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Making penicillin using animals - specifically, a goat

Making penicillin using animals - specifically, a goat


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In the scifi novel Lucifer's Hammer, one of the characters (a biologist, if I remember correctly) finds himself in a post-apocalyptic world and tries to make penicillin to save his own life. To do this, he repeatedly states that he needs "a goat" - for some reason which is never explained.

I know that penicillin (in its various forms) is a byproduct of some types of fungi (see Wikipedia), but I can't make sense of the statement "I need a goat to make it". Assuming you don't have a chemical lab at your disposal (think "post-apocalyptic world"), does this requirement make any sense to any of you (apart from "I need to eat the goat to stay alive long enough to find a deserted biochemical lab" :-) )?

If not, how would you go about finding or making penicillin in such an environment?


Here is a link to a survivalist blog with a protocol for making penicillin. (I'm not recommending this by the way.)

Is it possible that the reference to the goat in Lucifer's Hammer is for the extraction of insulin (from the pancreas)? Have a look at the Wikipedia entry for Eva Saxl - in Shanghai during WWII her husband kept her alive with insulin extracted from water buffalo pancreas.


Penicillin

Penicillins (P, PCN or PEN) are a group of antibiotics originally obtained from Penicillium moulds, principally P. chrysogenum and P. rubens. Most penicillins in clinical use are chemically synthesised from naturally-produced penicillins. A number of natural penicillins have been discovered, but only two purified compounds are in clinical use: penicillin G (intravenous use) and penicillin V (given by mouth). Penicillins were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. They are members of the β-lactam antibiotics. [2] They are still widely used today for different bacterial infections, though many types of bacteria have developed resistance following extensive use.

About 10% of people report that they are allergic to penicillin however, up to 90% of this group may not actually be allergic. [3] Serious allergies only occur in about 0.03%. [ for whom? ] [3] Those who are allergic to penicillin are most often given cephalosporin C (another β-lactam antibiotic) because there is only 10% crossover in allergy between the penicillins and cephalosporins. [2]

Penicillin was discovered in 1928 by Scottish scientist Alexander Fleming as a crude extract of P. rubens. [4] Fleming's student Cecil George Paine was the first to successfully use penicillin to treat eye infection (ophthalmia neonatorum) in 1930. The purified compound (penicillin F) was isolated in 1940 by a research team led by Howard Florey and Ernst Boris Chain at the University of Oxford. Fleming first used the purified penicillin to treat streptococcal meningitis in 1942. [5] For the discovery, Fleming shared the 1945 Nobel Prize in Physiology or Medicine with Florey and Chain.

Several semisynthetic penicillins are effective against a broader spectrum of bacteria: these include the antistaphylococcal penicillins, aminopenicillins and the antipseudomonal penicillins.


Making penicillin using animals - specifically, a goat - Biology

GOAT MEDICATIONS & HOW TO USE THEM

Goats are a minor ruminant species. There are less than 1.9 million ( 1,900,000) goats in the USA (2013, USDA) and the number is decreasing, so very few medications are made for them. Drug development, testing, and approval costs seldom justify focusing on such small numbers. Almost all of the medications we used to treat goats, prescription or over the counter, are "off label" or "extra label" usage. Lack of government approval does not mean that such products are dangerous or ineffective with goats. You as a goat raiser must learn which to use and how to use them.

In many areas of the USA veterinarians know little to nothing about goats. Goat producers must rely on knowledgeable breeders for the help they need to raise healthy goats. Find yourself a knowledgeable mentor and stick with that person until you decide the information is incorrect. Contacting multiple people on the Internet will only confuse you and may hurt your goats. There is much bad information about goats on the Internet, especially on social media.

I am NOT a vet. I have been raising goats since January 1990, and in all those years I have met only two vets who knew anything about goats. Use the information in this article at your own risk and only after you have consulted with a qualified goat veterinarian. (You will have to search diligently to find one.)

Contrary to popular belief, goats are fragile creatures. Any prey-prone species with short gestation and multiple births is going to experience high mortality. When a goat gets sick, it requires IMMEDIATE attention. It is going to die quickly if you don't take fast action. This requires both a knowledge of goat health and having appropriate supplies and medications ON HAND. You won't find what you need locally when you need it fast. Almost all antibiotics already require a prescription. You MUST develop a relationship with a local veterinarian so that you can buy what you need and have them on hand IN ADVANCE. If you don't do this, you are likely to have dead goats on your hands.

The medications are presented in alphabetical order some of the medications are interchangeable with others, i.e. they provide similar treatment benefits but are offered because specific products may not be available in all areas. I have not addressed meat or milk withdrawal timeframes. Some of the products may not be approved for use in food animals Gentamycin and Baytril 100 are restricted from usage in food animals in certain species and jurisdictions. Check with your local vet or animal health authorities to find out what you can legally use.

The products listed below and comments about them are based upon my personal experiences or those of vets with whom I have had a working relationship. Jeffers 1-800-533-3377 www.jefferspet.com carries most of these non-prescription items. Prescription items must come from your vet.

In December 2016, antibiotics were prohibited as feed additives. All sulfa-based products are subject to VFD (Veterinarian Feed Directive) which means prescription- only usage. Animal health businesses are restructuring to sell antibiotics only to veterinarians. Penicillin and all other antibiotics will be prescription items in the not-too-distant future. Stock up and develop a relationship with a vet, because it is going to happen soon.

A comment about antibiotics: Due to the goat's very fast metabolism, antibiotics (whether given orally or injectably) must be given for five consecutive days. These one- time injections do NOT work with goats. Some vets refuse to belief that they are wrong and goats die.

A-180 (danofloxacin) - Vet prescription. Injectable respiratory antibiotic. Neither I nor my vet like this product's use with goats. Nuflor Gold and Excenel RTU have worked better for us.

Albadry Plus - Teat infusion medication containing procaine penicillin and novobiocin sodium for treating mastitis in non-lactating goats and drying up lactating goats. Can be used topically on staph infections. Best to have the udder's contents tested to find out which organism is causing the infection so you can choose best antibiotic.

Albon (Sulfadimethoxine 12.5% or its generic equivalent DiMethox 12.5%) - Vet prescription. These products are the drug of choice for preventing and treating Coccidiosis. Give orally undiluted to kids at a rate of 3-5cc and to adults at a rate of 5-10cc for five consecutive days. Mixing with drinking water as directed on the label is another option, but I recommend AGAINST it. Sick goats should be treated individually with oral dosing for five consecutive days. The gallon jug is the most cost-effective purchase. Will not work with automatic waterers due to continual dilution of the product.

Albon 40% Injectable - Vet prescription. Dosed orally to treat coccidiosis. 1.56 cc given orally on first day per 25 pounds bodyweight days 2-5, dose at .78 cc per 25 pounds bodyweight. Mix with Nutri-Drench or similar product for palatability.

Alushield - Aluminum-based water-resistant aerosol bandage spray for topical use only.

Banamine (FluMeglumine) - Vet prescription. Anti-inflammatory that helps reduce fever, soothes irritation in the gastro-intestinal tract (gut) when diarrhea or other gut-related digestive illnesses occur, relieves pain and soreness associated with animal bites and other injuries. Use no more frequently than every 12 hours (stomach ulcers are possible) unless goat is dying, justifying the risk. Dosage is 1 cc per 100 lbs. body weight IM. A newborn kid with fever at Onion Creek Ranch would receive an injection of no more than 1/10 cc IM. Keeps best in hot climates when refrigerated. Must-have medication never run out. Buy the generic version (cheaper).

Baycox - See Toltrazuril for cost-effective alternative.

Baytril 100 (Enrofloxacin 100 mg/ml)
- Vet prescription. (not Baytril 2.27%). Usage in goats is "off-label" or "extra-label," but this antibiotic is being used in goats by some veterinarians. The appropriate IM dosage is 4 cc's per 100 lbs. of body weight for five consecutive days. This medication is very effective against gut-related illnesses and works synergistically (better together than individually) with SMZ (sulfadimethoxazine with trimethoprim). Some jurisdictions prohibit use of Baytril or Baytril 100 in any form (injectable or tablets) in food-production animals because the withdrawal time from meat and milk has not been determined. Great for treating Joint Ill when no other antibiotic works. If you have a sick goat on which no other antibiotic is working, Baytril 100 is the drug of last resort. Do not use without vet approval and supervision.

Beet Pulp, Shredded - While this isn't a medication, I mention it because it is useful and often misused. I use shredded beet pulp to add fiber to the rumen of old goats whose teeth have begun to wear. This is in addition to their normal feed, not in place of it.

Biosol (Neomycin Sulfate) - Vet prescription. Sulfa-based antibiotic for use with scouring kids and adults when Coccidiosis is not the underlying illness. Works effectively against E.Coli and other digestive-system bacterial infections. For kids, give 3 cc orally every 12 hours until diarrhea has stopped and feces is normal. For adult goats, use 5 cc to 10 cc orally and as directed for usage in kids. Do not overdose constipation can result. Do not stop diarrhea until you know its cause. Sometimes diarrhea is the body's way of eliminating toxins.

Black Oil Sunflower Seeds (BOSS) - Another non-medication, it is useful to add fat to the diet of thin and/or old goats. BOSS is 25% fat. Lightly top-dress feed with BOSS.

BoSe (not MuSe) - Vet prescription. (A horse product, MuSe is too strong and should not be used with goats.) Injectable medication for selenium deficiency (white muscle disease, aka nutritional muscular distrophy). Since selenium deficiency exists at different levels throughout the United States, it is critical to follow your veterinarian's directions on the usage of these products, as well as offering supplemental loose minerals containing selenium. Google "selenium deficiency" to see the general locations in the USA. Most of the East Coast, down to Florida and westward through the Great Lakes region, plus the West Coast, including California and parts of Nevada and Idaho, are selenium deficient to different degrees. Selenium deficiency usually shows itself in the form of weak rear legs in kids. Older goats don't put on weight, have weak legs, and generally stay in poor condition and poor health. Selenium is toxic at low dosages, and the dosing margin of safety is narrow. The addition of selenium to feed is controlled by US law. In some areas, producers only need to provide loose minerals containing selenium. In other regions, selenium injections are necessary. When BoSe injections are required, they are usually given at birth and again at one month of age (one-half cc SQ). Pregnant does receive injections six weeks before kidding, and bucks are vaccinated twice a year. Adult dosage of BoSe is 2-1/2 cc per 100 lbs bodyweight given SQ. It is easy to overdose selenium.

C&D Anti-toxin - Over-the-counter made-for-goats product that can be safely used for many problems when they already exist. Severe diarrhea in very young kids, toxicity caused by plants, poisons (bites, overeating disease, bloat, ruminal acidosis, and ingestion of toxic subtances like azaleas and antifreeze are several examples), one of the products administered to combat Floppy Kid Syndrome . . . these are a few of the applications of this very versatile product. C&D Anti-toxin provides short-term protection (about 12 hours) but works quickly towards solving the immediate problem. Follow label directions. Must be refrigerated. Freezes at very high temperatures. C&D Anti-toxin negates any protection previously given by the CD/T vaccine, so you must wait for at least five days after completion of C&D Anti-toxin therapy and re-vaccinate the animal with the initial CD/T vaccine injection plus the booster 30 days thereafter. Must-have medication. Always have on hand. There is no substitute.

CD/T vaccine (Clostridium Perfringens Types C&D + Tetanus Toxoid Vaccine) - Over-the-counter made-for-goats VACCINE that provides long-term protection against overeating disease (types C&D) and tetanus. Kids of one to three months of age and all newly-purchased animals regardless of age should be vaccinated with 2 cc and then a second vaccination should be given 30 days later. Two injections 30 days apart are required in order to provide long-term protection. Annually thereafter, one injection of 2 cc per goat will renew the protection. Give SQ. It may cause an injection-site reaction called a granuloma, which is an indication of the body's positive reaction to the vaccine. The granuloma goes away in time.

Caseous Lymphadenitis (CL) vaccine - Introduced in May 2012 by Texas Vet Lab of San Angelo, Texas. See the Articles page at www.tennesseemeatgoats.com or the June 2020 issue of MeatGoatMania for articles on how to use this very effective vaccine. Over the counter in some states prescription item in other states. Not available yet in a few states. Jeffers can tell you what each state requires. Call 1-800-533-3377 and ask to speak with their CL vaccine expert.

Chondroprotec - A skin regrowing medication. Prescription. Applied topically. The January 2013 issue of MeatGoatMania has an article and pictures of this amazing product.

Colostrum Replacers & Supplements - Do not confuse these two types of products. Newborns must have colostrum during the first hours after birth. If the dam is colostrum deficient, you must use a colostrum replacer. The best colostrum replacer is colostrum saved (and frozen) from does on your property who have already kidded. This colostrum will have antibodies that provide the kids needed immunity to the organisms existing in your particular location. If you don't have a supply of frozen colostrum, then you must use a commercially-prepared goat colostrum replacer ( *not* "supplement"). Do not use colostrum or colostrum replacer beyond the first 48 hours of the kid's life. Switch to goat milk or goat milk replacer. Colostrum has already done its job for the newborn after 48 hours and the kid's body can better digest goat milk.

CoRid (amprollium) - Over-the-counter product for preventing and treating coccidiosis. Comes in granular packets and gallon liquid. This product is a thiamine inhibitor, so I prefer other coccidia medications. When using CoRid, also dose with thiamine (Vitamin B1) at 4 cc per 100 lbs bodyweight given IM or SQ. Albon or its generic equivalent Sulfadimethoxine 12.5% (Dimethox 12.5%) is preferred over CoRid. If you must use CoRid, buy the gallon liquid and maintain better control over dosages. Follow package directions. Treatment dosage: Mix 1 oz CoRid in 5 oz. water and orally drench the sick goats twice a day for five consecutive days kids should receive 20-40 cc of this mixture twice a day, while adults should receive 40-80 cc. This is a higher-than-label dosage but is what it takes to control coccidia in goats. For prevention of coccidia, use 2 oz. per 15 gallons of water for treatment, use 3 oz. CoRid per 15 gallons of water. Limit the goats' water supply to one source and treat for five consecutive days. Daily individual dosing into each goat's mouth is much better than using in water.

Dewormers, Feed-based - Feed-based dewormers are usually not effective. Dewormers are dosed based on the goat's bodyweight there is no accurate way to do this with feed-based dewormers. The goat needing the dewormer the worst will also be the least aggressive goat who will get less feed, therefore a lower dosage of the feed-based dewormer. Unless you can control the precise amount of feed that each goat receives, I recommend against using feed-based dewormers.

Dewormers - There are multiple classes of dewormers. Some still kill stomach worms many are no longer effective. Generally speaking, the white-colored dewormers (Safeguard/Panacur and Valbazen) no longer kill stomach worms in much of the USA. All dewormers should be given ORALLY, regardless of package directions. See my article on Deworming & Vaccination Schedules on the Articles page at www.tennesseemeatgoats.com .

