Antibiotic use and resistance awareness among ruminant and poultry farmers in Tunisia.

Antibiotic resistance (AMR) is a growing global public health threat. In food-producing animals, antibiotic overuse and misuse play a key role in its emergence and transmission to humans. This study examined antibiotic use patterns among ruminant (cattle, sheep, goats) and poultry (chickens, turkeys) farmers in Tunisia, explored drivers of their decisions, and assessed awareness of AMR risks. A structured, anonymous 12-item questionnaire was administered face-to-face by 11 veterinarians to 110 farmers in Sousse, Mahdia, and Monastir (Sahel region). Data were analyzed statistically. Results showed that 90% of farmers lacked a livestock register, and 92.7% practiced self-medication without veterinary prescriptions. Digestive diseases (88.2%) were the most treated, followed by foot (60%), mammary (60%), and respiratory diseases (41.8%). Self-medication was significantly associated with treatment cost (p = 0.005) and over-the-counter antibiotic access (p = 0.016). Misuse was frequent: 62.7% did not complete treatment, 82.7% stopped once symptoms resolved, and 61.8% ignored withdrawal periods. Overall, 94.5% were unaware of AMR risks, and only 5.5% had received training in good husbandry practices. These findings underscore the urgent need for farmer education, strengthened veterinary oversight, and promotion of prudent antibiotic use to mitigate AMR risks and safeguard animal and public health in Tunisia.