Researchers led by Oluwawemimo Adebowale of the Federal University of Agriculture, Abeokuta, surveyed 48 integrated farms in Lagos and Ogun states between May and September 2023, using structured interviews with farmers alongside on-site assessments of biosecurity. The results, published in BMC Agriculture, offer the first baseline data on antimicrobial use in this emerging Nigerian farming system, and they reveal a landscape of heavy antibiotic reliance, patchy disease prevention, and knowledge gaps that could accelerate the global crisis of antimicrobial resistance.

The scale of drug use on these farms is striking. Farmers reported deploying at least ten different classes of antibiotics, including fluoroquinolones, tetracyclines, macrolides, aminoglycosides, penicillins, sulphonamides, lincosamides, cephalosporins, nitrofurans, and polymyxins. In poultry, the most commonly used drugs were enrofloxacin, reported by 89.4 percent of farmers, oxytetracycline at 80.9 percent, doxycycline and tylosin at 78.7 percent, and colistin at 63.8 percent. For fish, oxytetracycline and enrofloxacin dominated. Many of these compounds fall into the World Health Organization’s highest priority critically important antimicrobials for human medicine, meaning they are drugs on which doctors depend when other treatments fail. Colistin, a polymyxin widely used on the surveyed farms, is considered a last-resort antibiotic in human medicine, reserved for infections that no other drug can touch.

The WHO classifies antibiotics into three stewardship tiers known as AWaRE: Access, for first-line drugs with low resistance risk; Watch, for broader-spectrum drugs that require careful monitoring; and Reserve, for last-line treatments. The study found that farmers were using drugs from all three groups, including Watch and Reserve categories, often without veterinary oversight. Nearly 96 percent of farmers purchased antimicrobials from veterinary pharmacies, and 79.2 percent used them to prevent disease rather than to treat diagnosed infections, a practice that blankets healthy animals in drugs and creates intense selection pressure for resistant microbes.

The biology of the integrated system amplifies the risk. When poultry droppings containing antibiotic residues and resistant bacteria wash into fish ponds, the aquatic environment becomes a mixing vessel where resistance genes can move between bacterial species. A previous Nigerian study cited by the researchers confirmed that multidrug-resistant gram-negative bacteria from chicken excreta were disseminating into pond environments and fish. Because bacteria readily exchange resistance genes through horizontal gene transfer, a pond fertilized with medicated poultry waste is essentially an evolutionary accelerator. Fish raised in that water, and inadequately cooked before consumption, can carry resistant pathogens to the dinner table.

Disease pressure on these farms helps explain the drug dependence. Chronic respiratory disease was the most commonly reported chicken ailment, affecting 68.8 percent of farms in the previous year, followed by infectious coryza and bacterial gastroenteritis from salmonellosis and colibacillosis. Among fish, fin rot was the leading complaint. Yet the study found that preventive measures were applied unevenly: nearly all farmers vaccinated and dewormed their chickens, but fewer than one in ten reported routine vaccination of fish, leaving aquaculture largely unprotected and dependent on reactive drug use when outbreaks struck.

Biosecurity, the frontline defense that reduces the need for antibiotics in the first place, was found wanting. Only 54.1 percent of farms had established biosecurity protocols at the time of the visit, and field assessors judged just 37.5 percent of farmers as having good biosecurity measures in practice. The overall biosecurity score averaged 64.7 percent, with more than half of participants rated as poor. Two-thirds of farms reported migratory wild birds on the premises, a known vector for disease introduction, while fewer than a third had designated biosecurity work zones separating clean and dirty operations. In a system where poultry and fish share water, waste, and space, such lapses leave multiple doors open for pathogens.

Perhaps the most encouraging finding is that knowledge and attitude appear to be levers for change. Farmers’ knowledge of antimicrobial use correlated positively with their actual practices, as did their attitudes, and the two were strongly linked to each other. Farmers who understood the risks tended to think differently about drugs, and farmers who thought differently tended to use them more responsibly. More than 94 percent of respondents said they were willing to attend training on appropriate antimicrobial use, with workshops, seminars, and veterinary extension officers identified as the preferred channels. The farmers themselves identified the main drivers of indiscriminate drug use as lack of awareness and training, quackery, inadequate access to veterinary services, weak antibiotic policy enforcement, and poor biosecurity.

The study’s authors are careful to note its limits. The sample of 48 farms is small, reflecting the fact that integrated fish-chicken farming is still an emerging system in Nigeria, and the findings may not generalize to the entire country. The survey also relied on self-reported data and did not directly test for resistant bacteria on the farms, which the researchers flag as a priority for future work using microbiological and genomic methods. Still, the correlations they documented, however modest in magnitude, point to a clear intervention strategy: educate farmers, strengthen biosecurity, and the demand for antibiotics should fall.

