The Use of Critically Important Antimicrobials for Human Use in Poultry Farming in Pakistan: A Cross-sectional Study Among Different Types of Farmers

Abstract

WHO's Global Action Plan on Antimicrobial Resistance (AMR) and Pakistan's National Action Plan on AMR, aimed to phase out the Critically Important Antimicrobials (CIAs) in livestock farming. This cross-sectional study aimed to examine antimicrobial use (AMU) patterns among 386 poultry farms and investigate the association between farming types and AMU patterns in Punjab, Sindh, Balochistan, and Khyber Pakhtunkhwa, and Islamabad Capital Territory province in Pakistan. A questionnaire-based survey revealed that all participants were male, the majority belonged to the middle-income group (46.9%) and a significant proportion was university-educated (39.4%). Extensive use of the Highest Priority CIAs, including enrofloxacin (72.3%), colistin sulfate (61.9%), and tilmicosin (36.3%) was observed. High Priority CIAs, including amoxicillin, gentamycin, and neomycin, were used by 48.4%, 28.2%, and 36.3% of farms, respectively. A chi-square test showed a significant association between farming types and AMU patterns (p<0.05), except for aminoglycosides and doxycycline. Breeders showed the highest antimicrobial usage frequency, while backyard farmers tended to use them infrequently. Broiler and layer farmers occupied intermediary positions between these two extremes. Among various farming, broilers exhibited the highest prevalence of preventive AMU (47.8%). Breeders exhibited the lowest frequency of either combination therapy or whole flock treatment when few got sick at 22.2% and 44.4%, respectively. Our findings showed extensive CIA utilization in poultry farming. These findings could guide the phasing out process of HtP-CIAs in poultry, and potentially other food animals in Pakistan and policy making