Knowledge, Attitude and Practices of Antimicrobial Use among Veterinarians and Para-Veterinarians in Gaza Strip, Palestine
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Antimicrobial resistance (AMR) is an emerging global public health problem. Rationale use of antimicrobials can prevent the rise of this problem. The objective of this study is to characterize the knowledge, attitudes, and practices of antibiotic usage and AMR among veterinarians and para-veterinarians in Gaza Strip, Palestine. A cross-sectional study was conducted through the collection of a questionnaire from 86 personnel who served as part of a veterinary aid system, in September_ October 2022. The results show that the most common infections treated are respiratory tract infections (18%), mastitis (17%), and diarrhea (17%). The most frequent antibiotics used were penicillin/strepto-penicillin (15.6%), tetracycline/oxytetracycline (15.3%), and erythromycin (5.1%). About one-third (29.6%) of respondents relied on their previous experience when prescribing antibacterial. Nine in ten (90.7%) believed that there is ongoing antibacterial abuse in the veterinarian sector, and two-thirds (63.5%) believed that the use of wide-spectrum antibacterial is better than the narrow spectrum. The large majority of participants (91.9%) considered AMR a serious public health threat. Although most veterinarians and para-veterinarians in Gaza Strip consider the AMR a serious problem, many of them are contributing to the antimicrobial abuse in the veterinary sector. Targeted educational programs on responsible antimicrobial use and AMR are highly recommended for workers in the veterinary field. This should be implemented by regulating and monitoring the use of antimicrobials among veterinarians as well as farmers.
Received: 05 December 2024
Revised: 03 January 2025
Accepted: 06 April 2025
Published: 28 June 2025
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1. Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P&T. 2015;40(4):277. https://api.semanticscholar.org/CorpusID:26487708
2. Clifford K, Desai D, da Costa CP, Meyer H, Klohe K, Winkler AS, et al. Antimicrobial resistance in livestock and poor quality veterinary medicines. Bull World Health Organ. 2018;96(9):662. https://doi.org/10.2471/BLT.18.209585 DOI: https://doi.org/10.2471/BLT.18.209585
3. DadgostarP. Antimicrobial Resistance: Implications and Costs. Infect Drug Resist. 2019. 12, 3903-3910. https://doi.org/10.2147/IDR.S234610 DOI: https://doi.org/10.2147/IDR.S234610
4. De Kraker ME, StewardsonA J, Harbarth S.Will 10 Million People Die a Year due to Antimicrobial Resistance by 2050?. PLoS Med. 2016.13(11):e1002184. https://doi.org/10.1371/journal.pmed.1002184 DOI: https://doi.org/10.1371/journal.pmed.1002184
5. Schrijver R, Stijntjes M, Rodríguez-Baño J, Tacconelli E, Rajendran NB, Voss AJCm, et al. Review of antimicrobial resistance surveillance programmes in livestock and meat in EU with focus on humans. CMI. 2018;24(6):577-90. https://doi.org/10.1016/j.cmi.2017.09.013 DOI: https://doi.org/10.1016/j.cmi.2017.09.013
6. Thapa N, Sharma P, Dahal N, Chamling S, Raika V, Dorjee JJBJoAS. Antimicrobial resistance (AMR) in Bhutanese Livestock: A Review. BJAS. 2018;2(1):123-6. https://ojs.moal.gov.bt/index.php/bjas/article/view/267/159
7. Tian M, He X, Feng Y, Wang W, Chen H, Gong M, et al. Pollution by antibiotics and antimicrobial resistance in livestock and poultry manure in China, and countermeasures. J. Antibiot. 2021;10(5):539. https://doi.org/10.3390/antibiotics10050539 DOI: https://doi.org/10.3390/antibiotics10050539
8. Thornton PK. Livestock production: recent trends, future prospects. Philos. Trans. R. Soc. B: Biol. Sci. 2010;365(1554):2853-67.