The stakes extend well beyond Nigerian farm gates. At the 2024 United Nations General Assembly high-level meeting on antimicrobial resistance, world leaders committed to reducing human deaths from drug-resistant infections by 10 percent by 2030, a goal that depends heavily on curbing antibiotic overuse in animal agriculture. Nigeria’s Federal Ministry of Livestock Development, working with the Food and Agriculture Organization, has already developed national biosecurity guidelines for poultry and aquaculture farmers, and Lagos and Ogun states have been beneficiaries of related training, which may partly explain the relatively positive knowledge scores in this study. But the researchers warn that without policy changes and sustained antimicrobial stewardship programs, meeting the WHO target that Access-group antibiotics account for the majority of national consumption will be difficult, especially in Africa. Integrated farms like those surveyed here represent a genuine opportunity for sustainable food production, the study concludes, but only if the invisible plumbing of resistance that connects chicken waste, pond water, and the human food chain is acknowledged and managed before it becomes a public health emergency.

Subject of Research: Antimicrobial use and biosecurity in integrated commercial fish-chicken farming in Southwest Nigeria

Article Title: Cross-sectional study of antimicrobial use on integrated commercial fish-chicken farming in Southwest Nigeria: the link with on-farm biosecurity, farmers’ knowledge, and attitudes

Article References: Adebowale, O., Oyawole, O., Sanni, I., Odunfa, O., Oladejo, O. O., Folorunsho, E. O., Ajibola, A. B., & Nelson, G. U. (2025). Cross-sectional study of antimicrobial use on integrated commercial fish-chicken farming in Southwest Nigeria: the link with on-farm biosecurity, farmers’ knowledge, and attitudes. BMC Agriculture, 1(1), Article 10. https://doi.org/10.1186/s44399-025-00012-y

Image Credits: AI Generated

DOI: 10.1186/s44399-025-00012-y

Keywords: antimicrobial resistance, antimicrobial use, integrated fish-chicken farming, biosecurity, aquaculture, poultry, Nigeria, WHO AWaRE classification, colistin, antimicrobial stewardship, One Health, food safety

Antimicrobial resistance, or AMR, arises when bacteria evolve to survive the drugs designed to kill them. The World Health Organization considers it one of the top global threats to public health, and the United Nations Environment Programme has linked it to an estimated five million deaths worldwide in 2019, alongside a steady annual drag on economic output. Livestock farming sits squarely in the middle of the problem. Antimicrobials are used worldwide to treat infections, promote growth and prevent disease in food animals, and consumption in developing countries is projected to double by 2030 as livestock sectors intensify to meet rising demand for animal protein. Because many of the drugs used on farms are identical, or work through the same mechanisms, as those used in human medicine, imprudent use in animals can breed resistant bacteria that travel through meat, milk and the environment into human populations.

The research team, led by Rita Rosmala Dewi of Universitas Tjut Nyak Dhien with colleagues from several Indonesian and Nigerian institutions, chose Langkat Regency for good reason. The region is the northernmost administrative division of North Sumatra and its leading beef production hub, home to roughly 225,650 cattle, about 23.7 percent of the province’s entire herd. Between March and July 2024, the researchers randomly selected farmers from five of the regency’s twenty-three districts, Selesai, Salapian, Bahorok, Binjai and Kuala, using a sampling frame provided by the Langkat Livestock Offices. Most participants were cattle farmers, with smaller numbers raising goats and sheep. Crucially, the team did not rely solely on self-reported answers: during farm visits they verified antimicrobial use by inspecting treatment records and, where records were absent, examining the used drug bottles themselves to confirm brand names, dosages and antimicrobial classes.

The results paint a sobering picture. About 64.4 percent of the surveyed farmers used antibiotics on their farms, and the most common drug was oxytetracycline, a broad-spectrum tetracycline antibiotic, followed by penicillin, erythromycin, sulfadiazine and trimethoprim. Several of these classes are classified by the WHO as critically important for human medicine, meaning that resistance emerging on a farm could directly undermine treatments used in clinics. Yet the knowledge scores told a different story from the usage rates. Although 94.8 percent of farmers said they were aware of antibiotics, only 11.5 percent correctly understood what antibiotics actually do, that they target bacteria rather than viruses or fungi. Just 22.9 percent had heard of antimicrobial resistance, and a mere 12.5 percent could explain it accurately.

