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Antimicrob Resist Infect Control. 2018 May 2;7:60. doi: 10.1186/s13756-018-0354-9. eCollection 2018.

The social biography of antibiotic use in smallholder dairy farms in India.

Author information

1Public Health Foundation of India, Plot 47, Sector 44, Gurgaon, Haryana 122002 India.
2Department of Public Health Sciences, Faculty of Medicine, University of Liège - Hospital District, Hippocrates Avenue 13 - Building 234000, Liège, Belgium.
Indian Institute of Public Health, Gurgaon, Haryana 122002 India.
4Centre for Research and Action in Public Health (CeRAPH), University of Canberra, Building 22, Floor B, University Drive, Bruce ACT 2617 Australia.
5Indian Council of Medical Research, Division of Epidemiology, National Institute of Cholera and Enteric Diseases, Kolkata, 700010 India.
6International Livestock Research Institute, Nairobi, 30709-00100 Kenya.
7Zoonosis Science Laboratory, Uppsala University, Po Box 582, Uppsala, SE-751 23 Sweden.
8Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, Uppsala, SE-750 07 Sweden.



Antimicrobial resistance (AMR) has been identified as one of the major threats to global health, food security and development today. While there has been considerable attention about the use and misuse of antibiotics amongst human populations in both research and policy environments, there is no definitive estimate of the extent of misuse of antibiotics in the veterinary sector and its contribution to AMR in humans. In this study, we explored the drivers ofirrational usage of verterinary antibiotics in the dairy farming sector in peri-urban India.

Methods and materials:

The study was conducted in the peri-urban belts of Ludhiana, Guwahati and Bangalore. A total of 54 interviews (formal and non-formal) were carried out across these three sites. Theme guides were developed to explore different drivers of veterinary antimicrobial use. Data was audio recorded and transcribed. Analysis of the coded data set was carried out using AtlasTi. Version 7. Themes emerged inductively from the set of codes.


Findings were presented based on concept of 'levels of analyses'. Emergent themes were categorised as individual, health systems, and policy level drivers. Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers and easily available antibiotics, dispensed without appropriate prescriptions contributed to easy access to antibiotics, and were identified to be the possible drivers contributing to the non-prescribed and self-administered use of antibiotics in the dairy farms.


Smallholding dairy farmers operated within very small margins of profits. The paucity of formal veterinary services at the community level, coupled with easy availability of antibiotics and the need to ensure profits and minimise losses, promoted non-prescribed antibiotic consumption. It is essential that these local drivers of irrational antibiotic use are understood in order to develop interventions and policies that seek to reduce antibiotic misuse.


Antimicrobial resistance; Antimicrobial use; Dairy farm; Dairy farmer; India; Qualitative; Veterinary

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Conflict of interest statement

Signed consent was obtained from all participants prior to data collection and after explaining the nature of the study in detail as well as answering any questions that any of the participants had. The study received ethical approval from the ethics committee of the Public Health Foundation of India (TRC-IEC-219/14). Local field partners who were veterinary colleges obtained specific regulatory permissions from their colleges required for the conduct of the study in their site.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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