Enhancing Antimicrobial Stewardship On Dairy Farms With A Focus On Selective Treatment Of Clinical Mastitis
Date
2024-01-16
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Clinical mastitis (CM) treatment decisions have been the focus of antimicrobial stewardship in the dairy sector, as CM and antimicrobial dry cow treatments account for the majority of antimicrobials used on farms. To improve on-farm antimicrobial stewardship, a selective treatment approach of CM is explored, centering around milk culture-guided decisions. Detailed principles of selective CM treatment and an evidence-based protocol are presented in Chapter 2, alongside an overview of expected cow and farm impacts, impact of proportion of Gram-negative cases on expected reduction in antimicrobial use, adoption rates across the globe, and knowledge and technology gaps. A systematic review and meta-analysis is presented in Chapter 3, evidencing that a selective CM treatment protocol can be adopted without adversely influencing bacteriological and clinical cure, somatic cell count, milk yield, and incidence of recurrence or culling. Chapter 4 presents survey results of 142 farms detailing adoption of various CM protocols among Canadian dairy farmers, demonstrating an association between increased adoption of selective CM protocols and low average cow SCC, as well as a distinction between 3 groups of farmers with similar relative importance of decision factors. Delving further into CM decision-making, Chapter 5 presents considerations of Western Canadian dairy farmers at each decision step from identification of CM to treatment termination, as well as 3 overarching themes impacting each step: Personal attributes, Inter-actor dynamics, and Moving beyond protocols. Chapter 6 describes 4 themes related to perceptions on mastitis-related antimicrobial use: Antibiotic use paradox: Perception vs. reality; Low disease incidence is a badge of honor; In good hands: Veterinarians as safeguards; and “It takes a village to make a change”, alongside 10 proposed interventions designed using the Behavior Change Wheel to mitigate voiced barriers and appeal to facilitators towards milk-culture guided decisions. To advance this research future efforts should be focused on improving selection of CM cases to exclude antimicrobial treatment, discouraging inadequate mastitis-related antimicrobial stewardship practices, enhancing quality and accessibility of milk diagnostic tests, and stimulating and monitoring uptake of selective CM protocols.
Description
Keywords
Citation
De Jong, E. (2024). Enhancing antimicrobial stewardship on dairy farms with a focus on selective treatment of clinical mastitis (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.