Livestock production, particularly the dairy sector, is important for food and nutritional wellbeing of communities in India, it supports livelihoods of many farmers, and contributes to the economy of the country. India is a high consumer of antibiotics and antimicrobial resistant (AMR) bacteria are a major public health concern. Our objectives were to identify animal health and drug use practices that may contribute to emergence and spread of AMR in the country, review previous AMR- mitigation strategies, and discuss “theory of change” as an approach to informing the choice of interventions. We undertook a desk review of literature to identify practices with potential to contribute to emergence and spread of antimicrobial resistance in India. Searches were done in PubMed, Google scholar, and Google. Data were synthesized and discussed by themes. Animal disease surveillance is less developed and infrastructure to support delivery of services is inadequate. Several groups are known to offer animal health services. The untrained “animal health workers” and para-veterinarians are more popular with farmers as they charge less for consultations (compared to veterinarians who are few and charge more). Over-the-counter access of antibiotics, without prescription, and direct marketing of drugs to farmers are common. Because of this, farmers are able to treat their animals and only consult when cases become non- responsive to treatment. Antibiotics are mostly used in management of mastitis cases. Drug withdrawal periods are rarely observed and occurrence of antibiotic- contaminated milk has been reported. Awareness on AMR is low and antimicrobial stewardship in livestock is yet to be developed. Initiatives such as the National programme for containment of AMR, National Action Plan on AMR, and the National Health policy point to government’s commitment in addressing the problem of AMR in the country. Several animal health and drug use practices, with potential to cause AMR, have been described, and their contribution can be discussed further by engaging stakeholders in a “theory of change” exercise. Interventions that address AMR from the animal health perspective should be promoted, and incentives to increase their adoption explored.

中文翻译：

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对印度动物健康和药物使用实践及其与抗菌素耐药性的可能联系的回顾。

畜牧业生产，特别是乳制品行业，对于印度社区的粮食和营养福祉非常重要，它支持许多农民的生计，并为该国的经济做出贡献。印度是抗生素的大量消费国，抗菌素耐药 (AMR) 细菌是一个主要的公共卫生问题。我们的目标是确定可能导致国内 AMR 出现和传播的动物健康和药物使用做法，回顾以前的 AMR 缓解策略，并讨论“变革理论”作为干预措施选择的方法。我们对文献进行了案头审查，以确定可能导致印度抗菌素耐药性出现和传播的做法。搜索是在 PubMed、Google 学者和 Google 中完成的。数据按主题进行综合和讨论。动物疾病监测欠发达，支持提供服务的基础设施不足。众所周知，有几个团体提供动物健康服务。未经培训的“动物卫生工作者”和准兽医更受农民欢迎，因为他们的咨询费用较低（与数量较少且收费较高的兽医相比）。无需处方即可通过非处方药获得抗生素以及向农民直接销售药物的情况很常见。因此，农民能够治疗他们的动物，并且只有在病例对治疗无反应时才进行咨询。抗生素主要用于治疗乳腺炎病例。很少观察到停药期，并且有报道称牛奶被抗生素污染。人们对抗菌素耐药性的认识较低，牲畜的抗菌药物管理也有待发展。国家遏制抗菌素耐药性计划、国家抗菌素耐药性行动计划和国家卫生政策等举措表明政府致力于解决该国抗菌素耐药性问题。已经描述了几种可能导致抗菌素耐药性的动物健康和药物使用做法，并且可以通过让利益相关者参与“变革理论”练习来进一步讨论它们的贡献。应推广从动物健康角度解决抗菌素耐药性的干预措施，并探索鼓励措施以增加其采用。