Understanding antimicrobial use and prescribing behaviours by pig veterinary surgeons and farmers: a qualitative study

Abstract

Increasing awareness of bacterial antimicrobial resistance in human beings and veterinary medicine has raised concerns over the issue of overprescribing and the indiscriminate use of antimicrobials. Their use in food-producing animals is under scrutiny due to the perceived risk from the zoonotic transfer of resistant pathogens from animals to human beings. This study used focus groups to explore the drivers and motivators behind antimicrobial use and prescribing by veterinary surgeons and farmers in the pig industry in the UK. Studies of two veterinary and four farmer focus groups were undertaken, each with between three and six participants, in three geographically distinct regions of low, moderate and high pig density in England. Thematic analysis of the focus group transcriptions revealed convergent themes, both within and across, the veterinary and farmer focus groups. Veterinary opinion was such that 'external pressures', such as pressure from clients, legislation and public perception, were considered to strongly influence prescribing behaviour, whereas, farmers considered issues surrounding farming systems and management to be greater drivers towards antimicrobial use. Acquiring such in-depth insight into the antimicrobial prescribing behaviours in veterinary medicine provides more detailed understanding of prescribing practice and will aid the development of interventions to promote the responsible use of antimicrobials.

Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

“…Therefore, antibiotic prescribing decisions of veterinarians should be after consideration of intrinsic and extrinsic factors (e.g. type of husbandry practice in food-producing animals) (De Bryine et al 2013;Coyne et al, 2014;Speksnijder et al, 2015;Coyne et al, 2016). Even more concerning is that majority of the respondents in this study choose new generation antibiotics (e.g., extended-spectrum antibiotics) as first line of treatment.…”

EU Insights – Perceptions on the human health impact of antimicrobial resistance (AMR) and antibiotics use in animals across the EU

“…Interview topic guides and the online survey questionnaire were informed by a rapid literature review (Alarcon, 2013;BfR, 2015;Buller et al, 2015;Coyne et al, 2014;De Briyne et al, 2016;Dean et al, 2015;European Commission, 2005, 2010Fontané, 2015;Gibbons, 2013;Hughes, Hermans and Morgan, 2008;Jan et al, 2012;Laanen et al, 2014;Moreno, 2014;Schulze-Geisthövel et al, 2016;Speksnijder et al, 2014 andSwinkels, 2015;and Visschers et al, 2015).…”

“…Similarly to farmers, veterinarians showed little concerns that antibiotics use in farming creates AMR risks in humans (e.g, Buller et al, 2015), and some believed there is little scientific evidence of these risks (Coyne et al, 2014).…”

“…The literature suggest that factors affecting veterinarians' antibiotic prescribing behaviour include pressure from farmers and economic benefits from antibiotics use (Coyne et al, 2014;Speksnijder et al, 2014;Dean et al, 2011), pressure from other actors, such as veterinarians (Dean et al, 2011) and legislation (Coyne et al, 2014).…”

A cross-sectional study of oral antibacterial treatment patterns in relation to specific diarrhoeal pathogens in weaner pigs

“…However, the criteria for discontinuing repeated treatment of consecutive batches of pigs are not clear. A British focus group study documented that both farmers and veterinarians found it difficult to decide when to withdraw prophylactic treatments (Coyne et al 2014). A recent Danish study (Pedersen et al, 2015) found that 84% of the farmers used some clinical inspection criteria to determine when to initiate treatment, while antibacterials were used systematically on a fixed day post-weaning in 16% of the herds, suggesting a prophylactic application.…”