Knowledge, attitudes, and practices of dairy farmers toward antibiotic use and antimicrobial resistance in Punjab, India

Inappropriate antibiotic use in dairy farming contributes to the growing burden of antimicrobial resistance (AMR), a major global public health threat with substantial impacts on human, animal, and environmental health. Understanding farmers’ knowledge, attitudes, and practices regarding antibiotic use is essential for promoting responsible antibiotic stewardship. A descriptive cross-sectional survey was conducted from June 2023 to May 2024 across three agro-climatic zones of Punjab: Upper and Doab Plains, Satluj–Ghaggar Malwa Plains, and South-West Zone. Participants were recruited through field visits and non-probability convenience sampling. A pretested, structured questionnaire was administered to 450 dairy farmers; 390 completed responses were analysed after excluding incomplete responses. The survey captured demographic characteristics as well as knowledge, attitude and practices related to antibiotic use, withdrawal periods, and AMR. Non-parametric statistical analyses (Mann–Whitney U and Kruskal–Wallis H tests) were performed at a significance level of p ≤ 0.05, as the data were not normally distributed (Shapiro–Wilk test, p < 0.001), using SPSS version 25.0. Multiple linear regression analysis was used to identify the independent predictors of overall KAP scores and their components. Among respondents, 64.1% were male, 33.3% had no formal education, and 85.1% maintained herds of fewer than nine animals. The median knowledge score was 12 (9–14), with 21.79% of respondents demonstrating high knowledge (≥ 75th percentile), 40.26% moderate (25th–75th percentile), and 37.95% low (< 25th percentile). Median attitude and practice scores were 3 (2–5) and 6 (5–7), respectively, and 52.3% of farmers exhibited moderate antibiotic-use practices. Significant differences ( p < 0.001) in mean ranks were observed across age, education, zone, landholding, and herd size, while farming experience did not show a statistically significant effect. Gender differences were also found to be significant. Multiple linear regression analysis identified age (negative association), education (positive association), and herd size (positive association) as significant predictors of the outcome variable (R² = 0.569). The findings suggest that lower educational attainment and smaller herd size are associated with poorer outcomes, indicating the need for targeted awareness and capacity-building interventions among smallholder and less-educated groups.