Background: Antimicrobial resistance (AMR) is one of the most important global health crises in recent times and is driven primarily by antimicrobial consumption. In East Africa, there is a paucity of data regarding the knowledge, attitudes, and practices (KAP) related to antimicrobial use (AMU). We investigate the ways in which antimicrobial users in the veterinary sector accessed veterinary antimicrobials, and common behaviors of veterinary antimicrobial users and prescribers associated with AMU and AMR.

Methods: In total, 70 farmers, staff at 49 agricultural-veterinary antimicrobial shops (agrovet staff) and 28 veterinary animal healthcare workers or veterinary surgeons (veterinary professionals) were interviewed in Busia county, western Kenya in 2016 using a standard questionnaire as a framework for structured interviews. Data recorded included participant demographics, level of education, access to and sources of veterinary antimicrobials, prescribing patterns, and knowledge of AMR and antimicrobial withdrawal periods.

Results: The majority of antimicrobials were accessed through informal means, purchased from agroveterinary shops; more than half of staff did not hold nationally mandated qualifications to advise on or sell veterinary antimicrobials. Approximately 40% of veterinary antimicrobials were sold without a prescription and it was noted that both price and customer preference were important factors when selling antimicrobials in almost all agrovet shops. Knowledge of the dangers associated with AMR and AMU were mostly superficial. Treatment failure occurred often, and there was a lack of differentiation between AMR and simply treatment failure.

Conclusion: In this study area in East Africa with high-density human and livestock populations, AMU was primarily for maintenance of livestock health. These findings have highlighted several aspects surrounding inappropriate access to antimicrobials, and as such require attention from policy makers concerned with AMR in both livestock and human medicine sectors. Improving prescribing practices and ensuring a minimum level of general education and awareness of prescribers, as well as expanding the role of agrovet staff in antimicrobial stewardship programmes, may help begin to mitigate the maintenance and transmission of AMR, particularly amongst livestock.

背景：抗菌素耐药性 (AMR) 是近期最重要的全球健康危机之一，主要由抗菌素消费驱动。在东非，关于抗菌药物使用 (AMU) 的知识、态度和实践 (KAP) 的数据很少。我们调查了兽医部门的抗菌药物使用者获取兽医抗菌药物的方式，以及与 AMU 和 AMR 相关的兽医抗菌药物使用者和开药者的常见行为。

方法：2016 年，在肯尼亚西部的布西亚县，使用标准问卷作为结构化的框架，总共采访了 70 名农民、49 家农业兽医抗菌商店的员工（agrovet 员工）和 28 名兽医动物保健工作者或兽医（兽医专业人员）。采访。记录的数据包括参与者的人口统计数据、教育水平、兽用抗菌药物的获取和来源、处方模式以及对 AMR 和抗菌药物停药期的了解。

结果：大多数抗微生物药物是通过非正式途径获得的，从农牧商店购买；一半以上的工作人员不具备国家规定的提供兽用抗菌药物建议或销售资格的资格。大约 40% 的兽用抗菌剂是在没有处方的情况下出售的，并且注意到价格和客户偏好都是在几乎所有农庄商店销售抗菌剂时的重要因素。与 AMR 和 AMU 相关的危险知识大多是肤浅的。治疗失败经常发生，AMR与单纯治疗失败之间缺乏区分。

结论：在东非这个人口和牲畜人口密度高的研究区，AMU 主要用于维持牲畜健康。这些发现突出了围绕不适当获得抗微生物药物的几个方面，因此需要关注畜牧和人类医学领域抗菌素耐药性的政策制定者。改进处方实践并确保对处方者进行最低水平的普通教育和意识，以及扩大农业人员在抗菌药物管理计划中的作用，可能有助于开始减轻 AMR 的维持和传播，尤其是在牲畜中。