The irrational use of antibiotics is a major problem in present day clinical practices in veterinary interventions, as it results in toxicities and failures of treatment in patients and the emergence of drug resistant pathogens. Maintaining the minimum withdrawal period of antibiotic treated animals’ products and productions is also one of the problems in veterinary intervention, as owners failed to do so. Therefore, this study was designed with objective to assess the use and practice of antibiotic by professionals (veterinarian) and animal owners in and around Hawassa City. The method followed was cross sectional study during November 2018 to May 2019. Interview and questionnaire survey were conducted on 120 animal owners and 30 professionals. The animal health professional and animal owner antibiotic use and practice were evaluated as acceptable or not acceptable on bases of responsible and prudent use of antimicrobials in veterinary practices, Office International des Epizooties (OIE) standard guidelines. The result showed that the percentage of professionals and animal owners practiced at least acceptable level of use and practice of antibiotics were only 18.3% (22/120) and 33% (10/30), respectively. The education status of animal owners was found to be significantly associated with practice of antibiotic use by owner, whereas the education status and having previous professional training on antibiotic use were found to statistically significantly associate with use of antibiotic uses by professionals. The range antibiotics available for veterinary interventions in veterinary clinics for the last 5 years were short acting oxytetracycline (34%), long acting oxytetracycline (25.8%), pinstripe (12.7%), sulfadrugs (10.2%), Procaine penicillin (8.3%). The list of antibiotics used in Hawassa city is very narrow as compared to the list of antibiotics for veterinary use by OIE standard guideline, recommends use of various ranges of antibiotics. The study revealed both animal owners and professionals not follow acceptable level of uses antibiotic, potentially leads the development of antimicrobial resistance, toxicity in animals and humans consuming animal products and the subsequent inefficacy of the antibiotics in the area. Therefore, the use and practices of antibiotics should be changed and follow the standards of OIE through capacity development of the professionals and animal owners. Further, the country should seek towards a rule and/or regulation to enforce the proper uses and practices of antibiotics in particular and antimicrobials in general.

•    Hawassa City; OIE Antibiotic use standard guideline; 
Rational use of antibiotic

Tanga BM, Bedilu-Tessema A (2020) The use and practices of antibiotics in veterinary interventions in Hawassa City, in view of rational use of antimicrobials in Ethiopia. J Vet Med Res 7(5): 1199.

Antimicrobials represent one of humanity’s medical revolutions enabling us to treat both human and veterinary infections. It is, therefore, of utmost importance to preserve their effectiveness [1]. In veterinary medicine, antimicrobials play a crucial role in the maintenance of animal health, animal welfare, and food-safety [2]. Veterinary drugs are used as therapeutic, prophylactic and growth promotion, and can be used in either rational or irrational way [3]. Many scientists today intensively work on discovery and synthesis of new drugs with broader antimicrobial spectrum, stronger action and more satisfactory in terms of safety. Failure during antimicrobial therapy may occur when the pathogenic microorganism is not properly diagnosed and antagonism of two or more drugs administered together. To avoid these mistakes, clinically confirmed, effective antimicrobial combinations should be used. Rational approach to antimicrobial uses in veterinary practices requires careful evaluation of the health problem in each species of animals and selecting appropriate therapeutic strategies based on the use of right drug, right dosage and right cost. These requirements will be fulfilled if the process of recommending and prescribing of antimicrobial is appropriately followed. This includes: steps in defining patient’s problems (or diagnosis); in defining effective and safe treatments (drugs and non-drugs); in selecting appropriate drugs, dosage and duration; in writing a prescription; in giving adequate information animal owner; planning and executing evaluation of treatment responses [4]. Depending on the drug product, dosage form, and route of administration, the withdrawal time may vary from a few hours to several days or weeks [5], and which is important in veterinary practices but failed sometimes from owner’s side. In most circumstances, if recommended withdrawal periods are followed, the presence of unacceptable residues is not expected [6].

