Knowledge, attitudes, and perceptions of dairy farmers regarding antibiotic use: Lessons from a developing country

In lower- and middle-income countries, uncontrolled use of antibiotics is causing antimicrobial resistance, affecting both animal welfare and public health. Meanwhile, studies on antibiotic use in these countries are limited. A crucial step to limit the spread of antimicrobial resistance (AMR) is to examine the use of these drugs and identify its determinants. The aim of our study, the first of its kind in Lebanon, was to assess dairy farmers' knowledge and awareness of antimicrobial use (AMU) and AMR. For this, 18 farmers from different regions, educational backgrounds, experience levels, and herd sizes were interviewed. Results showed that owners of larger farms were more aware of AMU and AMR, and trying to implement preventive actions, whereas nonsystematic antimicrobial use was prevalent among the smaller farms. Mastitis and laminitis were the most treated diseases, and antibiotics used were oxytetracycline, penicillin, streptomycin, and florfenicol. Overall, antibiotic use was found as a preventive measure and a treatment of nonbacterial diseases. Irregular uses were linked to easy access of farmers to antibiotics, interrupted relations with veterinary authorities, and lack of self-assessment and inspection. Lebanese dairy farmers and owners reported feeling disadvantaged in their local trade field, facing illegal competition and unauthorized farms and industries, and lacking support from the government. Training and awareness programs must be implemented, and policies and regulations must be set, to reduce antibiotic use and hinder the spread of AMR in Lebanon.