Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons

Abstract

ObjectivesThe use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry.MethodsA qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts.ResultsEnsuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers.ConclusionsThe drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use.

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

“…antibiotic use) is critical for ASPs to be successfully implemented (Cotta et al, 2014;Viale et al, 2015;Cabello et al, 2016). Thus, veterinarians (as clinicians and educators) play a critical role in ABS and for successful implementation of ASP (Bowater, 2015;Coyne et al, 2016). Antibiotics used in humans, including the critically important ones, are in the same classes as those used in animals (WHO, 2011;Landers et al, 2012;Awad and Aboud, 2015).…”

“…Antibiotics used in humans, including the critically important ones, are in the same classes as those used in animals (WHO, 2011;Landers et al, 2012;Awad and Aboud, 2015). Emergence of resistant infections in animal populations can impact health and productivity, and potentially transfer to humans (zoonosis) (van Djuikeren et al, 2014;Coyne et al, 2016). But for veterinarians to implement and help in achieving the goals of ABS, they (as healthcare providers/professionals), should be interested in and knowledgeable about ABR and ABS (Awad and Aboud, 2015;Guardabassi and Prescott, 2015;Coyne et al, 2016).…”

“…Emergence of resistant infections in animal populations can impact health and productivity, and potentially transfer to humans (zoonosis) (van Djuikeren et al, 2014;Coyne et al, 2016). But for veterinarians to implement and help in achieving the goals of ABS, they (as healthcare providers/professionals), should be interested in and knowledgeable about ABR and ABS (Awad and Aboud, 2015;Guardabassi and Prescott, 2015;Coyne et al, 2016). Knowledge about ABS is critical for veterinarians because they are anticipated (as key healthcare providers) to take prominent roles in infection control programmes in healthcare (veterinary) systems and as educators of their clients/the public about ABR and ABS (Bowater, 2015;Khan et al, 2016).…”

“…Knowledge about ABS is critical for veterinarians because they are anticipated (as key healthcare providers) to take prominent roles in infection control programmes in healthcare (veterinary) systems and as educators of their clients/the public about ABR and ABS (Bowater, 2015;Khan et al, 2016). Therefore, assessing the veterinarians' perception and level of knowledge/awareness about ABS is crucial for identifying gaps in knowledge, development of effective ASPs and improvement of the curricula in Veterinary schools (Abbo et al, 2013;Paul and Gyssens, 2013;Cotta et al, 2014;Coyne et al, 2016). Moreover, taking into account the potential role of veterinarians in the development and execution of ASPs, it is imperative to know the practices/behaviours/attitudes of veterinarians towards ABS (Coyne et al, 2016).…”

“…Therefore, assessing the veterinarians' perception and level of knowledge/awareness about ABS is crucial for identifying gaps in knowledge, development of effective ASPs and improvement of the curricula in Veterinary schools (Abbo et al, 2013;Paul and Gyssens, 2013;Cotta et al, 2014;Coyne et al, 2016). Moreover, taking into account the potential role of veterinarians in the development and execution of ASPs, it is imperative to know the practices/behaviours/attitudes of veterinarians towards ABS (Coyne et al, 2016). This is crucial in order to understand the level of engagement among veterinarians as clinical stakeholders involved in antibiotics prescription and dispensing, determine key areas that will be useful in developing ASP and for education of the veterinarians/public which is an integral part of all ABR containment activities (Vickers, 2011;Abbo et al, 2013;Cotta et al, 2014).…”