Impact of the colistin ban on antimicrobial use and resistance-related practices among layer farmers in Indonesia: a comparative KAP study.

BACKGROUND

Antimicrobial resistance (AMR) is a growing global public and animal health threat, to which the misuse of antimicrobials in humans and livestock contributes. Here we describe the knowledge, attitudes, and practices (KAP) of Indonesian layer farmers regarding AMR and antimicrobial use (AMU) before the national ban on colistin use, as well as the awareness of farmers of the ban.

MATERIALS AND

METHODS

The first phase, conducted in 2014 as part of a study carried out between 2013 and 2016, involved a cross-sectional survey of small-scale layer poultry farmers, assessing their KAP toward AMU and AMR through a structured questionnaire. Farmers' responses were scored to determine KAP levels. The second study, conducted in 2023 among Indonesian layer farmers following the 2019 colistin ban, used a survey to evaluate 55 participants' awareness of the ban and their current AMU practices.

RESULTS

Before the colistin ban, 27.5% of layer farmers in Indonesia demonstrated a high level of knowledge regarding AMU and AMR, while the majority had moderate or low knowledge levels. Similarly, only 30% showed a positive attitude, and just 25% exhibited good practices related to AMU and AMR. Tetracyclines, fluoroquinolones, and macrolides were the most commonly used antimicrobials before the ban. After the ban, the use of colistin ceased, but no statistically significant changes in the usage profile of any other antimicrobial were observed. The post-ban survey revealed that 18.2% of the farmers were aware of the colistin ban, and none of the sociodemographic characteristics investigated were associated with awareness levels.

CONCLUSION

The findings highlight that, although the ban successfully eliminated colistin use in poultry production in Indonesia, limited KAP related to AMR and AMU may become critical bottlenecks to advancing future stewardship strategies.