Limiting the nontherapeutic use of antibiotics (ABU) in livestock is increasingly viewed as a critical component of global efforts to slow the emergence of antimicrobial resistance (AMR). Yet, such use may still play a role in day-to-day disease management on farms. If reductions in nontherapeutic ABU are to be achieved without compromising animal health, farmers may need viable alternative strategies to prevent disease and mitigate risk. It is therefore essential to first determine whether nontherapeutic ABU is actually linked to improved health outcomes in livestock. Equally important is the identification of non-antibiotic factors that contribute to healthier herds and reduce the perceived need for routine antibiotic use, alongside factors that encourage producers to adopt better antibiotic stewardship practices. To address these issues, we analyzed data from the AMUSE survey, which captures smallholder farmers’ knowledge, attitudes, and practices regarding AMR. The study included 320 herds belonging to 216 smallholder farms in Burkina Faso, representing cattle, small ruminants, and poultry. Binary logistic regression models were used to explore predictors of both animal disease occurrence and the use of antibiotics for nontherapeutic purposes. Analyses showed a positive relationship between nontherapeutic ABU and the presence of disease in herds, although further work is needed to unpack potential reverse causation. Herds managed by farmers who predominantly relied on public veterinary services or who had more years of formal schooling were less likely to report disease. In contrast, farmers who typically sought assistance from community animal health workers were more likely to employ antibiotics nontherapeutically, while consultation with public veterinarians was associated with lower use. For goats and sheep, receiving diagnostic or treatment support from any type of animal health professional was linked to increased nontherapeutic ABU. These results point to the importance of strengthening public veterinary services and improving educational opportunities as part of efforts to promote prudent antibiotic use while safeguarding animal health. They also suggest that some non-veterinarian animal health providers may prioritize immediate clinical outcomes over stewardship considerations, underscoring the need for targeted training and policy support.