https://doi.org/10.1098/rstb.2010.0134 DOI: https://doi.org/10.1098/rstb.2010.0134
9. Herrero M, Thornton PK, Gerber P, Reid RSJCOiES. Livestock, livelihoods and the environment: understanding the trade-offs. COSUST. 2009;1(2):111-20. https://doi.org/10.1016/j.cosust.2009.10.003 DOI: https://doi.org/10.1016/j.cosust.2009.10.003
10. Hockenhull J, Turner AE, Reyher KK, Barrett DC, Jones L, Hinchliffe S, et al. Antimicrobial use in food‐producing animals: a rapid evidence assessment of stakeholder practices and beliefs. Vet. Rec. 2017;181(19):510.https://doi.org/10.1136/vr.104304 DOI: https://doi.org/10.1136/vr.104304
11. Xiong W, Sun Y, Zeng Z. Antimicrobial use and antimicrobial resistance in food animals. Environ Sci Pollut R. 2018;25(19):18377-84.
https://doi.org/10.1007/s11356-018-1852-2 DOI: https://doi.org/10.1007/s11356-018-1852-2
12. Chantziaras I, Boyen F, Callens B, Dewulf J. Correlation between veterinary antimicrobial use and antimicrobial resistance in food-producing animals: a report on seven countries. J. Antimicrob. Chemother. 2014;69(3):827-34.https://doi.org/10.1093/jac/dkt443 DOI: https://doi.org/10.1093/jac/dkt443
13. Bos ME, Mevius DJ, Wagenaar JA, van Geijlswijk IM, Mouton JW, Heederik DJJ. Antimicrobial prescription patterns of veterinarians: introduction of a benchmarking approach. J. Antimicrob. Chemother. 2015;70(8):2423-5.https://doi.org/10.1093/jac/dkv104 DOI: https://doi.org/10.1093/jac/dkv104
14. Vijay D, Bedi JS, Dhaka P, Singh R, Singh J, Arora AK, et al. Knowledge, attitude, and practices (KAP) survey among veterinarians, and risk factors relating to antimicrobial use and treatment failure in dairy herds of India. J. Antibiot. 2021;10(2):216.
https://doi.org/10.3390/antibiotics10020216 DOI: https://doi.org/10.3390/antibiotics10020216
15. Norris JM, Zhuo A, Govendir M, Rowbotham SJ, Labbate M, Degeling C, et al. Factors influencing the behaviour and perceptions of Australian veterinarians towards antibiotic use and antimicrobial resistance. PloS one. 2019;14(10):e0223534.
https://doi.org/10.1371/journal.pone.0223534 DOI: https://doi.org/10.1371/journal.pone.0223534
16. Busani L, Graziani C, Binkin N, Franco A, Di Egidio A, Battisti AJVr. Survey of the knowledge, attitudes and practice of Italian beef and dairy cattle veterinarians concerning the use of antibiotics. Vet. Rec. 2004;155(23):733-8.https://doi.org/10.1136/vr.155.23.733.
17. Shahi MK, Saharuetai J. Knowledge, attitudes, and practices on antimicrobial use and antimicrobial resistance among poultry practitioner veterinarians. Front. vet. sci. 2024; 11: 1349088. https://doi.org/10.3389/fvets.2024.1349088 DOI: https://doi.org/10.3389/fvets.2024.1349088
18. Wangmo K, Dorji T, Pokhrel N, Dorji T, Dorji J, Tenzin TJPo. Knowledge, attitude, and practice on antibiotic use and antibiotic resistance among the veterinarians and para-veterinarians in Bhutan. PloS one. 2021;16(5):e0251327. https://doi.org/10.1371/journal.pone.0251327 DOI: https://doi.org/10.1371/journal.pone.0251327
19. Gemeda BA, Amenu K, Magnusson U, Dohoo I, Hallenberg GS, Alemayehu G, et al. Antimicrobial use in extensive smallholder livestock farming systems in Ethiopia: knowledge, attitudes, and practices of livestock keepers. Front. Vet. Sci. 2020;7:55.
