Antimicrobial use practices, attitudes and responsibilities in UK farm animal veterinary surgeons.

Increasing levels of antimicrobial resistance in human and veterinary medicine have raised concerns around 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 humans. This study aimed to explore UK veterinary surgeons antimicrobial prescribing behaviours, their attitudes to antimicrobial resistance and their perceptions of responsibility of antimicrobial use in pigs through a questionnaire study on a census sample of 261 veterinary surgeons in England, Wales and Scotland who had a clinical caseload which included commercial pigs. The questionnaire had a useable response rate of 34.1% (n = 61/179) in eligible veterinary surgeons. Overall, veterinary surgeons reported personal confidence that their prescribing decisions were responsible however, there was concern that the prescribing behaviours of other veterinary surgeons and physicians in human medicine may be less responsible; a sociological concept known as 'othering'. In parallel, veterinary surgeons seldom identified that treatment failure was a consequence of antimicrobial resistance in their own clinical caseload, however they considered it an issue for other veterinary surgeons and for human prescribers. Veterinary surgeons consulted a wide spectrum of resources on antimicrobial use in pigs which, on occasion, contained conflicting guidance on what was defined as responsible prescribing. The decision over whether or not to prescribe an antimicrobial was influenced by numerous factors relating to the veterinary surgeons' experience and the clinical situation presented, but maintaining pig welfare was a high priority. There was a shared desire to seek alternative methods to prevent disease to antimicrobial use, however the use of diagnostics to support prescribing decisions was an infrequently reported behaviour and could play a more significant role in prescriber decisions if more cost effective and rapid tests were available. Future interventions to optimise antimicrobial use in pigs needs to focus on the evolution of antimicrobial use practices in a changing political and scientific landscape whilst also considering individual motivations and justifications for use.

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

OBJECTIVES: The 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. METHODS: A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. RESULTS: Ensuring 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. CONCLUSIONS: The 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.

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

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.