Background/Objectives: Antimicrobial resistance (AMR) is a global public health threat, with antimicrobial use (AMU) in livestock recognized as a significant driver. This study examines farm-level AMU and AMR as well as the relationship between AMU and AMR on broiler farms in Indonesia. Methods: Data were collected from 19 farms in West Java between 2019 and 2021 to examine AMU in depth across four to five successive production cycles. The correlation between AMU and AMR in commensal Escherichia coli (E. coli) was investigated. AMU was recorded as treatment days per 30-day production cycle, and antimicrobial susceptibility was assessed using epidemiological cut-off (ECOFF) values to differentiate wildtype (WT) and non-wildtype (NWT) E. coli. Results: The average AMU was 12 treatment days per 30-day production cycle, with a wide range of 4 to 22 days. On average, E. coli isolates from each farm exhibited NWT phenotypes, reflecting AMR levels, for 6 out of 14 antimicrobials tested. This included notable levels for the highest priority critically important antimicrobials (HPCIAs) ciprofloxacin (93%) and nalidixic acid (64%). A significant correlation (Spearman ρ = 0.67, p < 0.05) was observed between the total farm-level AMU and the number of antimicrobials for which NWT E. coli isolates were found. However, no significant correlation was found between AMU and AMR for the five most frequently used antimicrobials, likely due to a high baseline prevalence of NWT E. coli isolates and relatively few independent observations. Conclusions: These findings highlight the urgent need to reduce AMU in general, specifically the use of (HP)CIAs, to mitigate AMR on Indonesian broiler farms.
Keywords: E. coli; Indonesia; antimicrobial resistance; antimicrobial use; broilers; farm level; poultry.