Knowledge, Attitude, and Practices (KAP) Survey among Veterinarians, and Risk Factors Relating to Antimicrobial Use and Treatment Failure in Dairy Herds of India

Abstract

The indiscriminate usage of antimicrobials in the animal health sector contributes immensely to antimicrobial resistance (AMR). The present study aims to assess the antimicrobial usage pattern and risk factors for AMR in animal husbandry sector of India. A cross-sectional survey about Knowledge, Attitude, and Practices (KAP) among veterinarians was carried out using a questionnaire comprising of 52 parameters associated with antibiotic use and the emergence of AMR in dairy herds. Respondents’ KAP scores were estimated to rank their level of knowledge, attitude, and practice. Furthermore, risk factors associated with treatment failure were analyzed by univariable and multivariable analyses. Out of a total of 466 respondents, the majority had average knowledge (69.5%), neutral attitude (93.2%), and moderate practice (51.3%) scores toward judicious antibiotic usage. Veterinarians reported mastitis (88.0%), reproductive disorders (76.6%), and hemoprotozoan infections (49.6%) as the top three disease conditions that require antibiotic usage. Most of the veterinarians (90.6%) resorted to their “own experience” as the main criteria for antibiotic choice. The use of the highest priority critically important antimicrobials (HPCIA) listed by the World Health Organization (WHO) in animals, particularly quinolones (76.8%) and third-generation cephalosporins (47.8%), has been reported. On multivariable regression analysis of the risk factors, the lack of cooperation of the dairy farmers in the completion of a prescribed antibiotic course by the veterinarian and the demand for antibiotic use even in conditions not requiring antibiotic use were found to be significantly associated with the outcome variable “treatment failure” having respective odds of 1.8 (95%CI: 1.1–3.0) and 3.6 (95%CI: 2.3–5.8) (p < 0.05). The average KAP score of veterinarians, poor farm management practices, lack of awareness among farmers on prudent antibiotic use, and lack of antibiotic stewardship are the significant factors that need attention to combat the rising AMR in veterinary sector in India.

Antimicrobial Use in Animals in Timor-Leste Based on Veterinary Antimicrobial Imports between 2016 and 2019

“…Although the use of antimicrobials in animals is Timor-Leste is very low, there is potential for future misuse and overuse with farming intensification. Future studies investigating the knowledge, attitudes and practices of animal health professionals and farmers on antimicrobial use would be useful for identify strategies for promoting prudent use of antimicrobials in animals as identified in other studies [79][80][81]. Even in the absence of such studies, early action can be informed by studies conducted in other developing countries [55,58,82].…”

Understanding Antibiotic Usage on Small-Scale Dairy Farms in the Indian States of Assam and Haryana Using a Mixed-Methods Approach—Outcomes and Challenges

“…The emergence of antibiotic resistance in humans, animals, and the environment is strongly associated with the unnecessary use and misuse of antibiotics [ 1 ]. Antibiotic resistance is a global problem; however, low-and middle-income countries (LMICs) are considered most affected [ 2 , 3 ].…”

“…On these small-scale dairy farms, minimal quality control and infrastructure exists and practices, such as non-therapeutic or irrational use of antibiotics in lactating cows, are uncontrolled and unregulated [ 2 , 11 , 12 ]. Such malpractices do not seem as widespread on larger sized dairy farms which have been identified as using antibiotics in a more responsible way than smaller-scale dairy farms [ 1 ]. Overall, however, regardless of the size of the dairy farm, dairy farmers’ knowledge regarding antibiotics and reasons for antibiotic usage is poorly understood [ 2 , 13 ], and questions related to antibiotic practices, like quantity used, motive, administration method, frequency given, who administers, as well as adherence to withdrawal periods, remain poorly defined in the literature [ 11 , 14 ].…”

The Antibiotic Treatment of Calf Diarrhea in Four European Countries: A Survey

“…An increased workload can also play an important role, as veterinarians fear to revisit when the animal did not improve after the first treatment, and they are called again [ 58 ]. Furthermore, veterinarians fear they will be blamed if antibiotics later prove necessary [ 58 , 63 ]. Similar results are reported in a Dutch study in 2015, where veterinarians confirmed that the perceived pressure from clients can be a driver for antibiotic use [ 61 ].…”

“…One of the most important factors in veterinarians governing the selection of an antibiotic for treatment is their own experience [ 46 , 59 , 63 ]. The lack of experience and confidence might be a reason for a higher amount of antibiotics used for the treatment of NCD carried out by younger colleagues.…”