The irrational use of drug s is a major problem in present day clinical practices as it could result in toxicities and treatment failures in patients and in the emergence of drug resistant pathogens and also improper use of drugs may cause ineffective treatment, unnecessary wastage of resources, and may harm the patient [1]. Over use of antimicrobials in veterinary medicine, for both food producing and companion animals, favors the development of antimicrobial a resistance [7]. Antimicrobial resistance (AMR) occurs when bacteria, viruses and fungi become resistant to antimicrobial drugs that are used for treating the infections irrationally [8].

There are several reasons which may contribute to irrational use of drugs. These are: lack of information; faulty and inadequate training and education of medical and/or veterinary graduates; poor communication between health professional and animal owner [9]. Due to lack of effective and reliable surveillance systems and poor dissemination of research information, health professionals in developing countries sometimes lack up to Date information on the AMR pattern within their populations.

In Ethiopia, a retrospective study conducted on rational of veterinary medicine by Takele Beyeneet al., [10] reported there were problems in proper diagnosing and generic prescription from clinical records. These, coupled with rapid spread of resistant bacteria and inadequate surveillance, could contribute to exaggerated impact of bacterial infections are the major causes of death in Ethiopia. But there is no study assessed the practices of professional’s use of antibiotics and practices of animal owners. Thus, this study was employed with objectives to assess to assess the use of antibiotics by veterinary professionals and practices by owners and factors affecting it. Application of antibiotic in veterinary practice

Study area

The study was conduct in one of metropolitan city in Ethiopia, Hawassa city veterinary clinic, capital city of SNNPRS, located in southern rift valley. The study area is located 07°02’22” N to38°29’16” E at an altitude of 1,690 m above sea level (GPS reading).The area has an average annual rain fall of 997.6 mmHg. The mean annual temperature is estimated to be round 25o c. Hawassa city has five veterinary clinics of varying standard and 30 veterinary professionals. The case in Hawassa city was assumed that it represents the common situation in country.

Study population and period

The study was conducted during November 2018 to May 2019, by following the use of antibiotics by professionals on animals (cattle, sheep and goats of all ages and sex groups) visiting Hawassa city veterinary clinic. Those animal patients not received antibiotics medicines are excluded from the study. The animal owners visiting veterinary clinic and having antibiotic treatments were interviewed with a separate questionnaire for the practices of antibiotics.

Study Design

Cross sectional study employed and consensus was reached among the farmers and animal health professionals for collection of the data, on willingness bases. The study is designed to assess use and practice of antibiotic and to compare with OIE standard for treatment of animal diseases.

Study Methodology

Both direct observation and structured questionnaire were used to assess the use of antibiotics by professionals (30) in five different veterinary clinics in Hawassa city. Data collection was conducted by interviews (face to face questionnaire) from 120 animal owners. The demographic characteristics of respondents including gender, age, education, training related to antibiotic use and practices, owner self-prescriptions and withdrawal period and maintaining dose was included in the questionnaires. The use of antibiotics and practices were categorized in to acceptable of non- acceptable according to “responsible and prudent use of antimicrobials in veterinary practices, Office International des Epizooties (OIE) standard guidelines Article 6.9.3. The professionals use of antibiotics is categorized as acceptable level, if they practice recommend drugs up on administer or prescribe antimicrobial agents only when necessary and taking into consideration the OIE list of antimicrobial agents of veterinary importance, make an appropriate choice of antimicrobial agents based on clinical experience and diagnostic laboratory information. And, animal owner practices were also categorized on the bases of practices recommended by the same guideline.

Data Management and Statistical Analysis

The data collected during the study was stored in Microsoft excel spread sheet and analysis was performed using the STATA (version 20) software. Descriptive statistics was used to analyze proportions and Chi-square test was used to compare categorical variables adjusted for owner and professional to check association between variable at p-value (p<0.05) as cut off points for determining statistical significance

Animal owners and professionals descriptions

A total of 120 animal owner and 30 professionals were sampled during the study. Out of30 professionals engaged in veterinary practice only 33% (10/30) were found to follow acceptable level of use of antibiotics. Similarly, from 120 animal owners studied only 18.3% (22/120) were following acceptable level of practice of antibiotics, respectively.

