**4. Delineating the use of antibiotics by farmers from farm-to-fork**

Low income countries should follow the approaches of World Health Organization, World Organization for Animal Health, and the Food and Agriculture Organization of the United Nations, which recommends to implement national action plans encircling human, food animal, dairy animals, and environmental sectors to formulate appropriate policies, interventions, and activities that could address the prevention and containment of antimicrobial resistance from farm-to-fork. Suitable interventions should be designed, which include the following fields and coverage.

#### **4.1 Use of antimicrobials by farmers**

In strong sense, there is dependence among piggery farmers on antimicrobials to sustain production, improve farm performance, and maintain health status. Lack of concern about the harmful effects of antimicrobial use on their own and public health was identified among pig producers as a result of a reduction in the curative ability of antimicrobials and the selection of antimicrobial resistance bacteria [33]. A study conducted in Danish system revealed that 82% of antimicrobials sold by pharmacies were direct to individuals on prescription with specifications for use, 78% of antimicrobials sold by pharmacies used for pigs, and 20% for cattle [34]. The overuse of antibiotic has exploited this miracle drug to such an extent that a study in the Netherlands revealed that 79% of farmers used antibiotics routinely and 18% occasionally extended antibiotic treatment. The choice of progressive farmers for adopting prudent use of antibiotics by avoiding routine use of antibiotics was perceived as good practice by fellow farmers. This was followed by repeating the initial label treatments [35]. There are certain specific antibiotics which are used by farmers to treat animals without veterinary consultation (e.g., gentamicin in Ohio). Thus, improving information flow from Veterinarians to farmers may be the most effective means of promoting prudent use of antibiotics on dairy farms [36]. Subjective norms and moral obligations together, in which perceived moral obligations to peers, clients, and the regulatory norm setting sector associated with the feedlot industry increase social pressures to use antibiotics in acutely sick, chronically sick, and high-risk feedlot cattle [37].

#### **4.2 Understanding the antimicrobials overuse in small dairy farms**

The incidence of death of farm workers due to treatment failure attributed by antimicrobial resistance is likely much higher in developing countries where more

**17**

*Antimicrobial Resistance and Rational Use of Antimicrobials in Livestock: Developing Countries'…*

people live in close contact with livestock, where food hygiene is not well practiced [38]. A report by WHO revealed that in developing countries throughout the world, even less than 50% of human are treated according to standard treatment protocol, and prescribing patterns were found substandard regardless of the type of prescriber [39]. Antibiotic-resistant food-borne infections, emergence of new multiresistant strains of bacteria, and spread of resistant genes are some main areas of

The basic reason for increase in antimicrobial resistance in food animals is factory farming. In intensive pig and poultry production, animals are reared in confined and overcrowded conditions, usually with no outdoor access, and they are bred and managed for maximum production yield, i.e., to grow faster in size and number or to produce more meat, milk, and eggs. This forces them to compromise their health and their immune responses and encourage infectious disease to develop and spread easily among these livestock [40, 41]. Without the aid of drugs for disease prevention, it would not be possible to keep the animals productive in the intensive conditions, in which they are often kept and managed without proper care by the livestock keeper. Earlier, the policy-makers of 50 years ago permitted antibiotics to be used for non-therapeutic reasons in animal production, often in spite of scientific misgivings, which can be perceived as a serious mistake now. Fifty years later, while the evidence continues to be disputed by some sections of the industry, the actual and potential damage to public health is acknowledged by scientists and policy-makers due to the spread of antibiotic resistance among livestock species and human being (vertical and horizontal

**5. Synchronized efforts by stakeholders to reduce the pace of spread of** 

All the stakeholders including veterinarians, paravets, farmers, and pharmaceutical companies should be made aware about their interacting roles from antimicrobial prescription to use, in which decision made by one stakeholders affects the worth and value of choices and decision for other stakeholder [42]. These aspects

One Health approach recognizes that human, animals, and ecosystem health are inextricably linked to each other. It came in to light because many factors have changed the interaction between humans, animals, and environment. Thus, for achieving the mutual optimal health outcomes, it needs the cooperation of human health, livestock, and environment health. Resistance to infectious diseases increase the cost of treatment as well as serious biosecurity concerns due to spread of antibiotic resistance. Thus, the animal production is hampered due to rise in incidence of infections.

The primary focus of an antimicrobial stewardship program is to optimize the use of antimicrobials to achieve the best treatment outcomes, reduce the risk of infections, reduce or stabilize levels of antibiotic resistance, and promote

*DOI: http://dx.doi.org/10.5772/intechopen.88458*

transfer of resistance) [15].

**antimicrobial resistance**

**5.2 Antimicrobial stewardship**

can be highlighted under following sub-heads.

**5.1 One Health approach to combat antimicrobial resistance**

risk due to indiscriminate and overuse of antibiotics [15].

**4.3 Antimicrobial resistance and intensive animal farming**

*Antimicrobial Resistance and Rational Use of Antimicrobials in Livestock: Developing Countries'… DOI: http://dx.doi.org/10.5772/intechopen.88458*

people live in close contact with livestock, where food hygiene is not well practiced [38]. A report by WHO revealed that in developing countries throughout the world, even less than 50% of human are treated according to standard treatment protocol, and prescribing patterns were found substandard regardless of the type of prescriber [39]. Antibiotic-resistant food-borne infections, emergence of new multiresistant strains of bacteria, and spread of resistant genes are some main areas of risk due to indiscriminate and overuse of antibiotics [15].

#### **4.3 Antimicrobial resistance and intensive animal farming**

The basic reason for increase in antimicrobial resistance in food animals is factory farming. In intensive pig and poultry production, animals are reared in confined and overcrowded conditions, usually with no outdoor access, and they are bred and managed for maximum production yield, i.e., to grow faster in size and number or to produce more meat, milk, and eggs. This forces them to compromise their health and their immune responses and encourage infectious disease to develop and spread easily among these livestock [40, 41]. Without the aid of drugs for disease prevention, it would not be possible to keep the animals productive in the intensive conditions, in which they are often kept and managed without proper care by the livestock keeper. Earlier, the policy-makers of 50 years ago permitted antibiotics to be used for non-therapeutic reasons in animal production, often in spite of scientific misgivings, which can be perceived as a serious mistake now. Fifty years later, while the evidence continues to be disputed by some sections of the industry, the actual and potential damage to public health is acknowledged by scientists and policy-makers due to the spread of antibiotic resistance among livestock species and human being (vertical and horizontal transfer of resistance) [15].
