Understanding Antibiotic Usage on Small-Scale Dairy Farms in the Indian States of Assam and Haryana Using a Mixed-Methods Approach-Outcomes and Challenges.

Naresh Kumar,Ram Pratim Deka,Eithne Leahy,Rajeswari Shome,Samiran Bandyopadhyay,Bibek R Shome,Johanna Frida Lindahl,Garima Sharma,Tushar Kumar Dey

doi:10.3390/antibiotics10091124

Abstract

The use and misuse of antibiotics in both humans and animals contributes to the global emergence of antimicrobial resistant (AMR) bacteria, a threat to public health and infection control. Currently, India is the world’s leading milk producer but antibiotic usage within the dairy sector is poorly regulated. Little data exists reflecting how antibiotics are used on dairy farms, especially on small-scale dairy farms in India. To address this lack of data, a study was carried out on 491 small-scale dairy farms in two Indian states, Assam and Haryana, using a mixed method approach where farmers were interviewed, farms inspected for the presence of antibiotics and milk samples taken to determine antibiotic usage. Usage of antibiotics on farms appeared low only 10% (95% CI 8–13%) of farmers surveyed confirmed using antibiotics in their dairy herds during the last 12 months. Of the farms surveyed, only 8% (6–11%) had milk samples positive for antibiotic residues, namely from the novobiocin, macrolides, and sulphonamide classes of antibiotics. Of the farmers surveyed, only 2% (0.8–3%) had heard of the term “withdrawal period” and 53% (40–65%) failed to describe the term “antibiotic”. While this study clearly highlights a lack of understanding of antibiotics among small-scale dairy farmers, a potential factor in the emergence of AMR bacteria, it also shows that antibiotic usage on these farms is low and that the possible role these farmers play in AMR emergence may be overestimated.

Highlights

The emergence of antibiotic resistance in humans, animals, and the environment is strongly associated with the unnecessary use and misuse of antibiotics [1]
Our study found that none of the farmers from farms where antibiotic residues were found in milk samples had heard of a withdrawal period
Irrational use of antibiotics in Indian dairy systems is aggravated by a number of factors; poor knowledge and misconceptions about antibiotics, easy access to antibiotics, and limited field supervision, possibly due to inadequate veterinary coverage [12], all seen in our study

Summary

Introduction

The emergence of antibiotic resistance in humans, animals, and the environment is strongly associated with the unnecessary use and misuse of antibiotics [1]. India ranks fourth in its usage of antibiotics in livestock [4]; regulations controlling antibiotic use in both human and animal medicine are very weakly enforced [5]. In higher-income countries (HICs), antimicrobial stewardship in veterinary medicine has gained increasing interest in recent years with extensive baseline data generated on antibiotic usage at farm level [6]. India is a large and diverse country and evidence documenting antibiotic usage, especially on dairy farms, is lacking throughout the country [5,7]. With India standing as number one in the world for milk production [9,10], the challenge of generating this evidence regarding antibiotic usage at dairy farm level, is an urgent public health concern

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Results

Discussion

Conclusion