Dexamethasone - Vet prescription. Cortico-steroid. Use sparingly and under the direction of a vet. Dex can have bad side effects. Used for swelling and inflammation after infection is under control. Do not use if broken bones exist Dex interferes with bone repair. Do not use on pregnant does unless you are trying to induce labor. Used to induce labor in pregnant does when the slow introduction of labor over a 48-to-72 hour period is desired (pregnancy diseases like Pregnancy Toxemia & Ketosis). Dex interferes with the functioning of the goat's immune system. Usage of this drug must be tapered off slowly serious problems can occur if Dex is given in large amounts and then suddenly stopped. Reducing the dosage each day for five consecutive days is normal procedure. Dosage varies depending upon the problem being treated.

Dextrose Solution (50%) - This over-the-counter IV product in a bottle is used orally with weak newborns by slowly dropping one or two cc in the mouth and under the tongue for quick energy. Can be mixed half and half with water and offered short-term to weak goats or kids who are either having trouble digesting milk or have overeaten on milk (Floppy Kid Syndrome) and need to be taken off milk for several days until the toxicity caused by undigested milk has been successfully treated.

Diatomaceous Earth (DE) - Although this product is being used by some producers as a "natural" dewormer, DE does NOT kill internal parasites (worms). Every controlled test done to determine efficacy of this product in killing internal parasites (worms) in goats has failed. It is somewhat effective on external parasites like flies. If a producer chooses to use DE as a food additive, make certain that "food-grade" DE is purchased and use DE in conjunction with an ethical (commercially-produced) deworming product. There is no such thing as a "natural dewormer" for goats.

Dopram V - Vet prescription. (May have to be compounded by a pharmacy as it may no longer be available commercially.) Eliminates respiratory distress in newborns caused by troubled births, including C-sections. Drop 2/10 cc under kid's tongue immediately upon birth to stimulate lung activity. Also use on "pulled" kids since the normal squeezing of the body during the delivery process is altered. This is a must-have medication at Onion Creek Ranch.

Draxxin (tulothromycin) - Vet prescription. Injectable respiratory antibiotic. Very expensive product that purports to be a one-time-only usage antibiotic. Because goats have the fastest metabolism of all ruminants, they need to be dosed daily for five days. Nuflor Gold and Excenel RTU given daily for five days work in my herd and are far less expensive.

Dyne - Over-the-counter oral high-calorie food supplement for animals off feed or needing quick energy. Must-have product.

Electrolytes, Oral (Bounce Back, ReSorb, Entrolyte HE, or equivalent) Over-the-counter products packaged in powered form. For rehydrating sick animals, regardless of age. Can be used as an oral drench, put into baby bottles for kids to suck, or mixed in drinking water. Can be used in conjunction with Lactated Ringers Solution on dehydrated kids or adults. Store in a cool, dry place. Never be without this product.

Entrolyte - This terrific product was pulled by Pfizer in January 2008 and will never come back on the market. It was an over-the-counter oral nutrient product for both rehydrating and providing nutrition to ruminants that were not ruminating or off-feed. Contained 13.4% protein in addition to electrolytes. No comparable replacement product is on the market, to my knowledge. Best alternative: Mix a package of electrolytes such as Bounce Back or ReSorb and mix enough powered milk replacer to make an 8 oz bottle and combine with electrolytes.

Epinephrine - Vet prescription. Used to treat Shock. Always have it on hand when giving injections. Shock must be treated within seconds or the goat will die. Dosage is 1 cc IM per 100 pounds body weight.

Excenel RTU - Prescription injectable antibiotic. Ready-to-use equivalent of Naxcel. Effective against respiratory and urinary tract infections. Dose daily at 6 cc per 100 lbs bodyweight. Day One: dose twice 12 hours apart. Days 2 through 5: dose once daily. Give IM.

Ferrodex iron injectable - Over-the-counter Injectable iron supplement for treating anemia. Interchangeable with oral Red Cell. I prefer dosing Red Cell orally.

Fleet's Enema or generic equivalent - Over-the-counter product that is useful for constipation and toxicity reactions to clean out the intestinal tract. If a doeling is born with her vagina turned inside out, use a children's Fleet's enema to move her bowels for the first time ("pass her plug") and the vagina will return to its proper position. Make sure to put the enema into the rectal opening -- not the vagina.

Formalin (10% buffered formaldehyde) - Classified as a disinfectant, this product works well when injected into CL abscesses and also is very effective in treating hoof rot/hoof scald. However, I am no longer recommending using Formalin but prefer rather lancing and cleaning out abscesses because too many goat raisers are not using it correctly. Goat raisers need to use the Texas Vet Lab vaccine that prevents CL and also reduces frequency and severity of reoccurrence if the goat already has CL. It is a great vaccine.

Fortified Vitamin B Complex - Over-the-counter product. This product can be used instead of Thiamine since it has 100 mg/ml thiamine in it. Products without "fortified" in the label have inadequate levels of thiamine. Example: If a Vitamin B Complex product has only 25 mg/ml thiamine, then the dosage given must be multiplied by four. B vitamins are water soluble a healthy rumen produces B vitamins daily. Dosage is 4 cc per 100 pounds bodyweight.

Gentamycin Sulfate - Injectable prescription antibiotic. Not authorized for use in all jurisdictions in food animals due to concern for antibiotic residue in meat. Works extremely well when used in conjunction with penicillin in the treatment of post-birthing infections and other bacterial infections. Mixed in equal parts with Dexamethazone and Sterile Water, the resulting product is a very effective eye spray for treating Pinkeye. Do not use on ulcerated eyes.

Gentosin Spray - Topical prescription spray useful in treating Pinkeye in non-ulcerated eyes. See Gentamycin Sulfate for details.

Goat NutriDrench - Oral quick energy supplement for stressed and/or off-feed goats. Contains many of the vitamins, minerals, and nutrients that a sick goat requires to survive its illness. Mixes well with propylene glycol or mineral oil for flavored dosing.

Granulex - Topical spray for removing dead & dying skin. May not be available. Ask vet.

Hoof Rot vacccines - Volar & Fusoguard are hoof-rot prevention vaccines for other species. Goat producers have told me that these vaccines don't work well with goats.

Immodium AD - Do not use this anti-diarrheal with goats. It can stop the peristaltic action of the gut, causing death.

Ivomec 1% injectable dewormer or generic equivalent Invermectin - Over-the-counter product for eliminating stomach worms. This clear liquid works best if used orally at a rate of 1 cc per 25 pounds body weight. Do not under-dose. Store at cool temperature and keep out of sunlight. Also used in treatment of Meningeal Deerworm Infection. Clear dewormers do not kill tapeworms. Ivermectin 1% is one of several dewormers used to kill stomach worms. All dewormers should be given orally to goats. Before deworming, DO FECAL COUNTS FIRST.

LA 200, Maxim 200, Biomycin (oxytetracyline 200 mg/ml) - Over-the-counter broad-spectrum antibiotic. Soon to be prescriptiion. Thick (use an 18 gauge needle and give SQ over the ribs) and may sting. Oxytretracycline 200 mg/ml must be used to treat abortion "storms." No vaccines are available to treat abortion diseases and no off-label vaccines are effective in preventing abortion diseases in goats. Oxytetracycline 200 mg/ml is the goat producer's only choice. Also used to treat Pinkeye, even in pregnant does, as an abortion organism can cause one strain of Pinkeye. Used both injectably and topically (in non-ulcerated eyes) for Pinkeye. Sometimes effective in treating hoof rot/hoof scald infections. Use 1 cc per 20 lbs. body weight SQ daily for a minimum of five consecutive days. The non-sting version of oxytetracycline 200 mg/ml is called Biomycin. Oxytetracycline 200 mg/ml is sold under several brand names check the content label for correct 200 mg/ml strength. Turns a dark red when opened and air enters the bottle, but if kept under controlled climatic conditions and used before the expiration date, it should work fine. There are versions that are 300 mg/ml and labeled as single-use. Don't believe it. Use antibiotics for five consecutive days.

Lactated Ringers Solution - Vet prescription. For rehydrating kids and young goats. Comes in IV bag but use SQ. Using a 60 cc syringe with an 18 gauge needle attached, draw up LRS, warm in a pot of water, check temperature as you would a bottle of milk for proper heat, and inject 30 cc under the skin (SQ) at each shoulder to treat hypothermic newborns. Can be used several times a day until the goat's electrolytes are in balance. Will be absorbed by the goat's body very quickly if dehydration is present. Can be used in conjunction with oral electrolytes (BounceBack/ReSorb). Refrigerate when storing or strange things will grow inside the bag. A must-have product.

Lime sulphur dip 97.8% . Used topically for mites and staph infections on the skin.

Lutalyse -- Prescription injectable. Used to cycle does into heat or induce abortion in doe bred you didn't want bred. Give 2 cc on the seventh (7th) day after observed breeding. Do NOT repeat.

Marquis - See Toltrazuril for cost-effective alternative.

Masti-Clear - Procaine-penicillin-based teat infusion for lactating does to treat mastitis.

Micotil - Never use Micotil on goats. Cattle antibiotic causes quick heart attack and death.

Milk of Magnesia -- Over-the-counter laxative product that is useful for constipation and toxicity reactions (to move toxic materials from the body), including bloat, ruminal acidosis, overeating disease, and Floppy Kid Syndrome in conjunction with other necessary medications. Use as oral drench at a rate of 15 cc per 60 lbs. body weight every four to six hours until the feces goes from normal to clumpy then back to normal 'pills.' Always keep the animal hydrated with electrolytes (BounceBack/ReSorb or equivalent) when using Milk of Magnesia or other laxatives. Useful with mastitis by increasing magnesium levels in goat's body. Keep Milk of Magnesia on hand at all times.

Multi Min - Vet prescription. Cobalt-blue colored injectable liquid that must be used sparingly in goats suffering from severe mineral deficiencies. Chelated (slow release) combination of zinc, magnanese, selenium, and copper. Helps with weak labor contractions. Overdosing is easy this medication builds up in fatty tissues. Dose SQ only.

Mineral Oil - Over-the-counter laxative product. Because mineral oil has no taste, the goat does not recognize mineral oil as a substance to be swallowed and can aspirate it into the lungs. Must be stomach tubed. If stomach tube is not immediately available, mix mineral oil with Goat Nutridrench or Karo syrup to add flavor and slowly orally drench the goat.

Molasses/Karo Syrup - Use orally with kids when quick energy is needed. See my article on Weak Kids on my website. Can be substituted for propylene glycol with ketotic does.

Kopertox - Over-the-counter product for hoof rot and hoof scald. Blue-green liquid for topical application as a "liquid bandage." Use with Oxytetracycline 200 mg/ml injections.

Nalalgen IP - Intra-nasal vaccine of short duration. Use to prevent shipping fever.

Naxcel (ceftiofur sodium) - Vet prescription. Broad-spectrum antibiotic used for respiratory illnesses (pneumonia). Comes in two bottles: One bottle contains a powder which must be kept refrigerated even in powder form, and the other bottle is sterile water. When the two are mixed, they keep for only seven days. Draw syringes in dosages of 1/2 cc, 1 cc, 2 cc, and 3 cc, put needle caps on them, place the filled syringes in a ziplock bag, label and date it, and put the bag in the freezer. Syringes thaw quickly, but hold the needle cap upright, because the medication will settle into the needle cap and will be lost when the needle cap is removed.

Newborn kids with respiratory distress or E.Coli infections need a minimum dosage IM of 1/2 cc daily for five consecutive days. A 100 pound goat needs at least 5-6 cc of Naxcel IM over the five-day course of treatment. I no longer use Naxcel but instead use Excenel RTU, the ready-to-use equivalent product that doesn't require refrigeration or mixing, or Nuflor Gold.

Niacin (Vitamin B3) - Give 1000 mg daily orally (crushed and dissolved) to does having weak labor contractions until kidding occurs.

Nolvasan - Bolus used inside uterus after difficult delivery to prevent metritis or vaginitis.

Nuflor Gold (florfenicol) - Vet prescription. My preferred antibiotic for respiratory problems, including pneumonia. Can also be used try to keep mastitis from becoming systemic. I tend to use Nuflor on adults and Excenel RTU on kids, but they are interchangeable. This is a thick liquid, so use Luer Lock syringes, or the needle may blow off the syringe. Dosage is 6 cc per 100 lbs bodyweight given IM for five consecutive days newborn kids should receive no less than 1/2 cc.

Oxytocin - Vet prescription. Used when a doe has not passed her afterbirth within 24-36 hours of kidding. Dosage is 1-1/2 cc per 100 lbs. body weight.

Penicillin, Benzathine (long-acting penicillin) - Over-the-counter antibiotic. Has been overused and is often no longer effective. Dosage is 5 cc per 100 lbs. body weight IM for five consecutive days. Must be refrigerated. Do NOT use this type of penicillin if Listeriosis or Goat Polio is suspected. I don't keep this penicillin in stock any longer.

Penicillin, Procaine (300,000 IU) - Procaine Penicillin must be used in double the normal dosage in conjunction with Thiamine (Vitamin B1) in the treatment of Listeriosis and Goat Polio. At normal 5 cc per 100 lb dosing, it is also used to treat infection resulting from injuries, bites, and after difficult birthings. Over-the-counter product right now but soon to be vet prescription. Must be refrigerated. Always have lots of this product on hand.

Peppermint Oil Cream (Cai-Pan) - Topical application for congested and/or mastitic udders.

Pepto Bismol (pink bismuth) - Over-the-counter product to help with irritation/distress caused by diarrhea in both kids and adults. Before using Pepto-Bismol when diarrhea is present, first determine the cause of the problem. Diarrhea is a symptom of many problems, not an illness in itself its presence can be helpful in instances like overeating disease. Use up to 2 cc every four to six hours for newborns 5 cc for kids approaching one month old as much as 10 to 15 cc for adults. See my article on Diarrhea on the Articles page of www.tennesseemeatgoats.com .

Pirsue - Vet prescription mastitis medication. Expensive but excellent product.

Pneumonia Vaccines: Presponse HM and Poly Bac Somnus - Both vaccines are newer than and provide better protection against pneumonia than the Colorado Serum product mentioned below they are also more expensive. I use Presponse HM and the dosage is 1 cc for goats under 60 lbs and 2 cc for goats over 60 lbs, with a two injections 21 to 30 days apart the first time and annually thereafter. The extra cost is reduced by the lesser amount of vaccine needed for the 60 lb & under goats. If pneumonia is a problem in your herd, use these newer products.

Pneumonia Vaccine (Mannheimia Haemolytica Pasteurella Multocide Bacterin) - Over-the-counter injectable pneumonia vaccine by Colorado Serum. This is a very old vaccine made for goats but it isn't very effective. Requires two initial injections of 2 cc each 30 days apart for all young goats and any new purchases brought onto the property regardless of age, then booster annually thereafter. Give first injection in conjunction with first deworming and first CD/T vaccination. Repeat 30 days later then annually thereafter. Dosage is 2 cc for all goats, regardless of age, sex, weight, or breed.

Polyserum or Bovi Sera - Over-the-counter injectable immune system boosters. Give SQ. Use with any ill or unthrifty goat. Give to young kids that did not receive adequate colostrum.

Primor (Sulfadimethoxine & Ormetoprim in 5:1 ratio)- Vet prescription . Oral sulfa-based antibiotic. Tablets sized by weight of animal for gut-related infections, including Coccidiosis. Tablets are scored by animal weight for easy dosing. Primor 120 is for 5-15 lb goats Primor 240, 10-30 lb goats Primor 600, 25-50 lb goats and Primor 1200, 50-100 lb goats. Give two times the appropriate weight's dosage the first day, and then dose to the goat's weight for the next 9 consecutive days.

