Animals : an Open Access Journal from MDPI · 6 authors, 3 centres
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This survey of 250 Italian dog owners found that 84% knew about antimicrobial resistance (AMR), and 96% considered it a major problem. Most owners (92%) would accept natural dietary supplements instead of antibiotics for treating canine acute diarrhea. Higher education levels were significantly associated with less self-medication of antibiotics without veterinary consultation (p = 0.004).
**Background:** Antimicrobial resistance (AMR) is a global health threat driven by overuse and misuse of antimicrobials in humans, food-producing animals, and companion animals. In dogs, acute diarrhea (AD) is a common reason for veterinary visits, yet many cases are self-limiting and do not require antibiotics. Nutraceuticals such as probiotics and polyphenols may offer effective alternatives. This study aimed to assess Italian dog owners' knowledge of AMR, their expectations regarding antibiotic treatment for canine AD, and their willingness to adopt non-antimicrobial strategies.
**Methods:** An online cross-sectional survey was administered from April to November 2020 via Google Forms, distributed through social media, email, and messaging services. The questionnaire had three sections: (1) demographic and epidemiologic data (14 questions), (2) antimicrobial usage habits (16 questions), and (3) AMR perception (5 questions). Only volunteers aged ≥18 years were included. A total of 250 completed questionnaires were returned. Statistical analysis used chi-square or Fisher's exact tests, with significance set at p < 0.05.
**Key Results:** Most respondents were female (79%), aged 36–70 (60%), and workers (77%). Education level was evenly split between university (49%) and non-university (51%). Most owned one dog (59.6%), with mixed breeds most common (34%). On average, each dog received 1.044 oral antibiotic courses per year. Intestinal diseases accounted for 19% of antibiotic prescriptions. Twenty-one percent of respondents admitted administering oral antibiotics without veterinary consultation, primarily using leftovers from previous prescriptions (65%). Premature termination of antibiotic therapy occurred in 17.1% of cases, mainly due to side effects (21.1%) or symptom resolution (21.1%). Eighty-four percent knew the meaning of AMR, and 96% considered it a major problem. Ninety-five percent believed public funding should support AMR research, but only 33% would personally fund it. Regarding canine AD, 47% said antibiotics should be used only when the cause is identified, 15% for bloody diarrhea, and 10% if diarrhea persists >2 days. Fifty-one percent expected recovery within 5 days. Notably, 92% would accept natural dietary supplements for treating AD. Higher education was significantly associated with lower likelihood of administering antibiotics without veterinary consultation (p = 0.004, OR = 0.24, 95% CI 0.07–0.70). No significant associations were found between education and AMR knowledge (p = 0.2), education and concern about AMR (p = 1), or age and concern about AMR (p = 0.99).
**Clinical Implications:** The findings indicate reasonable AMR awareness among Italian dog owners but highlight persistent gaps, including self-medication and premature treatment discontinuation. The high acceptance of nutraceuticals for AD management (92%) suggests a viable pathway to reduce unnecessary antibiotic use. The significant inverse relationship between education level and non-prescription antibiotic use underscores the importance of targeted educational interventions. The authors recommend developing globally accepted guidelines for canine AD management to help clinicians rationalize antimicrobial use and emphasize the veterinarian's role in educating owners about AMR as a One Health issue.