Different kettles of fish: varying patterns of antibiotic use on pig,
chicken and fish farms in Lao PDR and implications for antibiotic
resistance strategies
Abstract
The rapid intensification of the livestock sector in Southeast Asia has
been found to be associated with an extensive and expanding use of
antibiotics. This raises concerns regarding the rise of drug-resistant
bacteria in both animals and humans. Data on veterinary antibiotic use
(ABU) and antibiotic resistance (ABR) are scarce in Lao PDR, as in most
low and middle-income countries. This study aimed to explore the views
of small to medium-scale pig, poultry and fish producers regarding the
use of antibiotics. A total of 364 farmers were surveyed using a
questionnaire and farm visits. Patterns of knowledge, attitudes and
practices regarding ABU and ABR were explored with multiple factor
analysis and hierarchical cluster analysis. Farms were assigned to one
of three clusters in which specific farmers’ views were overrepresented.
Cluster 1 (in which pig farms were overrepresented) held a positive
attitude regarding preventive measures and information about
antibiotics. In cluster 2 (in which poultry farms were overrepresented),
there was a view that antibiotics should be used for disease prevention.
Finally, in cluster 3 (in which fish farms were overrepresented),
knowledge about ABU and ABR was weak, and ABU was very limited. No
specific attitude was under or overrepresented. Farmers mentioned that
they were unfamiliar with antibiotics and were uncertain about details
concerning ABR (such as whether or not to consume animal products just
after they received antibiotic treatment). Farmers from cluster 3 who
did not give antibiotics to their animal (90 out of 114) and did not use
vaccines (100 out of 114) were overrepresented. A total of 65%
(171/263) of the antibiotics found on farms were included on the World
Health Organization’s list of critically important antibiotics for human
medicine. These critically important antibiotics were mostly found in
clusters 1 (57/168, i.e., 33.8% farms had at least one critically
important antibiotic) and 2 (63/171, 36.8%). These findings indicate
that antibiotic stewardship strategies should tackle the use of critical
antibiotics as well prophylactic treatments to prevent antibiotic misuse
in small and medium- livestock farms.