Syndrome-specific antimicrobial escalation and diagnostic stewardship gaps in large-scale Hungarian pig farms: a cross-sectional survey.

چکیده اصلی

BACKGROUND: Antimicrobial stewardship in pig production depends not only on which drugs are used, but also on how syndrome burden is recognized, when therapy escalates from individual to group level, whether bacteriological and susceptibility-guided sampling is performed, and how medicines are recorded, stored, and administered. We investigated these connected decision layers in large-scale Hungarian pig farms. METHODS: Between November 2020 and March 2021, a questionnaire-based, respondent-reported cross-sectional survey was conducted among veterinarians and, where needed, farm managers or owners from 16 commercial pig farms across five Hungarian regions. Four production-unit categories were evaluated-farrowing units (n = 14), nursery units (n = 16), finisher units (n = 12), and breeding herds (n = 14), resulting in 56 production-unit observations. Syndrome burden was scored for respiratory, gastrointestinal, joint/neurological, and urogenital disease groups, together with isolation practices, treatment escalation, bacterial culture and antimicrobial susceptibility testing, and selected stewardship indicators. RESULTS: Antimicrobial decision-making was strongly syndrome- and stage-specific. Respiratory burden was highest in nursery units (93.8%) and finisher units (91.7%), gastrointestinal burden in farrowing units (100.0%) and nursery units (87.5%), joint/neurological burden in nursery units (100.0%), and urogenital burden in breeding herds (85.7%). Group treatment was common for gastrointestinal (76.9%) and respiratory syndromes (67.5%), but rare for joint/neurological syndromes (9.3%) and absent for urogenital syndromes. Bacterial culture and antimicrobial susceptibility testing were reported in only 46.2-61.5% of affected units, depending on syndrome group. Important stewardship gaps were also identified: only 41.1% of production units used electronic records, 62.5% stored antibiotics in locked locations, 60.7% lacked post-opening expiry labeling, and 16.1% acknowledged at least some reuse of expired products. CONCLUSION: Large-scale pig-farm antimicrobial management was not diffuse; it followed syndrome-specific therapeutic logics. However, the diagnostic and operational infrastructure supporting prudent use remained inconsistent. The most actionable gains lie in strengthening early segregation of clinically affected animals, susceptibility-guided diagnostic support, record quality, and the procedural discipline of medicine handling.

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