Highlighting the role of veterinary pharmacists in zoonotic diseases including COVID-19.

Veterinary pharmacy is an often unknown and therefore, underrepresented career path for pharmacists. Uniquely, pharmacists-even untrained in veterinary medicine-are the only health professionals legally allowed to provide care for human and nonhuman patients. The 2019 coronavirus disease (COVID-19) pandemic is a peculiar situation that, not only highlights veterinary pharmacy as a career path, but stresses the role veterinary pharmacists, trained in both human and veterinary medicine, can play in zoonotic diseases. Specialized training in veterinary medicine allows the pharmacist to serve as a resource for both physicians as well as veterinarians during zoonotic events by helping to ascertain feasibility of therapeutic options given the species. In addition, veterinary pharmacists involved in translational research would be vital for the drug development process as they would be aware of biologic nuances between the species and how they may affect the ultimate therapeutic outcome.

[Assessment of different pain management methods for the treatment of claw lesions in Meat Merino ewes]. / Bewertung verschiedener Methoden des Schmerzmanagements während der Behandlung von Klauenlederhaut-Läsionen bei weiblichen Merinofleischschafen.

OBJECTIVE: Pain management during veterinary procedures is a significant component of animal welfare and has legal as well as ethical implications. Even though regional intravenous anaesthesia (RIVA) is an accepted method for painful procedures involving the distal digits of sheep, this anaesthetic technique is rarely applied in the field. The primary goal was to investigate the feasibility, safety and efficacy of RIVA in sheep. A secondary goal was to examine whether the anaesthetic procedure can be improved by combining RIVA with sedation and whether these methods have a positive effect on the postoperative wellbeing of the animals. METHODS: A total of 36 Meat Merino sheep with contagious interdigital dermatitis and 12 healthy control sheep were used. Behaviour was observed during treatment of the lame sheep using various pain management protocols and during routine claw trimming of the healthy sheep, and all the sheep were observed after the procedures. The observed behaviours were assessed using scores and the scores compared among the animals of the 4 study groups (RIVA, sedation with xylazine hydrochloride + RIVA, placebo, control). RESULTS: RIVA was successfully conducted in sheep. Local reactions at the application sight and in the tourniquet area in 2 animals resolved completely. A significant reduction in defensive movements during the painful procedure confirmed the efficacy of RIVA. Stress-associated behaviours, including head shaking and idle chewing, occurred with a similar frequency in RIVA and placebo animals, leading to the conclusion that stress levels due to the handling in dorsal recumbency were comparable between these 2 groups. Sedation reduced the frequency of pain- and stress-associated behaviours, including guarding, favouring limbs, vocalisation, idle chewing and bruxism. Xylazine hydrochloride-RIVA animals displayed better weight-bearing in the affected limb, better food uptake and ruminated more postoperatively than sheep from the other study groups. CONCLUSION: RIVA in sheep is straightforward, safe and effective. Additional sedation reduces the stress and pain response. This pain and stress management has a positive effect on the postoperative wellbeing of sheep.

Ethnographic Decision Modeling to Understand Smallholder Antibiotic Use for Poultry in Guatemala.

Widespread use of antibiotics is of concern due to the selection for resistant bacterial strains, which render life-saving antimicrobials ineffective. Smallholders in rural Guatemala rely on human antibiotics to treat their poultry, and in this article, I aim to understand why they do so. I incorporate Ethnographic Decision Modeling (EDM) to understand treatment behaviors. Results indicate that access and affordability in opportunity costs are barriers to seeking veterinary medicines for poultry. Access to veterinary medicine and education campaigns on poultry health are necessary to support the appropriate use of antimicrobials for backyard poultry.

The use of antibiotics in cattle in North-East Benin: pharmaceutical inventory and risk practices of cattle breeders.