Probiotics, Oral - Over-the-counter oral ruminant gel which should be used after the completion of antibiotic therapy, treatment for diarrhea (scours), and daily when goats are in shipment. Helps lessen stress and settle the stomach. Keep refrigerated in warm climates.

Proplyene Glycol - Over-the-counter liquid for ketosis in does. Provides quick energy. Comes in one-gallon jugs. Use 50-60 cc orally very slowly twice a day for an average-sized adult doe until she begins eating. Mix with Goat Nutri Drench or Karo syrup so the goat can taste it and know to swallow. If this product is not available, use molasses or Karo syrup. Freezes at temperatures well above 32*F, so store indoors under controlled temperature.

Rally or Recovr - Injectable antihistamine for toxicity problems. Vet prescription.

Red Cell - Over-the-counter flavored oral iron supplement made for horses. Dosage is 4 cc orally given daily for at least 30 days. Use in treating anemia to rebuild red blood cells.

Resflor Gold - Prescription antibiotic that contains some Banamine. Resflor Gold supposedly has a long-acting effect, reducing required number of injections. However, goats MUST have antibiotics daily for 5 consecutive days because of fast metabolism. Use Nuflor Gold instead.

Robitussin DM - Over-the-counter oral medication for humans that helps with chest congestion, even when caused by onset pneumonia, with goats. MUST be used in conjunction with appropriate injectable antibiotic like Nuflor Gold or Excenel RTU.

Safeguard (Panacur) dewormer - White-colored dewormer. No longer kills stomach worms in most of USA. Used to kill tapeworms. Used to treat Meningeal Deerworm infection.

Spectoguard ScourChek - If still available, this prescription sulfa-based antibiotic product to control diarrhea in kids. Usage with adult goats may stop the peristaltic action of the gut. Follow label directions when dosing this pinkish-red liquid into the goat's mouth. Do NOT stop scouring until you figure out the cause diarrhea can be helpful in eliminating toxins.

Sterile Water - Vet prescription. Used in mixing medications.

Sulfadimethoxazine with Trimethoprim (SMZ) - Sulfa-based oral prescription antibiotic. Available in liquid and tablets. I use liquid SMZ with kids and the big easily-dissolved tablets with adults. Use to treat watery diarrhea and other gut-related illnesses. Used with Baytril 100, SMZ is synergistic (better than by itself) in treating E Coli and other difficult to cure infections. Excellent product. Must have in stock in your medicine chest.

Synergized DeLice or generic equivalent - Over-the-counter product. This permethrin-based oily liquid should be applied topically along the backbone from base of neck to base of tail. (This back drench works on goats because external parasites are the target back drenches don't work for treating internal parasites like stomach worms.)

Follow the directions carefully, and do not use on kids under 3 months of age and pregnant does. Topical back drench dosage should never exceed 3 ounces on the biggest and heaviest of goats. I use a reclaimed permanent wave squeeze bottle with applicator tip to apply this product. The bottle tip is just the right size.

For kids under three months of age and pregnant does, use a kitten-safe or puppy-safe powdered flea control product or carefully apply 5% Sevin dust. These products contain pyrethrins, which are much safer for very young animals. Cylence is a comparable topical product used to kill lice on adult goats.

Tagamet - Over-the-counter product for gut-related pain resulting from illnesses like coccidiosis. Dosage is one half of a Tagamet HR200 (200 mg) for 3-5 days.

Terramycin - Over-the-counter product. Opthalmic ointment used to treat Pinkeye, particularly in ulcerated eyes.

Tetanus Anti-toxin - Over-the-counter product for immediate and short-term protection against tetanus (lockjaw) when the problem exists. Tetanus is fatal if not promptly treated. Comes in single-dose 1500 unit vials use the entire 1500 unit vial IM for adults use half the 1500 unit vial for kids. No sooner than five days after this medication is last used, you must re-vaccinate with tetanus toxoid or CD/T (the complete two-injection series given 30 days apart) to reinstate long-term protection. Keep refrigerated.

Theodur - Vet prescription. Used to clear air passages when bronchitis exists. Precise dosage is not known for goats, but I have, under vet direction and supervision, used 1/2 tablet per day on a 15-20 pound kid. Theodur suppresses the appetite you must make sure that the animal is kept hydrated.

Thiamine (Vitamin B1) - Vet prescription. Strength must be 200 mg/ml. Used with any goat that is off-feed. Also used to treat goat polio and listeriosis. Dosage is 4 cc per 100 pounds bodyweight up to three times per day IM, or SQ.

Thrush Buster - Topical product to treat and prevent hoof scald (between toes).

ToDay (cephapirin sodium) - Over-the-counter product for mastitis treatment in lactating does. Milk out the udder and infuse one tube of To-Day into each teat for three to five consecutive days. Use the alcohol wipe provided to clean the teat thoroughly before infusing medication to avoid introducing new bacteria into an already-infected udder.

Toltrazuril - This is a close "relative" of the expensive Marquis and Baycox for treating Coccidiosis. I have never used it but am told but several goat producers that they find it quite effective, dosing one time at one cc per five pounds body weight. It is a one-time oral dosage of 1 cc per 5 lbs bodyweight preventative and 1 cc per 3 lbs bodyweight curative treatment.

ToMorrow (cephapirin benzathine) - Over-the-counter treatment for mastitis in dry does.

Triple Antibiotic Opthalmic Ointment - Vet prescription. Use topically to treat Pinkeye, particularly in ulcerated eyes.

Tylan 200 (tylosin) - Over-the counter antibiotic for respiratory problems. Use 1 cc per 25 lbs. body weight for five consecutive days intramuscularly (IM). The prescription products Nuflor Gold and Excenel RTU are far more effective than Tylan 200. I don't use this product.

Universal Animal Antidote Gel - Give orally when toxicity is suspected or diagnosed.

Valbazen - Over-the-counter white-colored dewormer. Can cause abortions in pregnant does if used in first trimester of pregnancy. For safety, never use on pregnant does. Kills tapeworms does NOT kill stomach worms. Dosage is 1 cc per 25 lbs. bodyweight given orally.

Vitamin B1 (thiamine) - Vet prescription. See Thiamine for uses and dosages.

Vitamin B-12 - Vet prescription. This red-colored injectable liquid is essential for use with goats who are anemic. Stimulates appetite. Administer 4 cc per 100 lbs. body weight IM.

All medications should be stored inside in a temperature-controlled environment away from sunlight. Some medications also require refrigeration.

This listing is not comprehensive, but is a good overview of medications available for goat health problems. I am NOT a vet. I do NOT encourage anyone to use these products and/or dosages without supervision and direction of a veterinarian. I encourage goat producers to find a qualified goat vet and develop a working relationship with that professional. This is what has worked for me with my goats. Many variables can affect the usefulness of this information, some of which may include breed, sex, age, nutritional and reproductive status of the goat, climatic conditions and general cleanliness under which the goats live, knowledge and skills possessed by the goat producer, and a host of other items. Consider this listing to be a guide. Remember, what works for me may NOT work for you in your goat-production operation.

Suzanne W. Gasparotto, ONION CREEK RANCH, Texas Revised 11.1.20

Important! Please Read This Notice!

All information provided in these articles is based either on personal experience or information provided by others whose treatments and practices have been discussed fully with a vet for accuracy and effectiveness before passing them on to readers.

In all cases, it is your responsibility to obtain veterinary services and advice before using any of the information provided in these articles. Suzanne Gasparotto is not a veterinarian.Neither tennesseemeatgoats.com nor any of the contributors to this website will be held responsible for the use of any information contained herein.

The author, Suzanne Gasparotto, hereby grants to local goat publications and club newsletters, permission to reprint articles published on the Onion Creek Ranch website under these conditions: THE ARTICLE MUST BE REPRODUCED IN ITS ENTIRETY AND THE AUTHOR'S NAME, ADDRESS, AND CONTACT INFORMATION MUST BE INCLUDED AT THE BEGINNING OF THE REPRINT. We would appreciate notification from any clubs or publications when the articles are used. (A copy of the newsletter or publication would also be a welcome addition to our growing library of goat related information!)

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Contents

The 2018 book 'Pharming animals: a global history of antibiotics in food production (1935–2017)' [21] summarises the central role antibiotics have played in agriculture: "Since their advent during the 1930s, antibiotics have not only had a dramatic impact on human medicine, but also on food production. On farms, whaling and fishing fleets as well as in processing plants and aquaculture operations, antibiotics were used to treat and prevent disease, increase feed conversion, and preserve food. Their rapid diffusion into nearly all areas of food production and processing was initially viewed as a story of progress on both sides of the Iron Curtain."

To retrace, while natural antibiotics or antibacterials were known to ancient man, antibiotics as we know them came to the fore during World War II to help treat war time casualties. It is recorded that antibiotics were first used in farming towards the end of the war, in the form of intra-mammary penicillin preparations to treat bovine mastitis. [22] At that time, milk was seen as an agricultural product which was highly susceptible to bacterial contamination, and farmers welcomed the opportunity to 'purify' their produce for the safety of consumers it was only later that concern switched from the bacterial load of the product to the residues that might result from untimely or unregulated treatment. [23]

The use of antibiotics to treat and prevent disease has followed a similar path to that used in human medicine in terms of therapeutic and metaphylactic [1] applications to treat and manage disease and improve population health, and the application of case-by-case strategic preventative treatments when animals are deemed at particular risk. However, in the late 1940s, studies examining the supplementation of B12 in chicks' diets found that B12 produced from the fermentation of Streptomyces aureofaciens, an antibiotic for use in human medicine, produced a better weight gain for chicks than B12 supplied from other sources, and a reduced amount of feed to bring the birds to market weight. [24] Further studies on other livestock species showed a similar improved growth and feed efficiency effect with the result that as the cost of antibiotics came down, they were increasingly included at low ('sub-therapeutic') levels in livestock feed as a means of increasing production of affordable animal protein to meet the needs of a rapidly-expanding post-war population. [22] This development coincided with an increase in the scale of individual farms and the level of confinement of the animals on them, and so routine preventative antibiotic treatments became the most cost-effective means of treating the anticipated disease that could sometimes arise as a result. [22] Veterinary medicine increasingly embraced the therapeutic, metaphylactic and strategic preventative use of antibiotics to treat disease. The routine use of antibiotics for growth stimulation and disease prevention also grew.

In 1910 in the United States, a meat shortage resulted in protests and boycotts. [25] [26] After this and other shortages, the public demanded government research into stabilization of food supplies. [25] Since the 1900s, livestock production on United States farms has had to rear larger quantities of animals over a short period of time to meet new consumer demands. It was discovered in the 1940s that feeding subtherapeutic levels of antibiotics improved feed efficiency and accelerated animal growth. [27] Following this discovery, American Cyanamid published research establishing the practice of using antibiotic growth promoters. [25] By 2001, this practice had grown so much that a report by the Union of Concerned Scientists found that nearly 90% of the total use of antimicrobials in the United States was for non-therapeutic purposes in agricultural production. [28] Certain antibiotics, when given in low, subtherapeutic doses, are known to improve feed conversion efficiency (more output, such as muscle or milk, for a given amount of feed) and may promote greater growth, most likely by affecting gut flora. [29] The drugs listed below can be used to increase feed conversion ratio and weight gain, but are not legally allowed to be used for such purposes any longer in the United States. Some drugs listed below are ionophores, which are coccidiostats and not classified as antibiotics in many countries they have not been shown to increase risk of antibiotic-resistant infections in humans.

Antibiotic Growth Promoters historically used in Livestock Production in some countries
Drug Class Livestock
Bacitracin Peptide Beef cattle, chickens, swine, and turkeys promotes egg production in chickens [30] [31]
Bambermycin Beef cattle, chickens, swine, and turkeys. [30] [31]
Carbadox Swine [30]
Laidlomycin Beef cattle [30]
Lasalocid Ionophore Beef cattle [30] [31]
Lincomycin Chickens and swine [30]
Monensin Ionophore Beef cattle and sheep promotes milk production in dairy cows [30] [31]
Neomycin/ Oxytetracycline Beef cattle, chickens, swine, and turkeys [30]
Penicillin Chickens, swine, and turkeys [30]
Roxarsone Chickens and turkeys [30]
Salinomycin Ionophore
Tylosin Chickens and swine [30]
Virginiamycin Peptide Beef cattle, chickens, swine, turkeys [30] [31]

The practice of using antibiotics for growth stimulation has been deemed problematic for these following reasons: [32]

  • It is the largest use of antimicrobials worldwide
  • Subtherapeutic use of antibiotics results in bacterial resistance
  • Every important class of antibiotics are being used in this way, making every class less effective
  • The bacteria being changed harm humans

Mechanisms for the development of resistance Edit

Antibiotic resistance - often referred to as antimicrobial resistance (AMR) although this term covers anti-virals, anti-fungals and other products - can occur when antibiotics are present in concentrations too low to inhibit bacterial growth, triggering cellular responses in the bacteria that allow them to survive. These bacteria can then reproduce and spread their antibiotic-resistant genes to other generations, increasing their prevalence and leading to infections that cannot be healed by antibiotics. [33] This is a growing matter of concern as antibiotic resistance is considered to be a serious future threat to human welfare. [10] Infectious diseases are the third leading cause of death in Europe and a future without effective antibiotics would fundamentally change the way modern medicine is practised. [10] [12]

Bacteria can alter their genetic inheritance through two main ways, either by mutating their genetic material or acquiring a new one from other bacteria. The latter being the most important for causing antibiotic-resistant bacteria strains in animals and humans. One of the methods bacteria can obtain new genes is through a process called conjugation which deals with transferring genes using plasmids. These conjugative plasmids carry a number of genes that can be assembled and rearranged, which could then enable bacteria to exchange beneficial genes among themselves ensuring their survival against antibiotics and rendering them ineffective to treat dangerous diseases in humans, resulting into multi-drug resistant organisms. [34]

However, it is important to note that antibiotic resistance also occurs naturally, as it is a bacterium's response to any threat. As a result, antibiotic-resistant bacteria have been found in pristine environments unrelated to human activity such as in the frozen and uncovered remains of woolly mammoths, [35] in the polar ice caps [36] and in isolated caves deep underground. [37]

High priority antibiotics Edit

The World Health Organization (WHO) published a revised list in 2019 of 'Critically Important Antimicrobials for Human Medicine, 6th revision' [38] with the intent that it be used "as a reference to help formulate and prioritise risk assessment and risk management strategies for containing antimicrobial resistance due to human and non-human antimicrobial use to help preserve the effectiveness of currently available antimicrobials. It lists its Highest Priority Critically Important Antimicrobials as: 3rd, 4th and 5th generation cephalosporins, glycopeptides, macrolides and ketolides, polymyxins including colistin, and quinolones including fluoroqinolones.

