Understanding antibiotic decision-making for bovine respiratory disease: a survey of UK farm veterinarians.

Introduction: Bovine Respiratory Disease (BRD) is a major cause of morbidity and mortality in young calves and a major driver of antibiotic use in the United Kingdom (UK), making veterinary decision-making central to antimicrobial stewardship (AMS). Methods: This study used a mixed-methods survey of UK farm veterinarians ( Results: For BRD diagnosis in calves, clinical examination (36.8%), necropsy (33.7%), and rectal temperature (31.6%) were the tools most regarded as extremely important. Oxytetracycline was the most commonly used primary antibiotic (52.6%), tulathromycin was the secondary option (38.9%), and NSAIDs were represented as the most common ancillary therapy (80.0%). The risk of antimicrobial resistance (AMR; 22.1%) and clinical experience (21.1%) primarily drove antibiotic selection. Prevention focused on colostrum management (80.0%), ventilation (65.3%), intranasal vaccines (46.3%), and injectable vaccines (40.0%). Influences on prescribing behaviours included motivations regarding responsible antibiotic use (68.4%), avoiding blame (45.3%), and veterinarian-farmer relationships (42.1%). Bacterial culture and sensitivity testing were the least important (24.2%), suggesting a need to strengthen AMS. Discussion: These results showed a phenomenon in clinical diagnosis, specific antimicrobial classes used, and relational factors in prescribing. The study showed that clinical assessment, social pressures, and policy contexts jointly shaped antimicrobial prescribing decisions. Enhancing diagnostic capacity, embedding evidence-based preventive measures, and applying behavioural frameworks to support veterinarian-farmer communication were identified as essential to improve AMS. The targeted interventions within One Health approach are required to support sustainable UK dairy health management.