This study's aim is to inventory antibiotics used in cattle in North-East Benin and assess risk practices that could be the cause of both food chain contamination by antibiotic residues and selection of antibiotic-resistant bacteria in animals and humans. A survey was conducted among 98 cattle breeders in the districts of Banikoara, Kandi, Bembereke, and Kalale in North Benin. Semi-structured interviews were conducted, covering breeder status, breeding system, and antibiotic use. Multiple correspondence analysis and hierarchical classification analysis were conducted to establish a breeder typology. Breeders mainly belonged to the Fulani ethnic group (71.4 ± 8.9%) and almost all of them received "no formal education" (96.9 ± 3.4%). Cattle herds were mainly composed of a single breed, the Borgou (76.4 ± 8.1%) or the Fulani Zebu (16.0 ± 7.0%). Some herds were mixed. Antibiotics groups used in cattle breeding were tetracyclines, beta-lactams, sulfonamides, aminoglycosides, and macrolides, used by respectively 100%, 69.4 ± 9.1%, 56.1 ± 9.8%, 44.9 ± 9.8%, and 34.7 ± 9.4% of breeders. These drugs were purchased in local markets (59.0 ± 15.4%) and veterinary pharmacy (41.0 ± 15.4%). They were mainly used against respiratory diseases, lameness, mastitis, omphalitis and neonatal enteritis, and skin diseases. Only 49.0 ± 9.9% of breeders seek veterinary services to treat animals and 92.9 ± 5.1% of them did not respect antibiotic withdrawal times. These practices suggest that both contamination of bovine meat with antibiotic residues and selection of resistant bacteria are to be expected, resulting in adverse health effects on consumers.

Approaches for quantifying antimicrobial consumption per animal species based on national sales data: a Swiss example, 2006 to 2013.

Antimicrobial use in animals is known to contribute to the global burden of antimicrobial resistance. Therefore, it is critical to monitor antimicrobial sales for livestock and pets. Despite the availability of veterinary antimicrobial sales data in most European countries, surveillance currently lacks consumption monitoring at the animal species level. In this study, alternative methods were investigated for stratifying antimicrobial sales per species using Swiss data (2006-2013). Three approaches were considered: (i) Equal Distribution (ED) allocated antimicrobial sales evenly across all species each product was licensed for; (ii) Biomass Distribution (BMD) stratified antimicrobial consumption, weighting the representativeness of each species' total biomass; and (iii) Longitudinal Study Extrapolation (LSE) assigned antimicrobial sales per species based on a field study describing prescription patterns in Switzerland. LSE is expected to provide the best estimates because it relies on field data. Given the Swiss example, BMD appears to be a reliable method when prescription data are not available, whereas ED seems to underestimate consumption in species with larger populations and higher treatment intensity. These methods represent a valuable tool for improving the monitoring systems of veterinary antimicrobial consumption across Europe.

Assessment of a Flavone-Polysaccharide Based Prescription for Treating Duck Virus Hepatitis.

Because polysaccharide and flavone ingredients display good antiviral activity, we developed a flavone/polysaccharide-containing prescription that would be effective against duck viral hepatitis (DVH) and investigated its hepatoprotective effects. Flavones were derived from Hypericum japonicum (HJF) (entire herb of Hypericum japonicum Thunb) and Salvia plebeia (SPF) (entire herb of Salvia plebeia R. Br.), and polysaccharides were derived from Radix Rehmanniae Recens (RRRP) (dried root of Rehmannia glutinosa Libosch). This prescription combination was based on the theory of syndrome differentiation and treatment in traditional Chinese veterinary medicine. In vitro and in vivo experiments were conducted using the three single ingredients compared to the combined HRS prescription to determine their anti-duck hepatitis A viral (anti-DHAV) activity. The results showed that all experimental conditions displayed anti-DHAV activity, but the HRS prescription presented the best effect. To further investigate the hepatoprotective effect of the HRS prescription on DHAV-induced hepatic injury, we tested the mortality rate, the hepatic pathological severity score, plasma biochemical indexes of hepatic function, blood DHAV gene expression levels and peroxidation damage evaluation indexes and then analyzed correlations among these indexes. The results demonstrated that the HRS prescription significantly decreased the mortality rate, reduced the severity of hepatic injury, decreased the hepatic pathological severity score, depressed blood DHAV gene expression levels, and returned the indexes of hepatic function and peroxidation almost to a normal level. These results indicate that the HRS prescription confers an outstanding hepatoprotective effect, and we expect that it will be developed into a new candidate anti-DHAV drug.