The European Medicines Agency (EMA) Antimicrobial Advice Ad Hoc Expert Group (AMEG) also published an updated categorisation [39] of different antibiotics in veterinary medicine by the antibiotic resistance risk to humans of using them alongside the need to treat disease in animals for health and welfare reasons. The categorisation specifically focuses on the situation in Europe. Category A (‘Avoid’) antibiotics are designated as ‘not appropriate for use in food producing animals’. Category B (‘Restrict’) products, also known as Highest Priority Critically Important Antibiotics, are only to be used as a last resort. These include quinolones (such as fluoroquinolones), 3rd and 4th generation cephalosporins, and polymyxins, including colistin. A new intermediate Category C (‘Caution’) has been created for antibiotics which should be used when there is no available product in Category D (‘Prudence’) that would be clinically effective. Category C includes macrolides and aminoglycosides, with the exception of spectinomycin, which remains in Category D.

Evidence for the transfer of macrolide-resistant microorganisms from animals to humans has been scant, [40] [41] and most evidence shows that pathogens of concern in human populations originated in humans and are maintained there, with rare cases of transference to humans. Macrolides are also extremely useful in the effective treatment of some Mycoplasma species in poultry, Lawsonia in pigs, respiratory tract infections in cattle and in some circumstances, lameness in sheep. [39]

Sources of antibiotic resistance Edit

Summary Edit

While the human medical use of antibiotics is the main source of antibiotic resistant infections in humans, [42] [43] [44] it is known that humans can acquire antibiotic resistance genes from a variety of animal sources, including farm animals, pets and wildlife. [45] [46] [47] [48] Three potential mechanisms by which agricultural antibiotic use could lead to human disease have been identified as: 1 - direct infection with resistant bacteria from an animal source 2 - breaches in the species barrier followed by sustained transmission in humans of resistant strains arising in livestock 3 - transfer of resistance genes from agriculture into human pathogens. [49] While there is evidence of transmission of resistance from animals to humans in all three cases, either the scale is limited or causality is hard to establish. As Chang et al (2014) [49] state: "The topic of agricultural antibiotic use is complex. As we noted . many believe that agricultural antibiotics have become a critical threat to human health. While the concern is not unwarranted, the extent of the problem may be exaggerated. There is no evidence that agriculture is ‘largely to blame’ for the increase in resistant strains and we should not be distracted from finding adequate ways to ensure appropriate antibiotic use in all settings, the most important of which being clinical medicine."

Direct contact with animals Edit

In terms of direct infection with resistant bacteria from an animals source, studies have shown that direct contact with livestock can lead to the spread of antibiotic-resistant bacteria. The risk appears greatest in those handling or managing livestock, for example in a study where resistant bacteria were monitored in farm labourers and neighbours after chickens receiving an antibiotic in their feed. [50] Manure may also be contain antibiotic-resistant Staphylococcus aureus bacteria which can infect humans. [51] [52] In 2017, the WHO included methicillin-resistant S. aureus (MRSA) in its priority list of 12 antibiotic-resistant bacteria, urging the need to search for new and more effective antibiotics against it. There also has been an increase in the number of bacterial pathogens resistant to multiple antimicrobial agents, including MRSA, which have recently emerged into different lineages. Some of them are associated with livestock and companion animals that are then able to be transmitted to humans, also called livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA). These new lineages can be found on soft tissues of livestock workers, for example in their noses. A study looked at the association between exposure to livestock and the occurrence of LA-MRSA infection and observed that LA-MRSA infection was 9.64 times as likely to be found among livestock workers and veterinarians compared to their unexposed families and community members, showing that exposure to livestock significantly increases the risk of developing methicillin-resistant Staphylococcus aureus (MRSA) infection. [53] [54] While total numbers colonised by LA-MRSA remain low, and fewer still suffer infection, [55] [56] the condition is nonetheless rising in prevalence, difficult to treat, and has become a public health concern. [57]

Foodborne antibiotic resistance Edit

Another way humans can be exposed to antibiotic-resistant bacteria is by pathogens on food. [58] In particular, If resistant bacteria are ingested by humans via food and then colonise the gut, they can cause infections which are unpleasant enough in themselves, but can be even harder to treat if they are serious enough to require antibiotic treatment but are also resistant to commonly-used antibiotics. [47] [59] Campylobacter, Salmonella, E. coli and Listeria species are the most common foodborne bacteria. [60] Salmonella and Campylobacter alone account for over 400,000 Americans becoming sick from antibiotic-resistant infections every year. [61] [62] Dairy products, ground minced beef and poultry are among the most common foods that can harbour pathogens both resistant and susceptible to antibiotics, [63] and surveillance of retail meats such as turkey, chicken, pork and beef have found Enterobacteriaceae. While some studies have established connections between antibiotic resistant infections and food-producing animals, [64] [65] others have struggled to establish causal links, even when examining plasmid-mediated resistance. [66] [67] [68] [69] Standard precautions such as pasteurising, or preparing and cooking meat properly, food preservation methods, and effective hand washing can help eliminate, decrease, or prevent spread of and infection from these and other potentially harmful bacteria. [70] [71]

Other sources of resistance Edit

As well as via food, E. coli from a variety of sources can also cause urinary and bloodstream infections. While one study suggests a large proportion of resistant E. coli isolates causing bloodstream infections in people could emanate from livestock produced for food, [72] other studies have since contradicted this, finding little commonality between resistance genes from livestock sources and those found in human infections, even when examining plasmid-mediated resistance. [73] [74] [68]

The use of antibiotics in livestock also has the potential to introduce antibiotic-resistant bacteria to humans via environmental exposure or inhalation of airborne bacteria. Antibiotics given to livestock in sub-therapeutic concentrations to stimulate growth when there is no diagnosis of disease - a practice still permitted in some countries - may kill some, but not all, of the bacterial organisms in the animal, possibly leaving those that are naturally antibiotic-resistant in the environment. Hence the practice of using antibiotics for growth stimulation could result in selection for resistance. [75] [76] Antibiotics are not fully digested and processed in the animal or human gut, therefore, an estimated 40 to 90% of the antibiotics ingested are excreted in urine and/or faeces. [77] [78] This means that as well as finding antibiotics in human sewage and animal manure, both can also contain antibiotic-resistant bacteria which have developed in vivo or in the environment. When animal manures are stored inadequately or applied as fertiliser, this can then spread bacteria to crops and into run-off water. [4] [77] Antibiotics have been found in small amounts in crops grown in fertilised fields, [79] and detected in runoff from animal waste-fertilised land. [80] Composting has been shown to reduce the presence of various antibiotics by 20-99%, [77] but one study found that chlortetracycline (CTC), an antibiotic used in livestock feed in China, degraded at different rates dependent on the animal it was fed to, and that manure composting was not sufficient to ensure the microbial degradation of CTC. [81]

In 2017, the World Health Organization (WHO) recommended reducing antibiotic use in animals used in the food industry. Due to the increasing risk of antibiotic resistant bacteria, the WHO strongly suggested restrictions on antibiotics being used for growth promotion and antibiotics used on healthy animals. Animals that require antibiotics should be treated with antibiotics that pose the smallest risk to human health. [16] HSBC also produced a report in October 2018 warning that the use of antibiotics in meat production could have “devastating” consequences for humans. It noted that many dairy and meat producers in Asia and the Americas had an economic incentive to continue high usage of antibiotics, particularly in crowded or unsanitary living conditions. [82]

However, the World Organisation for Animal Health has acknowledged the need to protect antibiotics but argued against a total ban on antibiotic use in animal production. [83] A total ban on antibiotics might drastically reduce protein supply in some parts of the world, [84] and when use of antibiotics is reduced or eliminated in livestock through legislation or voluntarily, both animal health and welfare and economic impacts can be negatively affected. [85] [86] For example, experiences from farms where antibiotic use has been cut back or eliminated in the interests of meeting a consumer demand for 'antibiotic-free' or 'reared without antibiotics' produce have been shown to have a detrimental effect on animal health and welfare. [87] [88] [89] When antibiotics are used sub-therapeutically (for animal performance, increased growth, and improved feed efficiency), then the costs of meat, eggs, and other animal products are lowered. [90] One big argument against the restriction of antibiotic use is the potential economic hardship that would result for producers of livestock and poultry that could also result in higher cost for consumers. In a study analysing the economic cost of the FDA restricting all antibiotic use in animal livestock, it was estimated that the restriction would cost consumers approximately $1.2 billion to $2.5 billion per year. [90] In order to determine the overall economic impact of restricting antibiotic use, the financial cost must be weighed against the health benefits to the population. Since it is difficult to estimate the value of potential health benefits, the study concluded that the complete economic impact of restricting antibiotic use has not yet been determined. [90]

Although quantifying health benefits may be difficult, the economic impact of antibiotic restriction in animals can also be evaluated through the economic impact of antibiotic resistance in humans, which is a significant outcome of antibiotic use in animals. The World Health Organization identifies antibiotic resistance as a contributor to longer hospital stays and higher medical costs. [91] When infections can no longer be treated by typical first-line antibiotics, more expensive medications are required for treatment. When illness duration is extended by antibiotics resistance, the increased health care costs create a larger economic burden for families and societies. [91] The Center for Infectious Disease Research and Policy estimates approximately $2.2 billion in antibiotic resistance- related healthcare costs each year. [92] So while restricting antibiotics in animals causes a significant economic burden, the outcome of antibiotic resistance in humans that is perpetuated by antibiotic use in animals carries comparable economic burdens.

The use of medicines to treat disease in food-producing animals is regulated in nearly all countries, although some countries prescription-control their antibiotics, meaning only qualified veterinary surgeons can prescribe and in some cases dispense them. [93] Historically, the restrictions have existed to prevent contamination of mainly meat, milk, eggs and honey with chemicals that are in any way harmful to humans. Treating a sick animal with medicines may lead the animal product containing some of those medicines when the animal is slaughtered, milked, lays eggs or produces honey, unless withdrawal periods are adhered to which stipulate a period of time to ensure the medicines have left the animal's system sufficiently to avoid any risk. [94] Scientific experiments provide data for each medicine in each application, showing how long it is present in the body of an animal and what the animal's body does to metabolise the medicine. By the use of 'drug withdrawal periods' before slaughter or the use of milk or eggs from treated animals, veterinarians and animal owners ensure that the meat, milk and eggs is safe and free of any contamination. [95] However, some countries have also banned or heavily controlled routine use of antibiotics for growth stimulation or the preventative control of disease arising from deficiencies in management or facilities. This is not over concerns about residues, but about the growth of antibiotic resistance.

Brazil Edit

Brazil is the world's largest exporter of beef. The government regulates antibiotic use in the cattle production industry. [96]

Canada Edit

Because of concerns about antibiotics residues getting into the milk or meat of cattle, the Canadian Food Inspection Agency (CFIA) enforces standards which protect consumers by ensuring that foods produced will not contain antibiotics at a level which will cause harm to consumers. In Canada the veterinary drug regulation consists of two federal government agencies, namely Health Canada and the CFIA, which are responsible for implementing and enforcing the Food and Drugs Act. Testing samples for drug residues include three methods: monitoring, surveillance, and compliance. There are Swab Test On Premises (STOP) procedures to detect antibiotic residues in kidney tissues. [97]

China Edit

China produces and consumes the most antibiotics of all countries. [98] Antibiotic use has been measured by checking the water near factory farms in China [99] [100] as well as through animal faeces. [101] It was calculated that 38.5 million kg (or 84.9 million lbs) of antibiotics were used in China's swine and poultry production in 2012. [102] The abuse of antibiotics caused severe pollution of soil and surface water in Northern China. [103]

In 2012, U.S. News & World Report described the Chinese government's regulation of antibiotics in livestock production as "weak". [104]

On the UK 5-Year Antimicrobial Resistance (AMR) Strategy 2013–2018, the importance of addressing AMR negative effects on animal health has been considered as same as human health. Several scientific partnerships with low-middle income countries would be established. [105] UK-China Newton fund has started to build multi-discipline collaboration cross the border to stop the increasing global burden caused by AMR. [106] To achieve the goal of citizen public health and food safety, “The National action Plan on Controlling Antibiotic-Resistance Bacteria on animal origins (2016-2020)” has been published by Ministry of Agriculture and Rural Affairs of People's Republic of China since 2017. This plan is fully integrated with the concept of one health. It covers not only the research and development, but also social context.

The following aims should be achieved by 2020: [107] [108]

  1. Implementation of Exit Plan, to encourage the drop of antibiotics as the growth promoters
  2. Regulation of drug market, to strengthen the registration and management of veterinary antibiotics
  3. Improvements on AMR surveillance system
  4. Strengthening on the testing of antibacterial residue
  5. Exemplification on effective models of decreasing the use on antibiotics
  6. Education on public and professions

European Union Edit

In 1999, the European Union (EU) implemented an antibiotic resistance monitoring program and a plan to phase out antibiotic use for the purposes of growth promotion by 2006. [109] The European Union banned the use of antibiotics as growth agents starting on 1 January 2006 with Regulation (EC) No 1831/2003. [110] In Germany, 1,734 tons of antimicrobial agents were used for animals in 2011 compared with 800 tons for humans. [ citation needed ] Sweden banned their use in 1986 and Denmark started cutting down drastically in 1994, now using 60% less. [111] In the Netherlands, the use of antibiotics to treat diseases increased after the ban on its use for growth purposes in 2006. [112]

In 2011, the European Parliament voted for a non-binding resolution that called for the end of the preventative use of antibiotics in livestock. [113]

A revised regulation on veterinary medicinal products, proposed in procedure 2014/0257/COD, proposed limiting the use of antibiotics in prophylaxis and metaphylaxis. An agreement on the regulation between the Council of the European Union and the European Parliament was confirmed on 13 June 2018, [114] [115] and the new Veterinary Medicines Regulation (Regulation (EU) 2019/6) is due to come into effect on 28 January 2022. [116]

India Edit

In 2011 the Indian government proposed a "National policy for containment of antimicrobial resistance". [117] Other policies set schedules for requiring that food producing animals not be given antibiotics for a certain amount of time before their food goes to market. [118] [119] A study released by Centre for Science and Environment (CSE) on 30 July 2014 found antibiotic residues in chicken. This study claims that Indians are developing resistance to antibiotics – and hence falling prey to a host of otherwise curable ailments. Some of this resistance might be due to large-scale unregulated use of antibiotics in the poultry industry. CSE finds that India has not set any limits for antibiotic residues in chicken and says that India will have to implement a comprehensive set of regulations including banning of antibiotic use as growth promoters in the poultry industry. Not doing this will put lives of people at risk. [120]

New Zealand Edit

In 1999 the New Zealand government issued a statement that they would not then ban the use of antibiotics in livestock production. [121] In 2007 ABC Online reported on antibiotic use in chicken production in New Zealand. [122] In 2017, New Zealand published a new action plan to address the ongoing concern of antimicrobial resistance (AMR). The action plan outlined five objectives with each objective looking both at AMR in humans and AMR in agriculture. [123] Compared to other countries, New Zealand has a very low prevalence of AMR in animals and plants. This is due to their low use of antibiotics in animal treatment. [124]

South Korea Edit

In 1998 some researchers reported use in livestock production was a factor in the high prevalence of antibiotic-resistant bacteria in Korea. [125] In 2007 The Korea Times noted that Korea has relatively high usage of antibiotics in livestock production. [126] In 2011, the Korean government banned the use of antibiotics as growth promoters in livestock. [127]

United Kingdom Edit

As with other countries in Europe, use of antibiotics for growth promotion was banned in 2006. [17] Less than one third of all antibiotics sold in the UK are now estimated to be used to treat or prevent disease in farmed animals, following a revision to the 2017 sales data published by the UK Government's Veterinary Medicines Directorate. [128] [129] Furthermore, 2018 sales data [130] estimated use at 29.5 mg antibiotics per kg of animal at time of treatment during that year. This represents a 53% reduction in sales of antibiotics to treat food-producing animals over five years. [131] The reduction has largely been achieved without legislation, and has been credited to voluntary industry action coordinated by the Responsible Use of Medicines in Agriculture (RUMA) Alliance [132] through a 'Targets Task Force' comprising a prominent veterinary surgeon and farmer from each livestock enterprise. [133] A European comparison of 2017 sales data found the UK had the fifth lowest sales in Europe during that year, with 2018 comparisons due to be released towards the end of 2020. [7]

While sales data give an overview of levels of use, products are often licensed for use in many species and therefore it is not possible to determine levels of use in different species without more specific usage data from each sector. In 2011, British Poultry Council members, representing 90% of the UK poultry meat industry, formed a stewardship programme that started recording antibiotics used to treat birds in the poultry meat sector in 2012. The first report was published in 2016 and reported a 44% reduction in antibiotic use between 2012 and 2015. [134] Since then, the organisation has produced three further reports, with the 2019 report confirming that the sector is maintaining reductions of over 80% in total use since it started its stewardship group, as well as reducing use of Highest Priority Critically Important Antibiotics by over 80% by stopping use of 3rd and 4th generation cephalosporins in 2012 and colistin in 2016, and only using macrolides and fluoroquinolones as a last resort. Preventative use of antibiotics has also stopped.

