Veterinarians' attitudes toward antimicrobial use and selective dry cow treatment in the Netherlands

ABSTRACT In the Netherlands, regulations have been in place since 2008 to reduce the overall use of antimicrobials to mitigate antimicrobial resistance. As part of these regulations, a ban on the preventive use of antimicrobials, such as applying blanket dry cow treatment, was introduced and alternative measures such as selective dry cow treatment (SDCT) were implemented. Both farmers and veterinarians play an important role in implementing these measures and have a shared responsibility with respect to prudent antimicrobial use (AMU). The attitude of Dutch dairy veterinarians toward restricted AMU and toward SDCT is unknown, but a favorable attitude toward this approach seems crucial for successful implementation. In 2015, an online questionnaire was collected from 181 veterinarians that contained questions with regard to their attitude and behavior toward reduction of AMU and toward SDCT. Descriptive statistics were used to describe the data, and multivariable logistic regression models with a logit link function were applied to evaluate potential associations between veterinarians' attitudes toward AMU and SDCT and the rationale behind their mindset, based on positive and negative aspects of reduction in AMU. The veterinarians were divided into 3 groups based on their opinion on 4 statements with regard to AMU and SDCT: veterinarians with an unfavorable, a neutral, and a favorable attitude toward reduction of AMU and toward SDCT. For the multivariable logistic regression analysis, the first 2 groups were combined and compared with the veterinarians with a favorable attitude. The general attitude of Dutch dairy veterinarians toward reduction of AMU was positive, and most expressed the belief that they can still be a good veterinarian when they prescribe less antimicrobials. Veterinarians indicated they progressively promoted SDCT beginning in 2013. Most veterinarians see the advice they provide to farmers on SDCT as the best possible approach and are convinced that their farmers apply this SDCT approach. The results of the multivariable analyses showed that veterinarians with a favorable attitude mentioned positive aspects of SDCT, such as an increased consciousness of AMU among farmers, improving animal health, reducing antimicrobial resistance, and a chance to add value for the farmer, more often than other veterinarians. The latter group significantly more often indicated negative aspects of SDCT, such as a higher risk of sick cows and feeling pushed to follow the rules. In conclusion, the general attitude of Dutch dairy veterinarians toward reduction of AMU and SDCT was found to be positive. However, given the influence veterinarians potentially have on the attitude of farmers and the variability found in their attitude and behavior, veterinarians need specific attention if regional or national programs are organized trying to change behavior of farmers and encourage prudent AMU and SDCT.