Assessing knowledge, attitudes, and preventive practices of smallholder livestock farmers toward antimicrobial use, resistance, and sources in Bangladesh

<h2>ABSTRACT</h2><h3>Objectives</h3> This study aimed to assess knowledge, attitudes and preventive practices (KAP) among smallholder livestock farmers toward antimicrobial use (AMU) and antimicrobial resistance (AMR). <h3>Methods</h3> A cross-sectional survey was conducted using structured, closed-ended questionnaires through face-to-face interviews. A total 390 farmers were randomly selected from five purposively chosen districts. Descriptive statistics, Multivariate logistic regression, and Spearman's rank correlation analyses were performed. <h3>Results</h3> The survey revealed significant gaps in knowledge and practices related to AMU and AMR, with only 17% of respondents demonstrating adequate knowledge and 31% adhering to appropriate practices, despite a high proportion (88%) expressing positive attitude. Multivariable analysis indicated that farmers who had training on AMU and AMR were more likely better knowledge (AOR = 6.00; 95% CI: 2.99–12.30), attitude (AOR = 1.81; 95% CI: 0.57–7.18), and practices (AOR = 2.46; 95% CI: 1.27–4.80) compared to those without training. Although 44% farmers reported obtaining antimicrobials through registered medical practitioners, whereas 19% adhered to the recommended guidelines for AMU. <h3>Conclusions</h3> The findings of this study will inform targeted educational and training interventions for farmers, aiming to curb the indiscriminate and inappropriate use of antimicrobials, thereby contributing to a reduction in the risk of AMR development.