As many products are licensed for use in poultry and pigs, the increasing transparency around use in the UK poultry meat sector motivated the UK pig sector to set up a stewardship programme in 2016 [135] through the National Pig Association. In 2017, an electronic Medicine Book for pigs (eMB-Pigs) was launched by levy body Agriculture and Horticulture Development Board. [136] eMB-Pigs provides a centralised electronic version of the existing paper or electronic medicine book kept on farms, and allows pig producers to record and quantify their individual use of medicines for easy review with the veterinary surgeon, at the same time as capturing use on each farm so that data can be collated to provide national usage figures. After it became a requirement of Red Tractor farm assurance for pigs [137] that annual, aggregated records of antibiotic use must be logged on the eMB system, data released May 2018 showed that according to records covering 87% of the UK slaughter pig population, antibiotic use had halved between 2015 and 2017, [138] Data for 2018 confirms that overall antibiotic use in the UK pig sector fell further, by 60% from the estimated 2015 figure, [139] to 110 mg/kg. Use of Highest Priority Critically Important Antibiotics also fell to 0.06 mg/kg, [140] a reduction of 95% from 2015, with use of colistin almost nil.

As reported in an annual update of progress against UK targets, factors such as levels of infectious disease domestically or internationally, weather and vaccine availability can all affect antibiotic use. [141] For example, the Scottish salmon farming sector worked with Government and researchers to introduce a vaccine for the disease Furunculosis (Aeromonas salmonicida) in 1994, which significantly reduced the need for antibiotic treatments, [142] but the trout sector is still without an effective vaccine for this disease. Lack of data can also make it difficult for farmers to know they compare with their peers or what they need to focus on, a particular problem for the sheep and cattle sectors in the UK, which are in the process of trying to set up their own electronic medicines hub to capture data. [141] While unnecessary or inappropriate use is not acceptable, the UK takes a position that zero use is not necessarily desirable either. [143]

United States Edit

In 1970 the FDA first recommended that antibiotic use in livestock be limited but set no actual regulations governing this recommendation. [18] By 2001, the Union of Concerned Scientists estimated that more than 70% of the antibiotics consumed in the US were given to food animals (for example, chickens, pigs, and cattle), in the absence of disease. [144] [145]

In 2004 the Government Accountability Office (GAO) heavily critiqued the FDA for not collecting enough information and data on antibiotic use in factory farms. From this, the GAO concluded the FDA did not have enough information to create effective policy changes regarding antibiotic use. In response, the FDA said more research was being conducted and voluntary efforts within the industry would solve the problem of antibiotic resistance. [146] However, by 2011, a total of 13.6 million kg (30 million lb) of antimicrobials were sold for use in food-producing animals in the United States, [147] which represented 80% of all antibiotics sold or distributed in the United States. [148]

In March 2012, the United States District Court for the Southern District of New York, ruling in an action brought by the Natural Resources Defense Council and others, ordered the FDA to revoke approvals for the use of antibiotics in livestock that violated FDA regulations. [149] On 11 April 2012 the FDA announced a voluntary program to phase out unsupervised use of drugs as feed additives and convert approved over-the-counter uses for antibiotics to prescription use only, requiring veterinarian supervision of their use and a prescription. [150] [151] In December 2013, the FDA announced the commencement of these steps to phase out the use of antibiotics for the purposes of promoting livestock growth. [144] [152]

In 2015, the FDA approved a new Veterinary Feed Directive (VFD), an updated guideline giving instructions to pharmaceutical companies, veterinarians and producers about how to administer necessary drugs through the animal's feed and water. [153] Around the same time, the FDA published a report of antibiotics sold or distributed for food-producing animals which found that between 2009 and 2013, just over 60% were 'medically-important' drugs also used in humans [147] the rest were from drug classes like ionophores, which are not used in human medicine. [154] Following this, the FDA asked drug companies to voluntarily edit its labels to exclude growth promotion as an indication for antibiotic usage. It subsequently reports that “Under Guidance for Industry (GFI) #213, which went into effect Jan 1, 2017, antibiotics that are important for human medicine can no longer be used for growth promotion or feed efficiency in cows, pigs, chickens, turkeys, and other food animals.” [155] These new 2017 guidelines for instance prohibited using a drug off-label for non-therapeutic purposes, which would make using the re-labeled drug for growth enhancement illegal. In addition, some drugs were reclassified from 'Over the Counter' (OTC) to 'Veterinary Feed Directive' (VFD) VFD drugs require a veterinarian's authorization before they can be delivered in feed. [19] [20] [156] [153] As a result, the FDA reported a 33% decrease from 2016 to 2017 in domestic sales of medically important antibiotics for use in livestock. Despite this progress, the Natural Resources Defense Council (NRDC) remains concerned that sales of antibiotics to the beef and pork industries remain elevated in 2017 compared with the poultry industries, and their use could still primarily be for preventing diseases in healthy animals, which further increases the threat on antibiotic resistance. [157] However, the FDA policy remains the same as it stated in 2013: [153]

The key aspect of FDA's strategy is the request that animal drug sponsors (those who own the right to market the product) voluntarily work with FDA to revise the approved use conditions for their medically important antimicrobial drug products to remove production uses (such as growth enhancement or feed efficiency), and bring the remaining therapeutic uses under veterinary oversight. Once manufacturers voluntarily make these changes, products can no longer be used for production purposes and therapeutic use of these products would require veterinary oversight.

Because of concerns about antibiotics residues getting into the milk or meat of cattle, in the United States, the government requires a withdraw period for any animal treated with antibiotics before it can be slaughtered, to allow residue to exit the animal. [158]

Some grocery stores have policies about antibiotic use in the animal whose produce they sell. In response to consumer concerns about the use of antibiotics in poultry, Perdue removed all human antibiotics from its feed in 2007 and launched the Harvestland brand, under which it sold products that met the requirements for an "antibiotic-free" label. In 2012 in the United States advocacy organization Consumers Union organized a petition asking the store Trader Joe's to discontinue the sale of meat produced with antibiotics. [159] By 2014, Perdue had also phased out ionophores from its hatchery and began using the "antibiotic free" labels on its Harvestland, Simply Smart, and Perfect Portions products, [160] and by 2015, 52% of the company's chickens were raised without the use of any type of antibiotics. [161]

The CDC and FDA do not now support the use of antibiotics for growth promotion because of evidence suggesting that antibiotics used for growth promotion purposes could lead to the development of resistant bacteria. [61] In addition to this, The Pew Charitable Trusts has stated that "hundreds of scientific studies conducted over four decades demonstrate that feeding low doses of antibiotics to livestock breeds antibiotic-resistant superbugs that can infect people". [162] The FDA, the U.S. Department of Agriculture and the Centers for Disease Control and Prevention have all testified before Congress that there is a definitive link between the routine, non-therapeutic use of antibiotics in food animal production and the challenge of antibiotic resistance in humans." [163] However, the National Pork Board, a government-owned corporation of the United States, has said: "The vast majority of producers use (antibiotics) appropriately." [164] In 2011 the National Pork Producers Council, an American trade association, also said, "Not only is there no scientific study linking antibiotic use in food animals to antibiotic resistance in humans, as the US pork industry has continually pointed out, but there isn't even adequate data to conduct a study." [165] The statement was issued in response to a United States Government Accountability Office report that asserts: "Antibiotic use in food animals contributes to the emergence of resistant bacteria that may affect humans". [166]

It is difficult to set up a comprehensive surveillance system for measuring rates of change in antibiotic resistance. [167] The US Government Accountability Office published a report in 2011 stating that government and commercial agencies had not been collecting sufficient data to make a decision about best practices. [168] There is also no regulatory agency in the United States that systematically collects detailed data on antibiotic use in humans and animals, which means it is not clear which antibiotics are prescribed for which purpose and at what time. While this may be lacking at a regulatory level, the US poultry meat sector has been working on the issue of data collection itself, and has now reported comparative data showing significant reductions in antibiotic use. [169] Among the highlights in the report [170] was a 95% decrease in in-feed tetracycline use in broiler chicks from 2013 to 2017, a 67% reduction in in-feed use of tetracycline in turkeys, and a 42% drop in hatchery use of gentamicin in turkey poults. This is an encouraging sign the 53% overall reduction in antibiotic use seen in the UK between 2013 and 2018 [131] [130] was initiated from a voluntary stewardship programme developed by the UK poultry meat sector. [134]

Increasing concern due to the emergence of antibiotic-resistant bacteria has led researchers to look for alternatives to using antibiotics in livestock. [171]

Probiotics, cultures of a single bacteria strain or mixture of different strains, are being studied in livestock as a production enhancer. [172]

Prebiotics are non-digestible carbohydrates. The carbohydrates are mainly made up of oligosaccharides which are short chains of monosaccharides. The two most commonly studied prebiotics are fructooligosaccharides (FOS) and mannanoligosaccharides (MOS). FOS has been studied for use in chicken feed. MOS works as a competitive binding site, as bacteria bind to it rather than the intestine and are carried out. [173]

Bacteriophages are able to infect most bacteria and are easily found in most environments colonized by bacteria, and have been studied as well. [171]

In another study it was found that using probiotics, competitive exclusion, enzymes, immunomodulators and organic acids prevents the spread of bacteria and can all be used in place of antibiotics. [174] Another research team was able to use bacteriocins, antimicrobial peptides and bacteriophages in the control of bacterial infections. [175] While further research is needed in this field, alternative methods have been identified in effectively controlling bacterial infections in animals. All of the alternative methods listed pose no known threat to human health and all can lead the elimination of antibiotics in factory farms. With further research it is highly likely that a cost-effective and health-effective alternative could and will be found.

Other alternatives include preventative approaches to keep the animals healthier and so reduce the need for antibiotics. These include improving the living conditions for animals, stimulating natural immunity through better nutrition, increasing biosecurity, implementing better management and hygiene practices, and ensuring better use of vaccination. [84]


Livestock and Poultry Producers: Protect People and Animals

Antibiotic resistance happens when germs develop the ability to defeat the drugs designed to kill them.

Animals, like people, carry germs in their gut, including antibiotic-resistant germs. Resistant germs have been identified in poultry and livestock (e.g., cattle, swine, sheep, and goat) and the food they produce around the world. Antibiotics are valuable tools for treating infections in people and animals, but any time antibiotics are used bacteria can develop antibiotic resistance.

Livestock and poultry producers are key in helping to reduce the development and spread of antibiotic resistance. Adopting these practices to continue protecting the health of animals and people who work on farms, the community, and our food supply.

The Veterinary Feed Directive (VFD) are federal rules that limit the use of antibiotics that are important in treating human diseases in food-producing animals. Veterinarians are responsible for overseeing the use of antibiotics. See FDA&rsquos website external icon for more information.


Antibiotics For Animals May Work For You, But Experts Say It's A Terrible Idea 04:28

When phlegm invades Andy Shecktor’s face or chest, he says he knows if the culprit is a bacterial infection.

“You can taste them,” he says. “I get a sinus infection that requires antibiotics and a doc at least once a year.”

But on these occasions, Shecktor, a 63-year-old man from Berwick, Pennsylvania, doesn’t go see a doctor, and he doesn’t get a prescription for antibiotics.

Instead, he pulls out a stash of medicine from his fridge that is clearly marked &mdash not for human consumption. It's for fish.

“The penicillin used for fish and that sort of thing are actually the exact same pills [as antibiotics for humans],” Shecktor says.

So, he figures, if he has a bacterial infection, why not just take these instead of going through a doctor?

There are lots of reasons you shouldn't, medical professionals and researchers say. For one, medications are often formulated specifically for certain animals &mdash though not always &mdash and may not work in humans or even in other animal species, says Claire Fellman, a veterinary pharmacologist at Tufts University. Plus, she says, “There can be dangerous contaminants. And misuse of antibiotics or other medications can result in serious illness or breed resistance.”

Concerns about safety haven’t stopped people like Shecktor, who find acquiring antibiotics through conventional means &mdash a doctor’s visit and a prescription &mdash too troublesome.

“It’s not so much the cost as the availability,” Shecktor says. “It’s just the way the medical industry is these days. It’s just tough to get the care you need. It’s tough to get the medications you need. It’s tough to even see a doctor.”

About 15 years ago, Shecktor says doctors in his area began tightening their use of antibiotics in an effort to curb the growth of bacteria that no longer respond to most antibiotic treatment. Shecktor says he knows that's important &mdash antibiotic resistance costs more than 35,000 Americans their lives each year, according to the Centers for Disease Control and Prevention. Still, he hated the change.

“I get sick. I know that it’s a bacterial infection. The doctors know it. But they’re not [prescribing] the medications. It became frustrating,” he says. “Then I got deathly ill. I had bronchitis and a sinus infection, and it was absolutely terrible.”

Shecktor went to the doctor’s office, but he says they wouldn’t prescribe him antibiotics. They told to come back the following week if he was still sick, but Shecktor wasn’t going to wait that long.

At home, Shecktor already had bottles of penicillin. They were for his pets. He and his wife care for a “persnickety” aging feline named Muffy or &mdash sometimes &mdash Stuffy Tiger.

“That’s what she looks like,” he says.

They also have a large rabbit named Cinnabon, two guinea pigs, and they used to have a fish. The antibiotics were originally for the fish, but Shecktor used them on the guinea pigs once when they got sick, too.

Then, hacking with a chest infection, he took them himself. Shecktor says he did research online about how to use them, and they worked. He was better in a day. Now, he keeps fish antibiotics in his fridge all the time. He says he uses them about once a year.

