Exploring the complexity of antibiotic prescribing behaviour among livestock and companion animal veterinarians in Belgium

Background Antimicrobial resistance poses a global health threat, driven by antimicrobial use (AMU). In veterinary medicine, antibiotics are being prescribed in both livestock and companion animals. Therefore, promoting responsible AMU across both sectors is essential. Methods This qualitative study explored the determinants of antibiotic prescribing among Belgian veterinarians using focus groups and thematic analysis. Results Forty‐two veterinarians specialised in companion animals, poultry, pigs or cattle participated in eight focus groups. Six themes were identified: (i) diagnostic assessments as the basis for antibiotic decision making, (ii) evaluating therapeutic options, (iii) the veterinarian's role in decision making, (iv) client characteristics, (v) initiatives promoting responsible AMU, and (vi) veterinarian–client communication. Antibiotic prescribing involves complex decision making, mainly guided by clinical expertise. Veterinarians value guidelines, but prioritise therapeutic autonomy. A shift from routine AMU to preventive care was found, especially among livestock veterinarians, while companion animal veterinarians are still adopting this mindset. Despite progress, challenges remain, including client expectations, prescribing habits and limited awareness. Limitations Although data saturation was not confirmed for pig and poultry, broader themes reached saturation, reinforcing the relevance of the findings. Conclusion This study provides a framework for enhancing antimicrobial stewardship in both livestock and companion animals.