Pet Owners’ Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Antimicrobial Resistance in Companion Animals in North Macedonia

Ivana Shikoska; Jane Vlahov; Boris Dimitrievski; Bojana Chapkunovska; Ljubica Rashikj; Mirko Prodanov; Martin Nikolovski; Elena Atanaskova Petrov; Aleksandar Cvetkovikj; Iskra Cvetkovikj

doi:10.2478/macvetrev-2026-0026

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Pet Owners’ Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Antimicrobial Resistance in Companion Animals in North Macedonia

Macedonian Veterinary Review

AHEAD OF PRINT

By: Ivana Shikoska, Jane Vlahov, Boris Dimitrievski, Bojana Chapkunovska, Ljubica Rashikj, Mirko Prodanov, Martin Nikolovski, Elena Atanaskova Petrov, Aleksandar Cvetkovikj and Iskra Cvetkovikj

Open Access

|Oct 2026

Abstract

Antimicrobial use (AMU) in companion animals is influenced not only by veterinary prescribing practices but also by pet owners, whose decisions on medication administration, compliance, and expectations can impact antimicrobial stewardship and antimicrobial resistance (AMR) at the human–animal interface. This study aimed to assess pet owners’ knowledge, attitudes, and practices regarding AMU and AMR in companion animals in North Macedonia. A cross-sectional, web-based questionnaire was completed by 410 pet owners in North Macedonia. Data was analysed using descriptive and inferential statistics. Of the respondents, 96.3% (395/410) acknowledged AMR as a serious health challenge, indicating high general awareness. However, this awareness did not consistently translate into accurate knowledge and recommended practices. For example, while 92.4% (379/410) identified bacteria as a target of antibiotic therapy, only 67.1% (275/410) chose bacteria as the only correct answer. Regarding interspecies transmission, 66.6% (273/410) agreed that companion animals may transmit antimicrobial-resistant bacteria to humans, while 60.2% (247/410) were previously aware of such transmission. Trust in veterinarians was high, but 36.1% (148/410) of respondents still expected antibiotic therapy for a wide range of clinical conditions. Additionally, 44.1% (181/410) reported administering antibiotics intended for human use to their pets, and 62.9% (258/410) reported keeping antibiotics at home “just in case.” Knowledge of bacteriological testing was associated with adherence to the prescribed treatment duration. These findings indicate that, despite high general awareness of AMR, important gaps remain in pet owners’ specific knowledge and practices. Pet owners should be considered an important target for antimicrobial stewardship efforts in small animal practice in North Macedonia.

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Articles in this issue

DOI: https://doi.org/10.2478/macvetrev-2026-0026 | Journal eISSN: 1857-7415

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Language: English

Submitted on: Mar 12, 2026

Accepted on: Jun 23, 2026

Published on: Oct 6, 2026

Published by: Ss. Cyril and Methodius University in Skopje

In partnership with: Paradigm Publishing Services

Keywords:

antibiotics,

antimicrobial stewardship,

awareness,

small animal practice,

AST

Related subjects:

Life sciences,

Life sciences, other,

Medicine,

Basic medical science,

Basic medical science, other,

Veterinary medicine

© 2026 Ivana Shikoska, Jane Vlahov, Boris Dimitrievski, Bojana Chapkunovska, Ljubica Rashikj, Mirko Prodanov, Martin Nikolovski, Elena Atanaskova Petrov, Aleksandar Cvetkovikj, Iskra Cvetkovikj, published by Ss. Cyril and Methodius University in Skopje
This work is licensed under the Creative Commons Attribution 4.0 License.

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