“I’ve had great success with it actually,” he says.

Shecktor doesn’t believe personal use of antibiotics is a significant factor in the growth of antibiotic resistance. Instead, he blames the mass use of antibiotics in agriculture for that problem.

“It’s big agriculture, you know, cramming too many chickens, jamming in your pigs and your cows into small spaces then feeding them antibiotics," he says."Nine million, billion times as much of this same medication is being given to cows and other farm animals every day,” he says. “That’s the problem.”

It's hard to know for certain how many people take antibiotics made for animals, but in this part of rural Pennsylvania, Shecktor says there are plenty of residents who would rather use cheap, easy-to-obtain veterinary medications than go to a physician.

“A lot of people, especially in the poorest sections and on the farms, have been using [veterinary medications] for a long time,” he says.

They’re not the only ones. In 2002, three Army doctors wrote to the New England Journal of Medicine about soldiers taking veterinary antibiotics. They described one serviceman who recounted his purchase of antibiotics from the fish aisle of a local pet store.

“He went on to explain that this over-the-counter source of antibiotics is common knowledge among all branches of the American Special Forces,” they wrote.

“I have to admit that I, too, have used veterinary drugs on myself in the past,” says Sam Telford, an infectious disease researcher at Tufts University. “I didn’t go to the doctor because it’s a pain.”

Telford emphasizes that this is a bad idea, and he doesn't think anyone -- including himself &mdash should be doing it.

“This is one of those 'do as I say, not as I do things,'" Telford says. "Indiscriminate use of antibiotics not under the supervision of a physician is a threat."

Telford says he’s only used animal doxycycline, a strong antibiotic, because he knows that this antibiotic is the same in both veterinary and human medicine (“It’s the same factory that makes the stuff,” he says). Plus, Telford says, he knows how to properly use doxycycline, which he takes to avoid Lyme disease.

“I get bitten by ticks a lot. When I get bitten for more than 24 hours, I take a doxycycline,” he says. “And this isn’t unique among my colleagues either.”

But incorrect use of antibiotics can lead to undesirable outcomes, Fellman &mdash the veterinary pharmacologist &mdash warns. For example, it might pave the way for antibiotic resistant super-bacteria to colonize your body.

“[People] could definitely breed resistance in themselves,” she says.

Veterinary drugs are not always approved by the Food and Drug Administration, either. While the federal agency does regulate prescription drugs like the animal doxycycline Telford has used, over-the-counter animal medications &mdash like the fish antibiotics Shecktor uses -- are not checked by the FDA for safety or efficacy.

“This seems very concerning that the products [people are using] have not been tested for purity or safety," Fellman says. "Any recalls that the FDA undergoes won’t apply. They’re not policing any of these products. There could be dangerous contaminants that you would never know."

And veterinary medications might not always work on humans, Fellman points out, even those who know the correct dosage to take. Drugs, or the pill formulation containing the drug, can be tailored to the specific biology of a species.

“There are animal formulations, there are human formulations, and they are tested in those species,” Fellman says. “What works for a dog might not work for a human.”

This segment aired on November 26, 2019.

Reporter, CommonHealth
Angus Chen is a reporter for WBUR's CommonHealth.


Restrain the Beast

The first (and most important) aspect of administering an injection is animal restraint. Trying to treat an unrestrained beast is like trying to change a tire on a moving auto&ndashyou're as likely to get run over as you are to accomplish the job you set out to do.

Smaller critters can be held by an assistant while you stick 'em. Remember, though, that an animal's (or a man's, as I can attest) normal response to a sharp object in the rump is to buck, jump, kick, and just generally get the hell away from the pain. It helps to be ready for the inevitable.

Sometimes one person can both hold and inject a small goat, calf, or some such by forcing the little feller or gal against a sturdy fence with a knee while giving him or her a shot in the neck or thigh. A full-sized cow or bull, on the other hand, will require careful restraint techniques. Cattle should be held in a chute or tied to a strong fencepost and forced against the fence itself by a helper. Use a substantial halter or nose lead on each of the larger brutes and tie the animal to a sturdy fencepost rather than the fencing boards or wire. I've seen bulls snap the rope right off a nose lead, and I've watched (usually angrily) while cattle walked through 2 X 4 planks or barbed wire like it wasn't even there.

When there's no alternative you can sometimes take your "patient's" mind off his or her problems with a large mouthful of some particularly favored food. This is possible because many animals can't think over the noise of a growling stomach&mdasha handicap that is not unknown in human beings as well.

OK. Once you've provided yourself with a stationary target, it's time to clean the injection site. To completely disinfect a portion of an animal's anatomy you'd have to shave it and then soak the area in a 70-percent alcohol solution for several hours. Unless you're crazier than most folks, however, you'll settle for something short of perfection. Adequate cleansing can be accomplished by mechanically removing any dirt or crud with soap and water first, and then washing the site again with the alcohol solution.

Now then. It's a good idea at this point to take a minute to "think the way the critter thinks." It's almost certainly going to try to escape the hurt, and since you've restrained the animal and made flight impossible, it just might make an attempt to kick the pain away.

Sound medical practice dictates that one should avoid getting his own leg broken while injecting medication into a beast's caboose region. Station yourself north of any possible southbound hooves by placin' your body firmly against the animal's side or flank area.

Likewise, when a shot is given in the neck region, the front hooves become the logical means of protest. In such a case, press yourself close to the beastie's shoulder before injecting away.


Penicillin

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Penicillin, one of the first and still one of the most widely used antibiotic agents, derived from the Penicillium mold. In 1928 Scottish bacteriologist Alexander Fleming first observed that colonies of the bacterium Staphylococcus aureus failed to grow in those areas of a culture that had been accidentally contaminated by the green mold Penicillium notatum. He isolated the mold, grew it in a fluid medium, and found that it produced a substance capable of killing many of the common bacteria that infect humans. Australian pathologist Howard Florey and British biochemist Ernst Boris Chain isolated and purified penicillin in the late 1930s, and by 1941 an injectable form of the drug was available for therapeutic use.

The several kinds of penicillin synthesized by various species of the mold Penicillium may be divided into two classes: the naturally occurring penicillins (those formed during the process of mold fermentation) and the semisynthetic penicillins (those in which the structure of a chemical substance—6-aminopenicillanic acid—found in all penicillins is altered in various ways). Because it is possible to change the characteristics of the antibiotic, different types of penicillin are produced for different therapeutic purposes.

The naturally occurring penicillins, penicillin G (benzylpenicillin) and penicillin V (phenoxymethylpenicillin), are still used clinically. Because of its poor stability in acid, much of penicillin G is broken down as it passes through the stomach as a result of this characteristic, it must be given by intramuscular injection, which limits its usefulness. Penicillin V, on the other hand, typically is given orally it is more resistant to digestive acids than penicillin G. Some of the semisynthetic penicillins are also more acid-stable and thus may be given as oral medication.

All penicillins work in the same way—namely, by inhibiting the bacterial enzymes responsible for cell wall synthesis in replicating microorganisms and by activating other enzymes to break down the protective wall of the microorganism. As a result, they are effective only against microorganisms that are actively replicating and producing cell walls they also therefore do not harm human cells (which fundamentally lack cell walls).

Some strains of previously susceptible bacteria, such as Staphylococcus, have developed a specific resistance to the naturally occurring penicillins these bacteria either produce β-lactamase ( penicillinase), an enzyme that disrupts the internal structure of penicillin and thus destroys the antimicrobial action of the drug, or they lack cell wall receptors for penicillin, greatly reducing the ability of the drug to enter bacterial cells. This has led to the production of the penicillinase-resistant penicillins (second-generation penicillins). While able to resist the activity of β-lactamase, however, these agents are not as effective against Staphylococcus as the natural penicillins, and they are associated with an increased risk for liver toxicity. Moreover, some strains of Staphylococcus have become resistant to penicillinase-resistant penicillins an example is methicillin-resistant Staphylococcus aureus (MRSA).

Penicillins are used in the treatment of throat infections, meningitis, syphilis, and various other infections. The chief side effects of penicillin are hypersensitivity reactions, including skin rash, hives, swelling, and anaphylaxis, or allergic shock. The more serious reactions are uncommon. Milder symptoms may be treated with corticosteroids but usually are prevented by switching to alternative antibiotics. Anaphylactic shock, which can occur in previously sensitized individuals within seconds or minutes, may require immediate administration of epinephrine.


Search VetGRAM

Search our online database of uses, restrictions and required withdrawal times (WDT) for FDA drugs approved in food animal species.

Request ELDU Advice

If you are a licensed veterinarians, please use our FREE online submission form for questions regarding accidental chemical contamination or drugs used in an extralabel manner in food animals.

Digest WDI Search

FARAD-recommended Withdrawal Interval Recommendations for selected extra-label uses of a limited number of drugs.

Prohibited and Restricted Drugs

The FDA can limit the prohibition on extra-label use to specific species, indications, dosage forms, routes of administration, or a combination of these, as well as prohibit them from use in any food-producing animal.

Learn about the law, requirements, and restrictions of extra-label drug use.

A VFD Order is a written statement from a licensed veterinarian that authorizes a client to use a VFD drug.

Drug handling and species specific operation information for veterinarians, pharmacists and producers.

This database contains documents that have time versus concentration data for live animals with a focus on food animal species.

Definitions of use classes for Major Food Animal, Companion Animal and Minor Species, as defined by the FDA.

FARAD exists because of the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA).


Antibiotic Use And Resistance In Food Animals Biology Essay

This report contains an introduction to veterinary antibiotic use, resistance and why we should be concerned. It reviews the most recent literature discussing veterinary antibiotic use and resistance patterns in India. Following this is an overview of the current laws in India, the United States and the European Union with regard to the antibiotic use in food animals. The report concludes with a series of recommendations for reducing inappropriate use of veterinary antibiotics and the spread of antibiotic resistance.

This report was written at the request of the Ministry of Heath & Family Welfare, Government of India, as order number X.19029/07/2011-DFQC. The goal of this report is to summarize the available information on antibiotic use and resistance in food animals, review the current laws on animal antibiotic use in India and other countries, and to suggest policies that could be adopted by the government of India.

Antibiotic Use and Resistance

India is the world’s largest exporter of beef and milk, and the third largest producer of eggs and fish. In 2009-10, livestock and fishery industries were valued at Rs. 4,08,386 crore, of this export earnings from livestock and poultry totaled Rs. 19,036 crore. In 2009, 1.6 lakh livestock animals were reported to have been affected by bacterial infections including salmonellosis and mastitis.

Antibiotics are used to treat bacterial infections in both humans and animals. Antibiotics in food animals are used for prophylactic, therapeutic purposes as well as growth promotion (at sub-therapeutic levels). While all antibiotic use contributes to the development of resistance, inappropriate use by farmers contributes to the problem while reaping no benefit. Resistant bacteria in animals can spread to the human population mainly through the consumption of animal products. There is also weak evidence for the entry of un-metabolized antibiotics into the environment contributing to the spread.

There is little information on antibiotic use and few studies describe antibiotic resistance in India. Most research shows high levels of resistance in all veterinary sectors. More studies are required to determine veterinary antibiotic usage patterns.

Currently, only few laws exist pertaining to antibiotic use in food animals. The two laws for internal meat, chicken and fish consumption refer to withdrawal periods and maximum residue limits of certain antibiotics for seafood. As India is a major exporter of animals and animal products, there are more laws pertaining to antibiotic use in food animals for export. The creation of new and enforcement of existing laws, could slow down the spread of antibiotic resistance in both animal and consequently human populations.

The report suggests that changes be made through improving animal hygiene and living conditions, monitoring antibiotic use and resistance patterns through the setting up of a surveillance system and educating veterinarians and farmers on appropriate use of antibiotics. Subsidies and alternatives to antibiotics can help provide an incentive for farmers to lower their use of antibiotics. As little is known about the situation in India, more research is needed to paint a full picture. Funding for research and development on veterinary specific drugs that are not used in humans could also help reduce the spread of antibiotic resistance in humans. Lastly, but perhaps most importantly without new appropriate laws, and the enforcement of current laws, little progress will be made.

CHAPTER 1: Antibiotic Use and Resistance

A little more than seventy years ago, the first human infection was cured by penicillin. In the ensuing decades, antibiotics have tamed many bacterial illnesses that were once deadly to humans. The same is true with respect to agricultural animals: antibiotics have been a boon for treating and preventing their diseases.

Unfortunately, the story does not end there. Antibiotic use – both life-saving and unnecessary, and in humans and animals alike – has led bacteria through a natural course of evolution whereby they become resistant to the drugs that were developed to fight them. These antibiotic-resistant bacteria can infect both humans and animals, sometimes traveling from one to the other, both within and across national borders.

Antibiotic resistance is a global problem, but actions at the national and local levels can slow and even reverse the spread of antibiotic-resistant bacteria, thereby slowing the loss of antibiotic effectiveness over time. Although antibiotic use in humans contributes to the problem of resistance, a significant proportion of antibiotic use, hence resistance, is due to use in animals both for treating illnesses and for the purpose of "growth promotion" – the addition of a very low dose of antibiotics to animal feed, which makes animals put on weight more quickly than they would without the antibiotics. Countries in Europe and elsewhere in the world have regulated the use of antibiotics for growth promotion, and forces in the United States are pushing toward this goal. However, in much of the developing world, antibiotic use for growth promotion in farm animals is rising and threatens the effectiveness of the most affordable first-line drugs.

The Use of Antibiotics in Food Animals

No reliable estimates of the amount of antibiotics used in livestock in India are available, but it may be more than the amount used in humans, judging from practices in other countries. The main uses of antibiotics in animal are for prevention and treatment of disease. Therapeutic use is defined as the use of antibiotics to treat an infection caused by pathogenic bacteria. Non-therapeutic use includes prophylaxis (also referred to as "metaphylaxis") and growth promotion.

Antibiotics are used prophylactically, often continually, to prevent disease in herds or flocks. In crowded, dirty conditions, disease outbreaks can occur quickly and become deadly. Farmers may use antibiotics in place of improving sanitation and to allow more animals to be kept in smaller spaces. Antibiotic prophylaxis is also used pre- and post-surgery, prior to transportation, and at other times when animals are under stress, to prevent respiratory and intestinal ailments, and as "dry cow therapy" (antibiotic treatment between lactation periods to reduce the high risk of infection) (Michigan State University, 2011a). In aquaculture, antibiotics are used therapeutically and prophylactically—often in high concentrations due to the ease with which bacteria travel in water—but not for growth promotion

In livestock and poultry, antibiotics used for growth promotion are added to animal feed in low, sub-therapeutic doses. The observation that small doses of antibiotics could increase the rate of weight gain was first noted in the 1940s and the practice gained widespread use beginning in the early 1950s. The reason why antibiotics work to promote growth is not well understood, but a number of hypotheses have been put forward (Hughes & Heritage, 2004).