An ethnopharmacological assessment of the use of plants against parasitic diseases in humans and animals.

ETHNOPHARMACOLOGICAL RELEVANCE: Ethnobotanical surveys are detecting an increasing frequency of exotic plant species in pharmacopeias, which has led researchers to investigate the role of such species in traditional medical systems. According to the diversification hypothesis, exotic species are included to complete pharmacopeias, i.e., to treat diseases for which no native species are known, thus broadening the scope of the plant repertoire. MATERIALS AND METHODS: The present study was conducted at two rural communities in northeastern Brazil aiming at a survey of the plants known or used by the population to treat endo- and ectoparasitic diseases in humans and animals. In addition, plant extracts exhibiting acaricide activity were assessed using the engorged female immersion and larval packet tests (LPT). RESULTS: The results of the present study showed a tendency for native species to be used against ectoparasites and exhibit a broader scope of use compared to exotic species. In turn, exotic species were predominantly indicated to treat diseases caused by endoparasites, although there was an overlap of native and exotic species relative to some therapeutic purpose, e.g., ticks. Only two of the plant species tested exhibited acaricide activity (Nicotiana glauca Graham and Croton blanchetianus Baill.), and in both cases, the activity was weak. CONCLUSION: The ethnobotanical data do not fully support the suggested hypothesis. Overall, the wide versatility of exotic species was not exclusively used to treat parasitic diseases in humans and animals. In addition, the selection of acaricide plants based on the ethnopharmacological study generated uninteresting results.

Variations in the sales and sales patterns of veterinary antimicrobial agents in 25 European countries.

OBJECTIVES: To describe sales and sales patterns of veterinary antimicrobial agents in 25 European Union (EU)/European Economic Area (EEA) countries for 2011. METHODS: Data on the sales of veterinary antimicrobial agents from 25 EU member states and EEA countries for 2011 were collected at package level (name, formulation, strength, pack size, number of packages sold) according to a standardized protocol and template and presented in a harmonized manner. These data were calculated to express amounts sold, in metric tonnes, of active ingredient of each package. A population correction unit (PCU) was applied as a proxy for the animal biomass potentially treated with antimicrobial agents. The indicator used to express sales was milligrams of active substance per PCU. RESULTS: Substantial variations in the sales patterns and in the magnitude of sales of veterinary antimicrobial agents, expressed as mg/PCU, between the countries were observed. The proportion of sales, in mg/PCU, of products applicable for treatment of groups or herds of animals (premixes, oral powders and oral solution) varied considerably between the countries. CONCLUSIONS: Some countries reported much lower sales of veterinary antimicrobial agents than others, when expressed as mg/PCU. Sales patterns varied between countries, particularly with respect to pharmaceutical forms. Further studies are needed to understand the factors that explain the observed differences.

Responsibilities of regulatory agencies in the marketing of antimicrobials.

The regulatory agencies' main responsibility regarding the marketing of veterinary medicinal products is to ensure that the products have a marketing authorisation with specific conditions of use adequate to ensure the quality, safety and efficacy of the product under consideration. In addition, control and surveillance systems are necessary to allow monitoring of the product after it has been authorised. In respectto antimicrobials, specific consideration must be given to minimising resistance development and retaining the effectiveness of these drugs for the treatment of humans and animals. Surveillance programmes should be in place to follow trends in resistance development, as well as in the consumption of veterinary antimicrobials, in order to provide for science-based policy recommendations regarding public and animal health.

Antimicrobial sensitivity--A natural resource to be protected by a Pigouvian tax?

