Understanding antimicrobial use by equine owners in Wales: Using cross-sectional survey and semi-structured interviews.

Abstract

Background: Antimicrobial resistance (AMR) is an increasingly serious threat to human and animal health. Antimicrobial use (AMU) in horses is gathering research interest, although there remain significant evidence gaps. Currently, there is scant qualitative research into equine owners' use of antimicrobials, specifically antibiotics, hindering the design of evidence-based stewardship interventions and policies.

Objectives: To understand Welsh equine owners' views and behaviours relating to antimicrobial usage.

Study design: Cross sectional survey and qualitative data collection and analysis.

Methods: An online survey (n = 319) and semi-structured interviews (n = 21) were conducted with Welsh equine owners. The survey examined participant knowledge of and relationship with their horse(s), sourcing of antibiotics, owner-vet interactions on antibiotic prescribing, antibiotic usage, and their understanding of AMR. Semi-structured in-depth interviews further explored horse owner perspectives, experiences, and decision-making relating to these areas, to add nuance and depth to quantitative data. Survey data were descriptively analysed, and interview data were coded and qualitatively analysed using a thematic approach.

Results: Welsh equine owners regarded their horses as members of the family (84.8%). Most sourced antibiotics from their vet (68.9%) with a minority (5.1%) never having done so or having used antibiotics left over (16.6%) and 13.6% would consider changing veterinary practice if they did not receive antibiotics when they requested them. Interview data suggest that antibiotic use was shaped by (i) key relationships of care (human-animal and owner-vet); (ii) competing priorities (treatment need versus ease of administration); and (iii) imperfect comprehension (education, information, AMU/AMR knowledge).

Main limitations: Potential self-selection bias of respondents due to the voluntary nature of participation.

Conclusions: This study highlights variations in the horse-owner relationship, conflicting priorities involved in horse ownership, and the quality of vet-client relationships which may influence treatment decision-making. It raises some concerns about the sourcing of antibiotics and variable understanding of AMR, with important implications for antimicrobial stewardship and educational priorities.