Knowledge, Attitudes and Practices Related to Antimicrobial Use and Resistance Among Livestock Sector Stakeholders in Seven Former Soviet Countries: A Multi-Country Regional Analysis

Abstract

Background/Objectives: Antimicrobial resistance (AMR) is one of the greatest health threats affecting humans, animals and the environment. Antimicrobial use (AMU) in the livestock sector contributes to the development and spread of AMR, highlighting the need to understand the current situation, to target knowledge gaps and non-prudent practices with tailored interventions, and improve antimicrobial stewardship. This is especially important in low- and middle-income countries (LMICs), where data on AMU and AMR are currently limited. This study assessed knowledge, attitudes and practices (KAP) among farmers, veterinarians, veterinary pharmacy personnel and feed mill personnel related to AMU (particularly considering the use of antibiotics) and AMR in seven former Soviet countries, Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan and Ukraine. Methods: Face-to-face interviews were conducted between 2020 and 2025 with 3012 participants, with results analyzed using an aggregated regional approach. Results: The interviews revealed common regional knowledge gaps and practices among livestock sector stakeholders related to antimicrobials, AMR, antimicrobial residues, and prudent AMU. Non-prudent practices, such as the purchase of antimicrobials without a prescription, the use of antimicrobials as growth promoters, the inappropriate disposal of antimicrobials, and the frequent use of highest priority critically important antimicrobials (HPCIAs) were reported. Another factor that may hinder prudent AMU was the limited access of veterinarians to diagnostic laboratories. Conclusions: Despite significant global efforts to tackle AMR, there is an ongoing need to address knowledge gaps and non-prudent practices of livestock sector stakeholders in former Soviet countries. The findings highlight the importance of antimicrobial stewardship interventions that address system-level drivers of improper AMU beyond stakeholder trainings.