Of the 120, the age range varied from 15 and 75 years old. Most participants were between 30-45 years (51.7%, n = 62). Regarding level of education of animal owners, 19 (15.8%) were uneducated, 31 (25.8%) completed primary education, 36 (30%) completed secondary education and 34 (28.3%) graduated from colleges. Only 25(20.8%) farmers had had chance of participating in a training of the appropriate use of antibiotics (Table 1).

Regarding professional’s education level, 33.3 %, 11% and9% were having Doctor of veterinary medicine Degree, Degree in Animal Health and Diploma in Animal Health, respectively. All the 30 professionals had no experience of working other than veterinary clinics and 75%of them had trained at least once after graduation on treatment and diagnosis of bacterial infection (Table 2)

The range of antibiotics used in Hawassa city Veterinary Clinic

Antibiotics have been used in Hawassa city is almost the same over years and vary few in number as compared to OIE listed of range of antibiotics for veterinary practice. The most commonly prescribed antibiotics were oxy-tetracycline 17(43.3%), penicillin streptomycin fixed combination 5(16.7%), sulfa drugs (sulfadimidine and sulphametoxazole-trimethoprim fixed combination) 2(3.3%), procaine penicillin1 (3.3%), oxy tetracycline and pinstripe 5(16.7%), and the use combinations two or more of the above drugs 4(13.3%) during the last oneyear period. The types of drugs and their proportion in the last five year were more or less similar drugs (Table 3), which in not acceptable use of antibiotics according to OIE guideline, predisposing to various negative consequences, as mentioned above.

The average number of antibiotic used in Hawassa city were short acting oxytetracycline 1700vial (34%), long actingoxytetracycline 1310 vial (25.8%), penstripe 1100 vial (21.7%), sulfa 520 vial (10.2%) and procainepencillin 430 vial (8.3%). The result indicates that the most abundant antibiotic in Hawassa city were long acting and short acting oxytetracycline.

Antibiotic practices by animal owner

The number and species of animals brought by owners to Hawassa city veterinary clinics were Cattle only 61(51.5%), sheep only 15(13.4%), goat only 4(3.1%), cattle and sheep mixed herd 10 (8.2%), Cattle and goat mixed herd 2(3.3%), sheep and goat mixed herd 22(19.6%) per owner during the study period. From 120 animal owners 47(39%) responded they have awareness about antimicrobial resistance and needs of precaution in its use. Regarding the practice of antibiotic use by owners, the owners reported they use for different purpose, for treatment of diseases 38(31.7%), for prevention 10(9%), for fattening 40 (33.3%), for treatment and prophylaxis at the same time 24(20.3%) and for combined purpose of treatment, prophylaxis and fattening 7(6%). Regarding the preference of animals owners treatment options when the animals are affected by diseases, 26(21.7%) prefers to take their animals to veterinary clinic or veterinary pharmacy, 19(15.8%) prefers traditional medicine and use medicine from open market, 16(13.3%) prefers to visit veterinary pharmacy, 11(9.2%) prefer to visit veterinary clinics and 48(40%) treat the animals by their own unless otherwise severe.

Regarding the animal owners following of the prescribed doses by professionals, 45(49%) the owners were found not following to recommendation/s by professionals and not administered the antibiotic to the full dose. When antimicrobial drug at the possession of animal owners were expired the majority of owner, 38(31.7%) through away them and 31(25.8%) reported they still use it if there is no major physical change, 21(17.5%) dispose by burying them in the backyard and only 1(1.1%) of owner return the antibiotics back to drug source (Table 4).

From 120 animal owners interviewed only 33(27.5%) owner were found to maintain antibiotic withdrawal period antibiotic. They reported using the animal products either for their family or they market animal products, which is very alarming and having significant consequences in the public health.

