Barriers and interventions for appropriate antimicrobial prescribing among veterinarians in Kerala

Antimicrobial resistance (AMR) is a global health emergency. Use of antimicrobials in animals has been implicated in the emergence of AMR in bacterial populations, with undesirable consequences for both human and animal health. The development of AMR is a natural phenomenon. However, due to overuse and misuse of antibiotics in different sectors; human and animal health, aquaculture and agriculture. The rate at which AMR occurring is exponentially increasing. This misuse threatens modern medicine and jeopardizes the safety of the routine treatment of infections. Among the major factors shaping antimicrobial resistance are antimicrobial prescribing and use. Tailoring Antimicrobial Resistance Program is a behavior change methodology that is utilized to adapt behavior change in relation to antimicrobial use. This study explores barriers and interventions for appropriate antibiotic prescription among the Veterinarians working in Animal Husbandry department in Kerala. Data were collected from 336 veterinarians across the Kerala state. Barriers for appropriate antimicrobial prescribing as perceived by the respondents were arrived at through methodology given by Garret and Woodworth (1969). Interventions as perceived by the respondents were arrived by percentage and ranking. Pressure/demand from clients for quick relief, lack of access to antibiotic sensitivity testing laboratory and insufficient fund allotment for drug purchase were the major barriers perceived by the respondents. The major interventions perceived were eestablishing more antibiotic sensitivity testing laboratory facilities, providing sufficient veterinary manpower in field and strict implementation of legislation to prevent over the counter supply of antibiotics without prescription. The findings would help develop and pilot behavior change interventions among veterinarians with the aim of optimizing appropriate antibiotic prescription and use, which would support the implementation of the antibiotic stewardship program. Effective behavior change interventions should consider multiple factors including individual and organizational factors to optimize appropriate antibiotic prescription.