Since their discovery more than 70 years ago antibiotic drugs have been efficient tools for treating bacterial infections, and their use has reduced the number of fatalities and the suffering from bacterial diseases. However, the use of antibiotics may lead to resistance to the same or other antibiotics. The risk of resistance appears to be larger in veterinary medicine, since antibiotics have been given as feed-additives in animal production, the amounts given are larger, and the risk of selecting the wrong antibiotic is higher due to lack of diagnostic facilities. Historically, as resistance developed, new classes of antibiotics were developed, but today however, the flow of new substances has slowed. The resistance that arises from antibiotic use is a negative externality or a cost that is not included in the price of antibiotics since it affects the public good of antibiotic sensitivity. The negative externality implies that antibiotic consumption becomes too high. Antibiotic use can be restricted by e.g., prohibiting the use in animal feeding stuffs, prescription only use, or banning the use for animals or by using economic incentives, but restrictions on antibiotic use could have negative effects on the development of new antimicrobials since restrictions might reduce the profitability of such efforts to the pharmaceutical industry. It is therefore of interest to see what economic theory can contribute towards a solution. The objective of this study is to examine if a Pigouvian tax is an option for balancing the externalities and incentives for veterinary drug use. However, as a practical solution, it is suggested to use the costs of developing new antibiotics for determining the tax. The magnitude the tax based on European Union numbers ranges between 29 and 287euro per kilogram active substance or between 9 and 86% of the average price of commonly used antibiotics depending on the foreseen period in years (1-10 years) between the development of a new antibiotic drug. Hence, the sensitivity of bacteria to antibiotics should be managed as a finite natural resource. A tax based on the expected costs of development new antibiotic substances may offer a practical option for balancing the incentives and externalities of antibiotic use and development.

Herbal usage and informant consensus in ethnoveterinary management of cattle diseases among the Kikuyus (Central Kenya).

For most smallholder farmers in Kenya conventional veterinary drugs have become very expensive and therefore unaffordable, causing them to seek low cost alternatives that are rarely documented in most ethnobiological studies. This study surveyed the utilisation of traditional herbal preparations in managing cattle ailments in Central Kenya with the aim of providing a comprehensive ethnobotanical profile and the most important plant species that may warrant scientific validation for efficacy and commercial utilisation. Using semi-structured questionnaires and detailed discussions with smallholder farmers, a total of 40 plant species in 26 families were found to be useful in traditional management of various cattle ailments in this region. Two plant families were particularly frequent in usage: Asteraceae and Lamiaceae, while the most utilised plant species were found to be Synadenium compactum N.E.Br. (Euphorbiaceae), Solanecio manii (Hook.f.) C. Jeffrey (Asteraceae) and Senna didymobotrya (Fresen.) Irwin and Barneby (Caesalpinaceae). Informant consensus was particularly high in managing anaplasmosis, East coast fever and ectoparasites. Such plant species become key target in efficacy tests and for development of commercial veterinary botanicals. The usage of some of the species is unfortunately unsustainable as some of the species are rare or endangered hence the need for conservation strategies to be undertaken.

Animal health pharmaceutical industry.

The animal health pharmaceutical industry has proactively reported on the volumes of member company antimicrobial active ingredients sold in the U.S. At the individual company level, reporting of finished product distribution data to the FDA is a regulatory requirement, with applications to surveillance and pharmacovigilance. An accounting of product manufactured is done for purposes of good business practices, as well as marketing analyses. Additional applications of antimicrobial usage data might include use in risk assessments, such as for the FDA's Center for Veterinary Medicine Guidance for Industry #152 for the evaluation of the microbiological safety of antimicrobials intended for use in food animals. Compilation of national usage data will be a complex undertaking, hindered by issues such as confidentiality, auditing, field use practice variations, population dynamics (e.g. disease incidence, market conditions for poultry and livestock production), and generic usage. The amounts or volumes in pounds should be considered relative to the large number of animals under husbandry in the United States. Large volumes might seem impressive unless put into proper context. Until such time as a clearly defined application of national usage data is agreed, it is recommended that local usage programs will provide more useful information to perpetuate prudent antimicrobial use in animals.