of antimicrobials to treat SCK-induced infectious diseases. Reducing the percentage of cows at risk for SCK from 80% to 10% was associated with an average decrease in the use of antimicrobials of 11% (prevalence of SCK from 34% to 17%, respectively) or 25% (prevalence of SCK from 68% to 22%, respectively), depending on the relative risk to contract SCK if risk was present. For a large percentage of the cows at risk for SCK, using a preventive bolus of monensin reduced the use of curative antimicrobials to the same level that was observed when the percentage of cows at risk for SCK was low. The present work suggests similar approaches for obesity and diabetes.
机译:在许多国家,减少使用抗菌剂已成为人类和兽医学的主要目标。医学预防和良好营养被视为减少抗菌药物使用的关键参数。但是,很少有人考虑通过限制传染病的流行和严重程度,代谢性疾病如何影响人和动物中抗菌药物的使用。为了以奶牛常见的代谢性疾病(亚临床酮症,SCK)为例来量化这种关系,我们构建了一个随机模型,该模型报告了给定人群中治愈性抗菌素的总量,其中有患SCK风险的奶牛普遍存在。我们考虑了SCK的患病率,与没有SCK相比SCK病例的疾病相对风险以及使用抗生素治疗SCK引起的感染性疾病。将有SCK风险的奶牛百分比从80%降低到10%与使用抗生素平均减少11%(SCK的患病率分别从34%降至17%)或25%(SCK的患病率)有关。分别为68%至22%),具体取决于存在风险时签约SCK的相对风险。对于大部分有SCK风险的母牛,使用莫能菌素预防性推注将治愈性抗菌药物的使用降低到与发生SCK风险的母牛百分比较低时观察到的水平相同。目前的工作提出了肥胖症和糖尿病的类似方法。

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