Antibiotics use by professionals

In Hawassa city clinics all professionals 30 (100%)uses presumptive diagnosis on the bases of clinical signs, history and epidemiology in order to diagnose the sick animals and not having access to bacteriological lab test, culture and drug sensitivity except for pathognomonic diseases. regarding using of antibiotics, 56% uses antibiotics for medical treatment,33.3%for prophylaxis,3.3% uses antibiotics to fattening and 6.7% used for combined use of medical treatment, prophylaxis and weight gain. Additionally, 23(76.7%) of professionals prescribed antibiotic for viral disease as means of treatment for control of secondary bacterial complications.

Out of 30,27(90%) of professional’s report that some diseases were found to be not cured by the existing treatment regimen and showing reoccurrence or resistance to existing antibiotics. From the 30 professionals in Hawassa Veterinary clinics, only 10(33.3%) were reported that they are using veterinary standard treatment guideline (VSTG) in decision to prescribe antibiotics for the patient animals. This result indicates that the type, dosage, dose and route/s of administration could be decided on the bases of experiences and/or personally varied, and it is not up to the OIE standard guideline.

The current study revealed those 20 (66.7%) professionals and 81.7% animal owner uses and practices of antibiotics in nonacceptable level. This result is higher than that of the researcher who reported by [11] up to 40% to 60%, reports of 58.1% [12] and 46.6 % by [13] a retrospective study in Adama district veterinary clinic, where antibiotics were prescribed inappropriately. The variation of the result in this study may be due to change over time of use of antibiotics and level of focus given to rational use antibiotics.

This finding indicates, the irrational use of antibiotics, the key driver for antimicrobial resistance, is mounting at an alarming rate and the condition is conceivably worse in many parts of the country, and also other developing countries [14]. The current study shows that 38% of animal owner were self-treating their animals, and this finding is lower than that of 75% of animal owner in north eastern Nigeria prescribe for their animals reported by [15]. This may be due to more drug availability and education level of owner live in Nigeria.

The educational qualification of the professionals, prescriber Bing antibiotics, 70%, majority were animal health assistants and animal Health Bachelor degree holders and only 30% were doctor of veterinary medicine. This finding is in line with similar study conducted Adama district veterinary clinic, where 70.8% and 29.2% of the prescriptions were made by animal health assistants and DVM, respectively [13]. This shows that the level of education of veterinary drug prescribers is low and needs attention so as to avoid failure of treatment, misuse of drugs and drug resistance development. Having other variables controlled, low educational status, being employed and unsatisfied with health care services provided are found to be strong predictors of inappropriate use of antibiotics. In current study there was statistically significantly association between education level and inappropriate use of antibiotics in both animal health professionals (P=0.025) and animal owner (P=0.028).This is may be more educated people were having knowledge on standard guideline. Additionally, all animal health professionals depend on presumptive diagnosis and not access for bacteriological lab test, culture and drug sensitivity testes, shows that there would be potential gap in determination of treatment and acquiring knowledge on its efficacy and effectiveness. This way of use of antibiotics is not acceptable according to OIE standard guide lines and require major change in the use of antibiotics by professionals and practice by animal owners.

The high level of un acceptable use and practice of antibiotic in veterinary clinics in Hawassa city have been ascribed to lack of awareness of animal owners and gap in knowledge and trainings to professionals and shortage in veterinary inputs and facility in the veterinary clinics. Different classes of antibiotics, though short range, were used for treatment and prophylaxis as well as fattening with the absence of a clear and strict roles from the animal owners, professionals and authorities to govern and regulate the use and practice of antibiotic. This entails of the veterinary practices has high gaps, in correctly diagnosing animal health problems and in properly implementing its treatment, lacking to follow both OIE standard veterinary treatment guideline and VTSG of the profession. Furthermore, the practice of antibiotic use in Hawassa city is by far below the expected standard, as it is seen by very limited number/narrow range of antibiotics over years, which is aggravated by the very irrational use and practices both at the professionals and animal owner’s level. In conclusion, it is alarming and should not be continued, otherwise the cost of the antibiotic resiaistane will not be limited to veterinary professions and it will have of significant effect in the public health. Thus, it is recommended the veterinary practice has to be standardized and professionally lead according to the OIE standard guide lines and professional discipline through professional development, awareness creation to animal owners and public and regulating the veterinary intervention up to standard.

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