Medically rational use of antibiotics to reduce resistance and support effective animal production in low- and middle-income countries

Background: Antibiotic resistance is a threat to human and animal health. The problem is exacerbated by the fact that similar antimicrobial drugs are used to treat both animals and humans. The global livestock sector is the largest consumer of antibiotics in the world. Since the use of antibiotics drives the emergence of resistance, it is crucial to reduce their use in the livestock sector, not only for the sake of animal health, but for public health as well. To tackle the issue of antibiotic resistance, countries are setting up regulations. These include banning the use of antibiotics as feed additives for growth promotion, making veterinary prescription a prerequisite for sale and restricting the use of antibiotics of critical importance for human medicine. Aim: To share our practical experience and summarize data from our studies on the use of antibiotics relating to animal management in South East Asia, East Africa and Northern Europe. Methods: We considered our 9 recent publications from 2018 to 2024, with a focus on several key factors associated with an increase in AB resistance. Results: We show that high animal productivity is possible with low use of antibiotics; and that the use of antibiotics in low and middle income countries is often not based on solid medical indications; and that there are other means but regulations to reduce the use of antibiotics. In resource-poor settings, enforcing and complying with regulations can be challenging. Thus, we have identified a rational approach that successfully reduced the use of antibiotics without undermining animal productivity. It is based on effective health management routines and biosecurity and has been promoted by FAO and CGIAR. Conclusions: Knowledge and awareness among farmers do not necessarily lead to changed behaviors. Effective incentives are required to encourage the rational use of antibiotics. Research in the field of veterinary medicine could focus on the social sciences, particularly economic issues, with a view to improving AB use.