Knowledge, attitudes, and practices of Brazilian dairy farmers and technical advisors regarding antibiotic use and antimicrobial resistance

Antimicrobial resistance (AMR) is a global threat, exacerbated by antibiotic misuse in animal agriculture, highlighting the need to understand antibiotic use (AMU) in major dairy-producing countries such as Brazil. A cross-sectional, online survey-based study was conducted with dairy farmers (n = 232) and technical advisors (n = 264) across Brazil, primarily from the major dairy-producing regions. Questionnaires assessed knowledge, attitudes, and self-reported practices related to AMU and AMR. Descriptive statistics and chi-square tests were used for group comparisons. Most participants reported using critically important antibiotics, including third- to fifth-generation cephalosporins and quinolones. Clinical mastitis was the main reported reason for AMU, followed by dry cow therapy. Advisors demonstrated greater knowledge of AMR than farmers (median correct answers: 6 vs. 4 out of 8). Significant discrepancies were observed between farmers' self-reported practices and advisors' perceptions, particularly regarding mastitis prevention and waste milk disposal. Although most farmers expressed willingness to reduce AMU and reported exposure to the concept of "prudent antibiotic use", risk-prone practices persisted, including antibiotic use under limited veterinary oversight. These findings indicate conditions that may increase the risk of selecting and spreading resistant bacteria in Brazilian dairy systems, including the use of critically important antibiotics in contexts of limited knowledge and insufficient veterinary guidance. This study highlights the need to strengthen antimicrobial stewardship through targeted educational interventions, improved access to veterinary support, enhanced advisor-farmer collaboration, and more effective regulatory frameworks.