# Consumer Perspectives on Antibiotic-Free Animal Products: A Systematic Review Identifying Critical Gaps in Non-Pharmaceutical Intervention Research

## TL;DR

This review finds that while consumers support antibiotic-free animal products, there's little research on how they feel about specific natural alternatives used in farming.

## Contribution

The novel contribution is identifying a critical gap in consumer research regarding specific non-pharmaceutical interventions used in antibiotic-free animal farming.

## Key findings

- Most studies focus on general antibiotic-free products rather than specific natural alternatives like probiotics or phytogenics.
- Consumers are willing to pay up to 20% more for antibiotic-free products, primarily due to health concerns.
- Research on consumer perceptions of specific non-pharmaceutical interventions is nearly nonexistent.

## Abstract

Micro-organisms that resist antibiotics are a growing danger to human health around the world. One major cause is the heavy use of antibiotics in farm animals raised for meat, eggs, and milk. To solve the problem, farmers are now trying natural alternatives like helpful bacteria, plant-based additives, and natural acids added to animal feed. But for such methods to succeed, consumers must be willing to buy and pay more for products made using such approaches. The systematic review looked at scientific studies from 2020 to 2024 to find out what people know and feel about natural alternatives. Fifteen relevant studies were found after searching through 847 research records. The biggest discovery was surprising: almost no research has asked consumers what they think about the specific natural alternatives farmers actually use. Most studies only asked about “antibiotic-free” products in general terms. People knew very little about how antibiotics are used on farms but viewed antibiotic-free products positively and were willing to pay about twenty percent more. Health concerns were the main reason people supported such products. More research is needed to help farmers communicate better with consumers.

Background: The global livestock industry faces pressure to reduce antimicrobial usage while maintaining animal health and productivity. Non-pharmaceutical interventions (NPIs) including probiotics, prebiotics, phytogenics, essential oils, organic acids, and enzymes have emerged as alternatives to antibiotic growth promoters. Commercial success depends on consumer acceptance and willingness to pay (WTP) for products from animals raised using these approaches. Objective: This systematic review synthesized peer-reviewed literature examining consumer knowledge, attitudes, perceptions, and WTP toward animal products produced using NPIs or marketed as antibiotic-free (ABF) to identify a critical gap in existing research. Methods: Following PRISMA 2020 guidelines, four databases (PubMed, Web of Science, Scopus, and Google Scholar) were searched for peer-reviewed studies published from January 2020 to December 2024. Inclusion criteria encompassed original research examining consumer perspectives toward NPIs or antibiotic-free (ABF) animal products. Narrative synthesis was employed due to study heterogeneity. Results: From 847 records, 15 studies met inclusion criteria. A critical finding was that virtually no peer-reviewed research directly examines consumer perceptions of specific NPIs such as probiotics, prebiotics, phytogenics, organic acids, or enzymes as feed additives. The included studies predominantly examined ABF production generally (60%) without specifying alternatives employed. Europe accounted for 80% of studies, while Asia accounted for 20%. Consumer awareness of agricultural antibiotic use was consistently low across contexts. Attitudes toward ABF products were favorable with one study reporting WTP premiums of 18–20%. Health consciousness was the strongest predictor of acceptance. Conclusions: The review highlights that while substantial literature exists on ABF products, no studies examine consumer perceptions of specific non-pharmaceutical interventions. Future research should investigate consumer responses to intervention specific labeling and communication strategies.