Antibiotic Resistance and its Spread

The development of bacterial resistance arises in two ways: (i) intrinsic resistance, which occurs when the bacterial species is able to innately resist the activity of an antibacterial agent (by preventing either the entry or binding of the antibacterial agent) and (ii) acquired resistance, which occurs when once susceptible bacterial species mutate or obtain genes from other bacteria, to acquire resistance (Figure 1). The speed at which bacteria multiply, as well as their exposure to a continuously changing environment, results in the development of naturally occurring mutations that reduce their sensitivity to antibiotics. Bacteria are also able to adapt to their environment by acquiring genetic material through plasmids and transposable elements from other species of bacteria. This is known as horizontal gene transfer (Serrano, 2005).

The use of antibiotics can lead to the development and spread of antibiotic resistance. Selection pressure on a bacterial population, such as that from antibiotics, can result in few surviving members who carry resistant genes (Figure 2). These bacteria then multiply, contributing to a growing population of bacteria with antibiotic resistant genes. Bacteria resistant to one type of antibiotic may exhibit resistance to related antibiotics. If robust enough, these bacteria can spread through a human population. "Antibiotic resistance cannot be prevented. Every time antibiotics are used, whether they save a life or are used to no effect (to treat viral rather than bacterial infections, for example), the effective lifespan of that antibiotic and perhaps related drugs is shortened

Multidrug resistant bacteria are resistant to more than two types of antibiotics. An example of this is methicillin-resistant Staphylococcus aureus (MRSA), which is resistant to all ß-lactam antibiotics including the penicillin and cephalosporin classes. Livestock are known to harbour MRSA, and these bacteria move easily to humans in close contact with infected or colonised animals. As animals infected by MRSA are often asymptomatic, the transfer of Livestock-Associated MRSA (LA-MRSA) to humans can go unnoticed

An instructive example of how using one antibiotic in animals can have a dramatic effect in humans involves the drugs avoparcin and vancomycin. Vancomycin is a last resort antibiotic, reserved for treating MRSA and other resistant infections. Avorparcin, an animal antibiotic related to vancomycin, was used for growth promotion in Europe. In the years following the introduction of avoparcin as a growth promoter, the increased use of avoparcin led to an increase in vancomycin-resistant enterococci (VRE) in humans. As a result, avoparcin is now banned in the European Union

Widespread resistance to antibiotics means that infections that were once easily treatable can become deadly (e.g., just over 30 percent of neonatal sepsis deaths in India are attributable to antibiotic resistance. This is of special concern to India, where the burden of infectious diseases is high and health care spending is low. In addition to causing increased morbidity and mortality, resistant infections are more expensive to treat than sensitive ones, often requiring longer hospital stays and pricier

Perhaps the most infamous antibiotic resistance gene is New Delhi metallo-ß-lactamase-1 (NDM-1). NDM-1 was first isolated from Klebsiella pneumoniae from a patient in 2008. The patient’s infection was resistant to all available antibiotics, including carbapenems, a class of antibiotics used as a last resort for highly-resistant infections The NDM-1 gene is carried on plasmids and can be transferred among a wide variety of bacterial species. It confers broad resistance to most antibiotics, including carbapenems (Deshpande et al., 2010). Since its discovery, NDM-1 has been found around the world, including major cities in India.

Uses of Antibiotics in Humans and Animals

The World Health Organization (WHO) defines three categories of antibiotic for human use: critically important, highly important and important (WHO, 2011). The criteria used by the WHO to classify antibiotics are:

An antimicrobial agent which is the sole, or one of limited available therapy, to treat serious human disease.

Antimicrobial agent is used to treat diseases caused by either: (1) organisms that may be transmitted to humans from non-human sources or, (2) human diseases caused by organisms that may acquire resistance genes from non-human sources.

Antibiotics classified as critically important meet both criteria, highly important antibiotics meet either criterion 1 or 2, and important antibiotics meet neither but are considered essential. Tables 1-3 list these antibiotics, noting their use in humans and in animals for therapy, prophylaxis and growth promotion. The tables (are not inclusive of all antibiotics, but provide examples in each class.

Antibiotic resistance genes can be transferred from animals to humans through contaminated soil and water, and through animal food products, such as milk and meat (figure 3)

Antibiotic use in animals, as in humans, creates selective pressure for resistant bacteria in the animal gut. In some cases, drug-resistant strains can move directly between humans and animals. In a recent example, an emerging strain of MRSA (clonal complex 398) originated in humans, was transmitted to pigs (where resistance emerged), and then transferred back to humans who were in close contact with the animals. Other cases in which farmers have acquired strains of bacteria resistant to the antibiotics used in their animals are reviewed by Van den Bogard and Stobberingh .

Consumption of animal food products and exposure to bacteria through animal-contaminated soil and water are also routes by which humans acquire antibiotic resistance genes.

Terracumulation and Antibiotics in Water

Terracumulation refers to the buildup of pollutants (including antibiotics) in soil over time and can happen as a result of the excretion of unmetabolized antibiotics given to animals (Rooklidge, 2004). Feces of antibiotic-fed livestock can contain unmetabolized antibiotics, which are then introduced to the soil and water. A study by Subbiah et al. found that ceftiofur used in animal feed can be responsible for selection of resistant Escherichia coli in contaminated soil .

Antibiotics and resistant bacteria entering water are also a concern, as the aquatic environment is thought to be the largest reservoir for antibiotic resistant genes (The Norwegian School of Veterinary Science, 2012). A recent study found antibiotic-resistant bacteria in fish that had not been subjected to treatment with antibiotics. The authors proposed that antibiotic residues from domestic farm and poultry waste are responsible for the presence of resistant bacteria.

Furthermore, antibiotics that enter soil and water can have damaging effects on the environment by killing off beneficial soil and water microbes. This shift in ecological contamination often goes unmonitored, and may not be realized until important aspects of the ecosystem are already damaged.

Some Aspects of Indian Livestock and Aquaculture Farming

Scale of Food Animal Farming

India is a top producer and exporter of animal meat and products. The Food and Agricultural Organization of the United Nations estimates that in 2011 there were 32.3 crore cattle and buffalo and 96.8 crore poultry birds in India. India was the world’s top beef exporter in 2012 and India’s share of the world’s beef exports is expected to rise from 20 percent to almost a quarter in 2013. Almost 4.2 lakh tonnes of beef are predicted to be produced in India in 2013, of which less than half will be consumed in India.

In 2006-2007, 10 crore tonnes of milk were produced, making India the largest producer of milk in the world (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011). India was the third largest producer of eggs in 2009-2010 with production of 5980 crore eggs per year (Ministry of Agriculture [Department of Animal Husbandry Dairying & Fisheries], 2011). 34 lakh tonnes of broiler meat is produced, almost of all of which is consumed domestically (USDA, 2012). Fish production has almost doubled in the last 10 years, and India is now the third largest producer of fish, producing 78 lakh tonnes of fish per year rying &ndof Paleontology Understanding Science Website. Retrieved Dec 15, 2013.

Economically, the livestock and fisheries department contributes to almost 30 percent of the annual earnings of the agriculture and allied sector. The fishery industry provides jobs for 14 million Indians. The value of the livestock and fisheries component during the 2009-10 fiscal year was Rs.4,08,386 crore. Of this, Rs. 3,40,473 crore came from the livestock sector and Rs.67,913 crore from fisheries. From livestock and poultry products alone, the total export earnings were Rs.19,036 crore rying &ndof Paleontology Understanding Science Website. Retrieved Dec 15, 2013. (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011).

The latest livestock and poultry census conducted in 2007 reveals that Tamil Nadu and Andhra Pradesh had the most poultry and Madhya Pradesh, Uttar Pradesh and West Bengal had the most beef cattle, while Uttar Pradesh was home to the largest number of buffalo. In 2007, there were 59,826 poultry farms in India, of which more than 90 percent were in rural areas. Tamil Nadu and Andhra Pradesh had the most fowl, followed by West Bengal and Maharashtra. There were about 4.1 crore dairy cattle in 2007, most of which were in rural areas. States with the most dairy cattle were Uttar Pradesh, Rajasthan, West Bengal and Tamil Nadu. In 2009-10 Andhra Pradesh and West Bengal had the greatest fish production and the most fishing villages were in Orissa and Tamil Nadu followed by Andhra Pradesh and Maharashtra. (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011).

Though there are a large number of food animals in India, most are raised on small farms with a handful of livestock each. Most of the farms are in rural and peri-urban areas (Shah Hossain, personal communication, January 11, 2013). While some commercial poultry farms, dairy, goat and pig farms exist, the majority of farming in India does not occur industrially. The most common types of livestock rearing are either mixed crop-livestock or pastoralism, neither of which are high volume operations.

Animal Health and Government Initiatives

Bacterial infections make up a significant proportion of animal illnesses. The reported number of bacterial infections in Indian livestock is summarized in the 2010-2011 report by the Department of Animal Husbandry, Dairying & Fisheries. In 2009, 120,923 Indian livestock animals had salmonellosis (7,129 died), 26,333 were affected by mastitis, 3,729 suffered from haemorrhagic septicaemia (1,595 died), 1109 were affected by black quarter (481 died) and 94 fell ill from brucellosis. In addition, enterotoxemia caused by Clostridium perfringens killed 533 animals and affected 2,167. These numbers may be underestimated, as reporting levels are unknown. (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011).

In order to mitigate the loss that farmers can incur as a result of a disease outbreak, the government has taken several initiatives. In 2008, they began offering livestock insurance in 300 districts to compensate against animal deaths. In addition, the government set up six quarantine centers. Imported animals found to be diseased are moved to one of six quarantine stations, located in New Delhi, Chennai, Mumbai, Kolkatta and airports in Hyderabad and Bangalore (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011).

In 2010, the government expanded the Centrally Sponsored Scheme to involve:

Assistance to States for Control of Animal Diseases (ASCAD) – an organization responsible for immunizations, strengthening existing state run biological production units and diagnostic laboratories, and providing training to veterinarians and para-veterinarians. The organization is also responsible for reporting incidence rates of livestock and poultry diseases to the World Animal Health Organization (OIE) twice a year.

National Project on Rinderpest Eradication (NPRE)

Professional Efficiency Development (PED), a regulatory organization for veterinary practitioners

Foot and Mouth Disease Control Programme (FMD-CP)

National Animal Disease Reporting System (NADRS) –a new computerized reporting system.

National Control Programme on Peste des Petits Ruminants (NCPPPR)

National Control Programme on Brucellosis (NCPB) – mass vaccination program completely funded by the government.

Establishment and Strengthening of Veterinary Hospitals and Dispensaries (ESVHD) (responsible for improving the current infrastructure of veterinary clinics and hospitals)

(Department of Animal Husbandry, Dairying and Fisheries, 2011)

Furthermore, the government invested Rs. 28.2 crore in veterinary vaccines from 2009 – 2010, issued by the ASCAD. Most vaccines are manufactured within India, with 21 public veterinary vaccine production units and 7 private producers. The government has recently given the responsibility for ensuring vaccine quality to the Choudhary Charan Singh National Institute of Animal Health. In addition, there are currently 250 disease diagnostic laboratories in place for microbiological testing (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011).

In 2011, the Ministry of Health and Family Welfare released the National Policy for Containment of Antimicrobial Resistance. This policy encourages the development of regulations for antibiotic use in food animals, appropriate food labeling, and banning non-therapeutic uses of antibiotics in animals. The development of an inter-sectoral committee and the creation of this report were also recommended. (Directorate General of Health Services, 2011)

The 2012 Chennai Declaration – a roadmap to tackle the challenge of antimicrobial resistance, was developed at the annual conference of the Clinical Infectious Disease Society and outlined the following needs:

to evaluate the extent of antibiotic usage in the veterinary practice and the indications of use (Prophylaxis, treatment, or growth promoter)

to regulate antibiotic usage in the veterinary practice

to ascertain and monitor the prevalence of resistant bacteria, especially important zoonotic food-borne bacteria in animals and food of animal origin to quantify the rate of transfer of medically-relevant resistance genes and resistant bacteria from animals to humans.

to regulate monitoring of residues of antibiotics in food of animal origin and study the role of antibiotic residues in food towards development of resistance.

to formulate/implement proper regulations for observance of withholding or withdrawal periods between the use of antibiotics and animal slaughter or milking to avoid residues of antibiotics in milk and meat.

An international effort by the Global Antibiotic Resistance Partnership was made through the New Delhi Call to Action on Preserving the Power of Antibiotics in 2011, and signed by the governments of Ghana, Kenya, Mozambique, South Africa and Vietnam. It emphasized the need for a multi-sectorial approach to (Global Antibiotic Resistance Partnership, 2011):

prevent bacterial infections and their spread

ensure access to appropriate drug prescribing, dispensing and use

strengthen and enforce regulation to ensure drug quality

implement surveillance for resistance bacteria and for antibiotic use patterns

stimulate R&D for new antibiotics

discourage sub-therapeutic use of antibiotics in animal feed for growth promotion.

There are too few veterinary hospitals/polyclinics (8,732) and dispensaries (18,830) in India to meet the needs of the food industry (Ministry of Agriculture [Department of Animal Husbandry, Dairying & Fisheries], 2011). There are currently no trained veterinary practitioners specializing in aquaculture or fish in the country.

Veterinary hospitals and dispensaries are staffed with veterinarians or para-veterinarians. It takes five years training to become a veterinarian and subsequent registration with the Veterinary Council of India. Becoming a para-veterinarian or a village-based livestock service provider (VLSP) require shorter training periods. VLSPs are usually located in villages and provide basic care including preventative health services. They serve as liaisons between livestock owners and veterinarians

Animal feed containing antibiotics are available over the counter and are also produced by local farmers using their own recipes and formulas. The proportions of store-bought and homemade preparations are unknown. There are no restrictions on the production or distribution of feed containing antibiotics (Nadeem Fairoze, Shah Hossain and JPS Gill, personal communication, January 11 and 17, 2013). Because most cattle are raised on small farms, there are no feed-lots (mass cattle feeding operations that often involve regular feeding of antibiotics) in India.

The situation in aquafarming is slightly different from that in livestock. Antibiotics used in aquaculture are available throughout the country and can be purchased without a prescription. Some laws are in place to control antibiotic production and distribution, but enforcement is inadequate. There are no effective controls on the production, distribution and marketing of antibiotics used in aquaculture. In general feed for aquaculture is not manufactured with antibiotics, but antibiotics are added to feed the farmers based on recommendations from unqualified aquaculture consultants (VI George, personal communication, January 30, 2013).

Continued use of veterinary antibiotics for growth promotion (and other unnecessary uses), given the expected increases in production of animal products, could make untreatable bacterial diseases more common among animals. An even greater concern is the contribution of antibiotic resistant bacteria in animals to increased resistance in humans.

CHAPTER 2: A Review of the Literature on Antibiotic Use and Antibiotic-Resistant Bacteria in Food Animals

The published reports of antibiotic use and bacterial resistance in agriculture in India are summarized in this chapter. The literature covers a number of settings, antibiotics, and bacterial species, but the body of evidence is small in comparison to the size of the agricultural enterprise in India, and in light of the seriousness of the resistance problem. From our review, however, the sum of the evidence suggests high and increasing levels of bacterial resistance in all veterinary sectors. Basic information from all the studies included in this review can be found in Annex tables 4 and 5.

