Knowledge, attitudes, and practices of livestock veterinarians on antibiotic use and resistance: a cross-sectional study.

Antimicrobial resistance (AMR) is a pressing global health threat that requires integrated efforts under the One Health approach. Together with human medicine and agriculture, veterinary medicine is key to mitigating AMR emergence and spread. Veterinarians work at the forefront as public health agents and their antibiotic prescribing decisions may be influenced by several factors. This cross-sectional study aimed to assess the knowledge, attitudes, and practices (KAP) of livestock veterinarians regarding AMR and antibiotic use. A questionnaire-based study was conducted in Portugal, from September to December 2025, involving 87 veterinarians working with food-producing animals. Six participants completed only the sociodemographic and professional information section. Results indicated high awareness, with participants (N = 81) recognizing AMR as a major public health concern and acknowledging their role as essential stewardship agents. While 66.2% (N = 74) of participants demonstrated appropriate overall prescribing practices, 51.4% admitted using broad-spectrum antibiotics when the causative agent was uncertain. The antibiotic classes reported as most frequently prescribed were penicillins (28.1%), tetracyclines (15.8%), sulfonamides (12.0%), and quinolones/fluoroquinolones (8.2%). Key influences on prescription decisions included previous clinical experience (86.5%) and colleague testimonials (69.0%), while farmer pressure, according to veterinarians' reporting, had minimal to no impact. Barriers to optimal stewardship included limited access to diagnostics and technical difficulties with the electronic prescription system. In conclusion, although veterinarians possess high awareness of AMR and generally follow established recommendations, their practices are influenced by structural, contextual, and behavioral factors. Enhancing antimicrobial stewardship requires multifactorial strategies, including improved availability of and access to diagnostic tools and tailored educational initiatives.