Antimicrobial use and practices by animal health professionals in 20 sub-Saharan African countries.

The use of antimicrobial (AM) in animal production is an important contributor to antimicrobial resistance (AMR) worldwide. Animal health professionals should play a key role in ensuring judicious use of AM. However, they are subjected to influence from clinical and non-clinical factors. The present study evaluates the perceptions and concerns of animal health practitioners regarding antimicrobial use (AMU) and prescription practices. A cross-sectional online questionnaire survey was conducted among animal health practitioners, predominantly veterinary doctors (88 %) in 20 African countries. Results showed that the most prescribed and administered AM were tetracycline (66 %) followed by β-lactams (32 %) and macrolides (25 %). Most respondents were very confident in deciding on the right dose of AM (77 %) and treatment plans (76 %) as compared to choosing the correct AM (52 %) and making an accurate diagnosis (46 %). Self-reported confidence in the implementation of antimicrobial stewardship was significantly influenced by the respondents' work environment, gender and access to information on AM. Lack of diagnostic facilities and susceptibility tests were major hindrances to adequate prescriptions and use of AM. Perceived drivers of AMR identified were excessive prescription by animal health professionals and the use of AM without proper diagnosis. Almost two thirds (62 %) of the respondents had sufficient information on AM when needed while the main source of information was professional training and drug labels. Thus, reinforcement of regional and country-level guidelines and tailored continuing education programs for veterinarians as well as the development of field-friendly disease diagnosis and management tools are essential to considerably improve AMU.