Antibiotic loopholes and lunacy

People are justifiably concerned about overuse of antibiotics, in both veterinary and human medicine. There's ample talk about restrictions on use of antibiotics in animals (especially livestock), which is an area that needs good, objective research and discussion. Some politicians have made grand statements about restricting antibiotic use and have proposed strict legislation. (In North America, there's a lot more talk than action). However, I continue to be amazed that amongst all the hand-wringing about antibiotic use in animals, governments haven't taken the very simple initial step of making all antibiotics only available by a veterinarian's prescription. This seems to be a very logical first step, but it's one that almost never gets discussed.

A good example of why this type of regulation is needed comes from a website about Terriers, which says:

"Almost all human antibiotics can be used on dogs and almost everyone either has old antibiotics in their medicine cabinet or knows people that do. Look around, and you will probably find what you need."

  • What??!! Just what we need... recommendations that people sift through old drug supplies for a dose or two of who-knows-what, which may or may not be expired and may or may not be potentially useful for whatever problem is present, and may even be harmful. Determining whether or not an antibiotic should be used, and determining the drug and dose is not something that should be up to a pet owner. It should be up to a veterinarian.

"Drugs past the expiration date are going to be fine as long as they are no older than a year or so past the expiration date (even then they may be fine)."

  • Dumb. Drugs don't instantly go bad at their expiration date, but you don't know what you have left at that point. If you actually need an antibiotic, you need one that works like it's supposed to.

"If you prefer to order your medications outright, you can order cephelaxin (Fish-Flex) from most dog catalogues and it will cure 99% of your flesh wounds as well as most urinary tract and ear infections. Cephalexin or cefalexin is sold as a fish antibiotic in dog catalogues with full-knowledge it is being used for off-label treatment in dogs. It should cost about $30 for 100 250 mg. capsules, which is a perfect dose for a terrier."

  • Ugh!!  A good example of why loopholes like easy access to antibiotics for fish use need to be closed. Many dog internet sites sell fish drugs. I wonder what percentage of "fish" drugs actually make it into fish?

"You probably have some old amoxicillin around the house from the last time you got sick. This is fine to use even if "expired" more than a year ago. Expiration dates on non-liquid antibiotics are a marketing tool (i.e. they encourage people to throw good drugs down the drain) and have no scientific basis -- a fact demonstrated by the U.S. military."

  • Can't say I've seen that study. Expiry dates aren't a marketing ploy. You should use all the antibiotics prescribed, and if for some reason you have any left, you should throw the rest out. It has to do with health and proper use of antibiotics, not marketing.

Take home messages:

  • It's time for politicians to actually do something about antibiotic use and ban all over-the-counter access.
  • Beware of internet advice. Scrutinize sources of information carefully.
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Comments (3) Read through and enter the discussion with the form at the end
John Prescott - August 23, 2009 7:08 PM

Good commentary. Making antibiotic use veterinary prescription only was one of the major recommendations of the Health Canada Committee on Non-human Use of Antimicrobial Drugs (1999), but we're not there yet. I was amazed to find out about a product called Angel Dust that can be bought on-line in the US (including by Canadians) from "Botanical Dog". This is designed to stop tear staining in dogs. Despite the blurb that it contains "100% pure beef liver" it also contains the macrolide antibiotic tylosin, and is recommended to be dosed daily for 3 months, declining to four times a week thereafter. This is a crazy use of an antibiotic, for a trivial purpose that will only promote resistance. This is only a minor one of several loopholes, some of staggering scale, that need to be closed.

PBurns - August 24, 2009 8:52 AM

How embrassasing for you that you seem to know so little about antibiotics, but your blog is about "worms and germs."

Question: Do you actually know anything about worms?

You see, the information given at terrierman.com web site is not only right on the money, it is right on the money according to Harvard University and the U.S. Military See >> https://www.health.harvard.edu/fhg/updates/update1103a.shtml

As the Harvard health letter notes,

_ _ _ _ _

"It turns out that the expiration date on a drug does stand for something, but probably not what you think it does. Since a law was passed in 1979, drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug.

"Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date."

_ _ _ _

YES, know what you are dosing for, what drug is appropriate, and the duration of the dose. The terrierman.com web sitem, however, is explicit on these points and the information given is 100% correct. Sorry that it does not bolster the "only a veterinarian can know what do do" nonsense that the veterinary trade industry likes to suggest, but farmers and dog men have been properly treating their animals with antibiotics since long before you were born. And they still are, not only in Canada and the U.S., but around the world. Woops!

The issue of perpetual dosing of dogs for "tear stains" and the dosing of cattle and chicken feed with antibiotics that serve no medical purpose is ENTIRELY different than treating a known problem with a simple off-the-shelf cure. Surely you know this? Well, maybe not. Apparently expiration dates are a mystery to you too!

Bottom Line: The Worms and Germs blog did not do the slightest bit of research before typing, and apparently knows NOTHING about antibiotics. The information on expiration dates is hardly a state secret, and in fact every competent doctor and veterinarian knows it.

PBurns

Scott Weese - August 24, 2009 9:01 AM

Try reading the link carefully. The study was an evaluation done by the FDA, not the US military. It did not say that all drugs are fine years after expiry. The majority of drugs were fine past their date but that doesn't mean they all were. It focuses on safety, not efficacy of drugs. Most old drugs are safe to take. That doesn't mean they still work. They state the' true effectiveness of a drug may decrease over time'. That's the critical point. If the effectiveness of a painkiller decreases over time, the worse effect is you still have pain. If the effectiveness of an antibiotic decreases over time, you risk not treating the infection properly and increasing the risk of resistance. Also, read the last paragraph, which states that if you need the drug to be 100% effective, you should buy a new bottle. That's the case with antibiotics.

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