Assessing Upstream Determinants of Antibiotic Use in Small-Scale Food Animal Production through a Simulated Client Method

Abstract

Small-scale food animal production has been celebrated as a means of economic mobility and improved food security but the use of veterinary antibiotics among these producers may be contributing to the spread of antibiotic resistance in animals and humans. In order to improve antibiotic stewardship in this sector, it is critical to identify the drivers of producers’ antibiotic use. This study assessed the determinants of antibiotic use in small-scale food animal production through simulated client visits to veterinary supply stores and surveys with households that owned food animals (n = 117) in Ecuador. Eighty percent of households with food animals owned chickens and 78% of those with chickens owned fewer than 10 birds. Among the households with small-scale food animals, 21% reported giving antibiotics to their food animals within the last six months. Simulated client visits indicated that veterinary sales agents frequently recommended inappropriate antibiotic use, as 66% of sales agents recommended growth promoting antibiotics, and 48% of sales agents recommended an antibiotic that was an inappropriate class for disease treatment. In contrast, few sales agents (3%) were willing to sell colistin, an antibiotic banned for veterinary use in Ecuador as of January 2020, which supports the effectiveness of government regulation in antibiotic stewardship. The cumulative evidence provided by this study indicates that veterinary sales agents play an active role in promoting indiscriminate and inappropriate use of antibiotics in small-scale food animal production.

Social and Environmental Determinants of Community-Acquired Antimicrobial-Resistant Escherichia coli in Children Living in Semirural Communities of Quito, Ecuador

“…These cutoffs for ranges of animal ownership were determined a priori, based on previous literature and to see the effects of smallscale farming and pet ownership. 41 Ownership of 11 to 20 animals was found to be associated with XDR E. coli, but the exposure in this particular study did not differentiate between the type or species of animals owned (e.g., livestock versus poultry versus domestic pets). Animals in these communities range from household pets, such as dogs and cats, to food animals including chickens, cattle, and pigs.…”

Antibiotic Resistance Awareness among Undergraduate Students in Quito, Ecuador

“…Appropriate practices have also been observed among Ecuadorian medicine students [ 24 ]. However, incorrect use of antibiotics has been reported in studies focusing on different groups, including caretakers, farmers, or sales agents [ 15 , 16 , 17 ]. This could thus lead to a generalized misuse of antibiotics.…”

“…The law also stipulates that prescriptions are required and that these must be made by certified professionals, except for over-the-counter drugs [ 14 ]. In spite of these guidelines, inappropriate use of antibiotics has been reported in several Ecuadorian populations [ 15 , 16 , 17 ].…”

Antimicrobial Use by Backyard Food Animal Producers in Ecuador: A Qualitative Study

“…Second, these small-scale food animal producers retain a traditional reverence for interwoven threads of environmental and human health found throughout the Andean region. Centered on Pachamama or Mother Earth, Andean cosmovision is based on notions of balance interconnectedness, health, and diet [30,31] and has been enshrined as rights of nature in the Ecuadorian constitution [36] and in legal frameworks elsewhere in the region [37]. Similarly, unlike their conventional counterparts, organic food animal producers in the United States eschew the use of antimicrobials as a matter of conscience as well as practicality [38].…”

“…Beyond the strictly economic, there is a second reason for which backyard producers avoid using antimicrobials for disease prevention and control or for growth prevention. Historically, peasant farmers, indigenous households, and other small-scale producers in the Ecuadorian highlands and other parts of the Andean region have retained a traditional view of human productive activity as a component of the physical and spiritual environment that surrounds them and which views Mother Earth (Pachamama, in the Kichwa language) as an all-encompassing state of balanced well-being and which is to be revered and protected and upon which individual, community, and planetary health depends [30,31]. In this context, the use of antimicrobials is viewed as harmful to human and animal health.…”