While a number of studies have examined the resistance profiles of bacteria isolated from livestock, poultry, and aquaculture, the frequency of antibiotic use and reasons for use during animal rearing are poorly represented in the published literature. Several researchers have measured antibiotic residues in animals or animal products as a proxy for the level of antibiotic usage, though few have directly administered questionnaires to farmers concerning antibiotic use.

Most of the published literature concerns antibiotic use in dairy farming and residues in milk.

In an early study (1985), Ramakrishna and Singh tested raw milk samples in markets in Haryana for streptomycin, which was found in approximately 6 percent of samples (Ramakrishna & Singh, 1985).One decade later, dairy farmers in Hyderabad, Secunderabad, and surrounding villages were surveyed on antibiotic use practices. Among 38 dairy farmers, about half used oxytetracycline to treat diseases such as mastisis and fever. Oxytetracycline residues were found in samples from markets (9 percent) and individual animals (73 percent), while no resides were found in government dairy samples. From interviews with 155 urban and rural farmers, Sudershan and Bhat found that antibiotic use was lower among the farmers in rural areas (20 percent) compared to those in urban areas (55 percent). In addition, these interviews revealed that 87 percent of urban and 38 percent of rural farmers treated their animals without consulting a veterinarian.

A survey completed by the National Dairy Research Institute near Bangalore in 2000 reported that tetracyclines, gentamycin, ampicillin, amoxicillin, cloxacillin, and penicillin were commonly used to treat dairy animals. Mastitis was treated with β-lactams or streptomycin. None of the above studies mentioned antibiotic use for the purpose of growth promotion in dairy farming.

The prevalence of antibiotic residues in milk samples has been reported to be higher in silo and tanker samples than in market and commercial pasteurized milk samples. Two of the five pooled milk samples collected from public milk booths in Assam contained antibiotic residues at high levels (at least 5 μg/ml equivalent of penicillin) and two to six percent of milk samples collected from individual cows, tankers and organized and unorganized farms in southern states were reported to contain antibiotics

In 2010, 11 percent of raw milk samples collected from Delhi and villages surrounding Delhi contained β-lactams and 2 percent contained streptomycin. Other antibiotics, including gentamycin, tetracycline, and erythromycin were not detected (National Dairy Research Institute, 2011). The presence of antibiotic residues in milk is evidence that antibiotics are used in dairy animals from these regions, though details of the frequency, duration, and reasons for use are unknown.

A survey of freshwater fish hatcheries in West Bengal in 2006-2007 reported that oxytetracycline, althrocin, ampicillin, sparfloxacin, and enrofloxacin were used commonly in fish farms both for prophylaxis and treatment. The aquaculturists also reported using ciprofloxacin, enrofloxacin, and other drugs in a few hatcheries to improve larval survival. The authors report that responsible use of antibiotics in the hatcheries is lacking and suggest that the observed usage patterns may contribute to the development of drug resistance.

In many countries, antibiotics are commonly added to commercial feed for growth promotion in chickens. Often the amount of antibiotics given is not under the direct control of the farmers, due to premixed antibiotics contained in the feed they purchase. Dr. Mohamed Nadeem Fairoze from the Veterinary College of KVAFS University estimates that in Karnataka, 70 percent of antibiotics used in poultry are for growth promotion, while the remaining 30 percent is for therapeutic use However, we were unable to find documentation of the level of antibiotic use in the poultry sector, either for growth promotion, prophylaxis or treatment.

A number of researchers have isolated bacteria from animals or seafood and tested them for resistance to common antibiotics. The levels of resistance reported are consistently high in food animals including livestock, poultry, and fish, and shellfish.

Several studies have reported resistance profiles of bacteria isolated from sick cattle and buffalo. In 2003, Escherichia coli 0157 was isolated from stool samples collected from adult cattle after slaughter and from diarrhoeic calves in West Bengal. Of the 14 strains isolated, resistance was most frequent against antibiotics commonly used in the region such as nitrofurantoin (57 percent), co-trimoxazole (29 percent), tetracycline (21 percent) and ampicillin (21 percent). Nearly three-quarters of the isolates were resistant to at least one antibiotic, and more than half were multi-drug resistant.

Similarly, a high level of antimicrobial resistance was reported from shiga toxin-producing E. coli isolated from calves with diarrhoea in Gujarat and the Kashmir valley. All of the strains from Gujarat were resistant to at least three antibiotics and almost half were resistant to eight or more of the 11 antibiotics tested. Resistance was ubiquitous for kanamycin and cephalexin and was above 50 percent for seven of the antibiotics.

Isolates of Staphylococcus aureus from milk samples of cows with mastitis were also resistant to a variety of antibiotics. Between 20 percent and 30 percent of isolates from mastitic buffalo were resistant to tetracycline, gentamicin, erythromycin and lincomycin. Similarly, S. aureus isolates from milk samples of mastitic Sahiwal cattle were resistant to streptomycin (36 percent), oxytetracycline (34 percent), and gentamicin (30 percent). Thirteen percent were methicillin-resistant, and these MRSA isolates were significantly more resistant to other antibiotics than methicillin-susceptible isolates. All isolates from the mastitic Sahiwal cattle remained susceptible to vancomycin. Another study on mastitic cattle found that resistance to ampicillin, carbenicillin and oxacillin was near 100 percent for all bacteria tested. Analysis of milk samples and milk products from shops in Mizoram showed similar resistance patterns, with complete resistance against ampicillin as well as high resistance to penicillin (87 percent) and cefotaxime (59 percent) (Tiwari et al., 2011).

The level of resistance in Indian poultry is reported to be high for many antibiotics, however resistance to chloramphenicol remains low.

In 1981, a study of fowl from the area around Ludhiana reported that almost all E. coli strains from apparently healthy fowl and about 80 percent from diseased fowl were resistant to chlortetracycline, tetracycline, oxytetracycline, and triple sulphas (Sarma, Sambyal, & Baxi, 1981). In 1995, isolates of Enterococcus from State Duck Farms in Assam showed total resistance to oxytetracycline, chlortetracycline, erythromycin, oleandomycin, lincomycin, and clindamycin. Some strains were also resistant to streptomycin and nitrofurantoin, and high sensitivity remained only for chloramphenicol.

Similarly, all 123 strains of Pasteurella multocida isolated from chicken and other birds (duck, quail, turkey, and goose) from 11 states across India were resistant to sulfadiazine. A majority of isolates were also resistant to amikacin, carbenicillin, erythromycin, and penicillin, with sensitivity to chloramphenicol at 74 percent (Shivachandra et al., 2004). In contrast, only a minority of Campylobacter jejuni strains isolated from healthy chickens in northern India showed resistance to ampicillin and tetracycline (7 percent and 13 percent respectively).

In 2009, several species of bacteria in poultry litter from a farm in Tamil Nadu were screened for resistance to a variety of antibiotics. A majority of isolates were resistant to at least one antibiotic, and resistance was highest to streptomycin (75 percent) and erythromycin (57 percent). Resistance was also greater than 40 percent for kanamycin, ampicillin, tobramycin, and rifampicin. The authors speculate that the high levels of resistance may be due to antibiotic use for growth promotion.

Finally, a study of Salmonella from eggs in South India reported that all strains isolated were resistant to ampicillin, neomycin, polymyxin-B and tetracycline. Lower levels of resistance were recorded for ciprofloxacin, kanamycin, nalidixic acid, and sulphamethoxazole. Multidrug resistance was also reported in Salmonella isolated from poultry in Haryana.

Studies including other livestock

Resistance patterns in Salmonella isolated from livestock have been reported in India since the 1970s, when resistance to streptomycin and tetracycline was substantial, but sensitivity to ampicillin, chloramphenicol, erythromycin, and nitrofurans remained high. In the years since, more studies have investigated the levels of resistance in livestock across the country. A quarter of the E. coli strains isolated from livestock near Lucknow in 1984-1986 were resistant to at least one antibiotic among the nine that were tested, and almost half of these isolates were multidrug resistant. Resistance was most frequent in isolates from sheep and goat diarrhea (82 percent and 100 percent respectively). Similarly, a majority of E. coli strains isolated from bovines, sheep, and poultry in 1992 at the Veterinary Hospital in Lucknow were resistant to one or more of the seven antibiotics tested (M. Singh, Sanyal, & Yadav, 1992). Two recent studies of bacteria from pigs in North East India reported a high prevalence of resistance to many antibiotics in Pasteurella and E. coli isolates.

Singh and colleagues have published several papers reporting drug resistance patterns in Salmonella and Enterococcus isolated from equines (hoofed mammals, such as horses). Almost all Salmonella isolates from horses, donkeys, and mules kept by low-income individuals and from equine farms were resistant to three or more antibiotics. The highest frequencies of resistance were to sulfamethoxazole (91 percent), tetracycline (71 percent), doxycycline (68 percent), furazolidone (66 percent) and colistin (55 percent). Widespread resistance was found in Salmonella isolates from equids in Izatnagar: 100 percent were resistant to at least one antibiotic and 89 percent were resistant to more than one. Resistance was highest to furazolidone (87 percent), sulphamethoxazole (82 percent), and tetracycline (43 percent). Finally, Singh showed that resistance levels of Enterococci isolates from equids were higher in North India than have been seen in the United States and many countries in the EU. Eighty percent of the isolates from the equids studied were resistant to vancomycin and over 99 percent were resistant to at least five of the 19 antibiotics for which resistance was tested. Resistance was highest to cefdinir (97 percent), oxacillin (91 percent), cefotaxime (89 percent), ampicillin (88 percent), cloxacillin (88 percent), cotrimazine (87 percent) and vancomycin (80 percent).

Antibiotic resistance in the marine sector has been closely studied in India in comparison with other agriculture sectors. Several studies of Salmonella isolates from fish and other seafood have been conducted. One study from Tamil Nadu found that over 90 percent of Salmonella isolates from fish and crustacean samples from retail outlets were resistant to bacitracin, penicillin, and novobiocin. This study found that many of the antibiotic-resistant isolates originated from poultry, livestock and humans, suggesting transmission of antibiotic-resistant bacteria

In a study conducted in Cochin from 2003 to 2007, half of the Salmonella isolates from seafood were resistant to sulfamethizol. Resistance to carbenicillin and oxytetracycline was also prevalent. Multidrug resistance was detected in two-thirds of isolates, with four out of 256 samples resistant to five drugs.

In 2012, Salmonella isolates from fish and shellfish from markets and fish landing centers in Mangalore were tested for nine antibiotics. Two-thirds were resistant to at least two antibiotics, and a quarter of the isolates were resistant to three drugs or more. A study of Salmonella isolates from fresh water prawns and cuttlefish found no resistance to the 16 antibiotics tested.

Examinations of Vibrio species isolated from seafood have also revealed high levels of antibiotic resistance. In 1988-1989 V. cholerae isolates from finfish, shellfish and crustaceans in southeast India were resistant to 10 of the 13 antibiotics tested. Among the antibiotics tested, the highest levels of resistance were found against tetracycline (50 percent) and sulphadiazine (43 percent).

More recently, V. cholerae isolated from seafood in the same region has showed higher levels of resistance. In a study completed in 2009, resistance to ampicillin, penicillin, streptomycin and bacitracin was 88 percent, 84 percent, 85 percent and 64 percent respectively, while resistance to other antibiotics was present at lower levels (P. A. Kumar et al., 2009).

Similarly, V. parahaemolyticus isolated from finfish in Cochin showed a high level of resistance to ampicillin (89 percent) and streptomycin (89 percent). More than half were also resistant to carbenicillin, cefpodoxime, cephalothin, colistin, and amoxycillin. Most isolates remained susceptible to tetracycline, nalidixic acid, and tetracycline.

Finally, a study of Aeromonas, Pseudomonas, and other bacteria isolated from freshwater fish hatcheries in West Bengal showed high prevalence of resistance to oxytetracycline, nitrofurantoin, and co-trimoxazole. Resistance to multiple antibiotics was observed in 90 percent of the bacteria isolated from catfish hatcheries and 30 percent of the bacteria present in carp hatcheries.

Resistance was widespread in farmed shrimp from the east coast of India between 1999 and 2002. All Vibrio and Aeromonas isolates were resistant to ampicillin and a large proportion were also resistant to chlortetracycline (66 percent) and erythromycin (53 percent). Similarly, E. coli O157:H7 isolates from shrimp collected from retail markets in Cochin were resistant to bacitracin and polymyxin B.

Several other studies of antibiotic resistance in bacteria isolated from the marine sector are similar to the studies summarized here.

CHAPTER 3: Laws Affecting the Use of Antibiotics in Livestock

National and supranational legislative bodies around the world have enacted laws to regulate the use of antibiotics in agriculture. Existing laws in India and for comparison, the European Union (EU) and the United States are reviewed in this chapter.

Laws aim to limit the amount of antibiotic residue ingested by consumers, to ban the use of certain antibiotics in animals (mainly because they are important for use in humans), and, in more recent laws (particularly those of the EU), to reduce antibiotic use with the aim of slowing the evolution and spread of antibiotic resistant bacteria. In the EU, a critical step in this process was the banning of antibiotic use for growth promotion. India has no such ban.

In addition to laws, the Codex Alimentarius, developed by FAO and the WHO specifies a series of recommendations to "ensure safety and quality in international food trade." The Maximum Residue Limits for Veterinary Drugs in Foods updated in July 2012, recommends maximum residue limits (MRLs) for commonly used veterinary drugs, including antibiotics (Codex Alimentarius Commission, 2012). It includes detailed recommendations for MRLs in specific types of animal tissue for countries to consider when adopting national MRLs.

India has few laws affecting antibiotic use in food animals. Most are concerned with exports and aquaculture. In 2002, S.O. 722(E) amended an order from 1995 to include restrictions for antibiotics in fresh, frozen and processed fish and fishery products intended for export (see annex 3). The amendment includes maximum residue limits for tetracycline oxytetracycline, trimethoprim, and oxolinic acid, and it prohibits the use of certain antibiotics (table 6) in units processing all types of seafood (Ministry of Commerce and Industry [Department of Commerce], 2002).

In 2003, order S.O. 1227(E) prohibited the use of "antibacterial substances, including quinolones" from the culture of, or in any hatchery for producing the juveniles or lavae or nauplii of, or any unit manufacturing feed for, or in any stage of the production and growth of shrimps, prawns or any other variety of fish and fishery products (Ministry of Commerce and Industry [Department of Commerce], 2003a)

In addition to laws restricting antibiotic use in aquaculture for export, the export inspection council of India has requirements for the establishments to process fish & fishery products meant for export. These requirements include procedures for testing for antibiotic residues (Export Inspection Council of India, 2005).

In January 2012, G.S.R. 28(E) required that medicine for treatment of animals state a withdrawal period in the labeling (Ministry of Health and Family Welfare [Department of Health], 2012). The withdrawal period is defined as the time between last administration of the medicine and the entrance of the animal or animal product into the food chain. For medicines with no defined withdrawal period, withdrawal periods in meat/poultry and marine products should be 28 days and 500 degree-days (respectively).

In addition to veterinary specific regulations with respect to antibiotic use, the 2nd amendment of the Drugs and Cosmetics rules (2006), contains a list of 536 drugs that fall under Schedule H. These drugs, which include antibiotics, require by law a prescription for their use (Ministry of Health and Family Welfare [Department of Health], 2006).


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