https://doi.org/10.3389/fvets.2020.00055 DOI: https://doi.org/10.3389/fvets.2020.00055
20. Acharya KP, Wilson RTJFim. Antimicrobial resistance in Nepal. Front. med. 2019;6:105. https://doi.org/10.3389/fmed.2019.00105 DOI: https://doi.org/10.3389/fmed.2019.00105
21. Wright E, Jessen R, Tompson A, Rutland C, Singleton D, Battersby I, et al . Influencing attitudes towards antimicrobial use and resistance in companion animals-the impact on pet owners of a short animation in a randomized controlled trial. JAC-AMR. 2024; 6(3):1-10.https://doi.org/10.1093/jacamr/dlae065 DOI: https://doi.org/10.1093/jacamr/dlae065
22. Farrell S, Benson T, McKernan C, Regan Á, Burrell AM, Dean M. Exploring veterinarians' behaviour relating to antibiotic use stewardship on Irish dairy farms using the COM-B model of behaviour change. Res. J. Vet. Sci. 2023; 156:45-53.
https://doi.org/10.1016/j.rvsc.2023.01.019 DOI: https://doi.org/10.1016/j.rvsc.2023.01.019
23. Josh W McClelland ,Jacqueline M Norris ,Dale D Howes ,Merran G . Knowledge and perceptions of Australian postgraduate veterinary students prior to formal education of antimicrobial use and antimicrobial resistance. Int. J. One Health. 2022; 14:1-9.
https://doi.org/10.1016/j.onehlt.2021.100366 DOI: https://doi.org/10.1016/j.onehlt.2021.100366
24. Smith M, King C, Davis M, Dickson A, Park J, Smith F, et al. Pet owner and vet interactions: exploring the drivers of AMR. Antimicrob Resist Infect Control 7. 2018;7(1):1-9.https://doi.org/10.1186/s13756-018-0341-1 DOI: https://doi.org/10.1186/s13756-018-0341-1
25. De Briyne N, Atkinson J, Pokludová L, Borriello S, Price SJVR. Factors influencing antibiotic prescribing habits and use of sensitivity testing amongst veterinarians in Europe. Vet. Rec. 2013;173(19):475.https://doi.org/10.1136/vr.101454 DOI: https://doi.org/10.1136/vr.101454
26. Hardefeldt LY, Gilkerson J, Billman‐Jacobe H, Stevenson M, Thursky K, Bailey K, et al. Barriers to and enablers of implementing antimicrobial stewardship programs in veterinary practices. J Vet Intern Med. 2018;32(3):1092-9. https://doi.org/10.1111/jvim.15083 DOI: https://doi.org/10.1111/jvim.15083
27. Firouzabadi D, Mahmoudi LJJoeicp. Knowledge, attitude, and practice of health care workers towards antibiotic resistance and antimicrobial stewardship programmes: A cross‐sectional study. JECP. 2020; 26(1): 190-6. https://doi.org/10.1111/jep.13177 DOI: https://doi.org/10.1111/jep.13177
28. Ekakoro JE, Okafor CCJV, science a. Antimicrobial use practices of veterinary clinicians at a veterinary teaching hospital in the United States. VAS. 2019; 7: 100038. https://doi.org/10.1016/j.vas.2018.09.002 DOI: https://doi.org/10.1016/j.vas.2018.09.002
29. Adekanye UO, Ekiri AB, Galipó E, Muhammad AB, Mateus A, La Ragione RM, et al. Knowledge, attitudes and practices of veterinarians towards antimicrobial resistance and stewardship in Nigeria. J. Antibiot. 2020;9(8):453. https://doi.org/10.3390/antibiotics9080453 DOI: https://doi.org/10.3390/antibiotics9080453
30. Scherpenzeel C, Santman-Berends I, Lam TJJods. Veterinarians' attitudes toward antimicrobial use and selective dry cow treatment in the Netherlands. JDS. 2018; 101(7):6336-45. https://doi.org/10.3168/jds.2017-13591 DOI: https://doi.org/10.3168/jds.2017-13591