Gaps extended into the more technical corners of drug stewardship. Only about 15.6 percent of farmers knew about drug residues, and just 10.4 percent could correctly define an antibiotic residue as the accumulation of the drug in animal or human bodies through the ingestion of treated meat and milk. Roughly 40.6 percent had heard of a withdrawal period, the mandatory interval between the last antibiotic dose and the slaughter or milking of an animal, designed to keep residues out of the food supply. Only 36.5 percent knew that antibiotics can cause side effects, and fewer than a third were familiar with the concept of biosecurity, the hygiene and management measures that reduce disease pressure and thereby the need for drugs in the first place. Scored against a modified Bloom’s classification, 80.2 percent of farmers fell into the poor knowledge category.

Attitudes, by contrast, were a patchwork of encouraging signals and worrying contradictions. Nearly all farmers, 99 percent, agreed that only a veterinarian should prescribe antibiotics, and 95.8 percent endorsed using antibiotics only when needed. Almost none, just 2.1 percent, considered antibiotics necessary as growth promoters. But when practice was probed, the consensus fractured: 61.5 percent believed antimicrobials could treat any type of animal disease, 70.8 percent said they would sell animal products or slaughter animals during treatment or without observing the withdrawal period to cut costs, and 87.5 percent admitted they stop antimicrobial treatment once animals appear better, an underdosing habit that is a classic driver of resistance. Nearly two-thirds also said they would alter doses without consulting the prescriber. Overall, 46.9 percent showed unfavourable attitudes, while a striking 80.2 percent demonstrated poor practices.

The statistical analysis revealed which farmers were most at risk, and where interventions might pay off. Multivariable logistic regression showed that farmers keeping six to ten animals were about six times more likely to have good knowledge than those with three to five animals, possibly because medium-scale farmers show greater curiosity about new farming practices and tend to be better educated. Farmers with herds larger than twenty animals were significantly less likely to hold poor attitudes, and those in the Selesai district had roughly eleven-fold higher odds of a desirable attitude compared with Binjai, a disparity the authors suggest may reflect differences in educational access between rural and urban areas. Most tellingly for policy, attending training on AMR and antimicrobial residues increased the odds of good practices five-fold, and farmers in Kuala district, many with more than five years of experience, also practised better. Spearman’s rank correlation showed weak positive links between knowledge and attitudes, and between knowledge and practice, but no correlation at all between attitude and practice, a reminder that believing the right thing does not guarantee doing it.

The study’s context matters. Indonesia adopted a national action plan on AMR covering 2017 to 2019, followed by a second plan for 2020 to 2024, aiming to raise public awareness and promote judicious antibiotic use. Yet implementation remains incomplete, and farmers can still buy antibiotics over the counter at pharmaceutical counters without a veterinary prescription. That regulatory gap, combined with limited animal health services, helps explain why misuse persists even among farmers who say they trust veterinarians. Previous KAP studies in Java and Aceh had already flagged inadequate practices among Indonesian livestock farmers, but North Sumatra, with its vast agricultural system and diverse animal species, had remained largely unexamined until now.

The authors are careful about the limits of their work. The cross-sectional design cannot establish cause and effect, self-reported answers may be distorted by recall bias, and the sample of five districts out of twenty-three means the findings cannot be generalized across the region. Still, the study provides a baseline that Indonesian policymakers have lacked, and its implications are clear. Training works: even the small fraction of farmers who had received AMR education practised measurably better. With antimicrobial consumption in developing-world livestock projected to climb steeply, closing the gap between what farmers believe and what they do, through targeted training programmes, stronger veterinary oversight and enforcement of prescription rules, may be one of the most cost-effective defences available against a post-antibiotic era.

Subject of Research: Knowledge, attitudes and practices of livestock farmers regarding antimicrobial resistance, usage and residues in North Sumatra, Indonesia

Article Title: Knowledge, attitudes and practices regarding antimicrobial resistance, usage and residues among livestock farmers in North Sumatra, Indonesia

Article References: Dewi, R. R., Sihombing, J. M., Jajere, S. M., Purba, A., Ma’arif, I., & Hafid, H. (2025). Knowledge, attitudes and practices regarding antimicrobial resistance, usage and residues among livestock farmers in North Sumatra, Indonesia. BMC Agriculture, 1(1), Article 19. https://doi.org/10.1186/s44399-025-00019-5

Image Credits: AI Generated

DOI: 10.1186/s44399-025-00019-5

Keywords: antimicrobial resistance, antimicrobial use, livestock farming, Indonesia, North Sumatra, antibiotic residues, withdrawal period, food safety, One Health, veterinary medicine, KAP survey, public health