Table_1_Waiting for markets to change me—High-stakeholders' views of antibiotic use and antibiotic resistance in pig production in Brazil.DOCX

Overuse of veterinary antibiotics is a risk factor for antimicrobial resistance (AMR), which is a global public health emergency. More than 70% of the antibiotics consumed worldwide are used in farm animals, mainly in poultry and pig herds. Brazil is the fourth largest pork producer globally and the second-largest user of antibiotics in animals. Qualitative research can help understand the complexities around antibiotic use (AMU) in Brazilian pig herds and identify stakeholders' attitudes concerning the rational AMU and AMR in the production chain. This study aimed to explore the knowledge and attitudes of high-level professionals in the animal production chain about AMU and AMR in pig farming, the relationship with pig welfare and AMU in Brazil. We conducted 32 in-depth interviews with individuals active in the pig industry. The majority of the participants considered AMU excessive and inappropriate in pig farms in Brazil. However, attitudes toward a restrictive AMU scenario in Brazilian pig farms were predominantly negative, justified by economic, sanitary and social barriers. These included unsatisfactory management and biosecurity conditions in pig farms that, in their opinion, justify AMU to prevent diseases; issues surrounding prescription and acquisition of veterinary drugs; and employment and income relationships arising from the sale of antibiotics. The views of high-level professionals in the Brazilian livestock chain reveal antibiotics as a structural element that enables pig production. Antibiotics were viewed as essential resources for producing cheap food. Foreign markets were considered the most relevant driver of change in AMU practices rather than pressure from Brazilian consumers. A common belief expressed was that AMR is more associated with the inappropriate AMU in human medicine than in the livestock sector. Resistance to change in these stakeholders may hinder the implementation of future public policies to restrict the use of antibiotics in Brazil. Our findings suggest that successful measures to deal with the AMU/AMR challenges in the pig chain shall not be rooted in personal behavior change. Instead, honest interdisciplinary dialogues and structural changes are needed to define common grounds and a way forward to break the cycle perpetuating antibiotics as structural commodities.

兽药过度使用是抗菌素耐药性（antimicrobial resistance, AMR）的重要风险诱因，而抗菌素耐药性本身属于全球性公共卫生紧急事件。全球范围内消耗的抗生素中，逾70%被应用于养殖动物，主要集中在家禽与生猪畜群中。巴西是全球第四大猪肉生产国，同时也是动物用抗生素的第二大使用国。质性研究有助于厘清巴西生猪养殖中抗生素使用（antimicrobial use, AMU）的复杂现状，并识别产业链中利益相关者对于合理抗生素使用与抗菌素耐药性的态度。本研究旨在探究动物生产产业链高层从业者对巴西生猪养殖中抗生素使用与抗菌素耐药性的认知与态度，及其与生猪福利及抗生素使用之间的关联。本研究针对生猪产业内的32名在职人员开展了深度访谈。多数受访者认为，巴西生猪养殖场的抗生素使用存在过度且不当的问题。但针对巴西生猪养殖领域限制抗生素使用的方案，受访者的整体态度偏负面，其理由涵盖经济、卫生与社会层面的多重阻碍：包括生猪养殖场管理与生物安全水平不佳——在受访者看来，这一现状需通过抗生素使用来预防疾病；兽医处方药的开具与获取存在乱象；以及抗生素销售带来的雇佣与收入关联。巴西畜牧产业链高层从业者的观点显示，抗生素已成为支撑生猪生产的结构性要素，被视为生产廉价食品的必要资源。相较于巴西国内消费者的施压，海外市场被认为是推动抗生素使用实践变革的最关键驱动因素。受访者普遍认为，抗菌素耐药性更多与人类医学领域的不当抗生素使用相关，而非畜牧养殖环节。这些利益相关者对变革的抵触态度，可能会阻碍未来限制巴西抗生素使用的公共政策落地。本研究结果表明，应对生猪产业链抗生素使用与抗菌素耐药性挑战的有效措施，不应仅立足于个体行为改变。相反，需开展坦诚的跨学科对话并推动结构性变革，以达成共识并打破将抗生素作为结构性商品的恶性循环，从而找到可行的解决路径。