Thermostability of oxytetracycline, tetracycline, and doxycycline at ultrahigh temperatures

An overview of the occurrence, impact of process parameters, and the fate of antibiotic resistance genes during anaerobic digestion processes

Antibiotic resistance genes (ARGs) have emerged as a significant global health threat, contributing to fatalities worldwide. Wastewater treatment plants (WWTPs) and livestock farms serve as primary reservoirs for these genes due to the limited efficacy of existing treatment methods and microbial adaptation to environmental stressors. Anaerobic digestion (AD) stands as a prevalent biological treatment for managing sewage sludge and manure in these settings. Given the agricultural utility of AD digestate as biofertilizers, understanding ARGs' fate within AD processes is essential to devise effective mitigation strategies. However, understanding the impact of various factors on ARGs occurrence, dissemination, and fate remains limited. This review article explores various AD treatment parameters and correlates to various resistance mechanisms and hotspots of ARGs in the environment. It further evaluates the dissemination and occurrence of ARGs in AD feedstocks and provides a comprehensive understanding of the fate of ARGs in AD systems. This review explores the influence of key AD parameters such as feedstock properties, pretreatments, additives, and operational strategies on ARGs. Results show that properties such as high solid content and optimum co-digestion ratios can enhance ARG removal, while the presence of heavy metals, microplastics, and antibiotics could elevate ARG abundance. Also, operational enhancements, such as employing two-stage digestion, have shown promise in improving ARG removal. However, certain pretreatment methods, like thermal hydrolysis, may exhibit a rebounding effect on ARG levels. Overall, this review systematically addresses current challenges and offers future perspectives associated with the fate of ARGs in AD systems.

Molecular insights on the binding of chlortetracycline to bovine casein and its effect on the thermostability of chlortetracycline

Bovine casein was selected as a model protein to evaluate the impact of food matrix on the thermal degradation of antibiotics. Fluorescence quenching and isothermal titration calorimetry experiments revealed that chlortetracycline (CTC) could spontaneously bind to casein via hydrogen bonding and hydrophobic interactions. The amino acid residues forming the binding pocket were further identified using molecular docking, while saturation transfer difference NMR deciphered that the binding of CTC engages its -N(CH3)2 group. Moreover, the degradation behavior of free CTC versus that bound in casein-CTC complex was compared during thermal treatment. Compared with free CTC, a lower first-order rate constant was observed in the presence of casein. Removal of casein shortened the half-life of CTC by at least 48.1% at low concentrations. Elucidating that the formation of protein-antibiotic complexes alters the amenability of antibiotics to degradative reactions, which could help eliminate residual antibiotics and guarantee the safety of dairy products.

Wastewater Characterization: Chemical Oxygen Demand or Total Organic Carbon Content Measurement?

The long time (2 h) required for measurement, expensive chemicals (Ag2SO4), and toxic reagents (K2Cr2O7, HgSO4) limit the application of the standard method for measuring the oxygen equivalent of organic content in wastewater (chemical oxygen demand, COD). In recent years, the COD has increasingly been replaced by the total organic carbon (TOC) parameter. Since the limit values of the pollution levels are usually given in terms of the COD, efforts are being made to find the correlation between these parameters. Several papers have published correlation analyses of COD and TOC for industrial and municipal wastewater, but the relationship has not been discussed for individual chemicals. Here, this relationship was investigated using 70 contaminants (laboratory chemicals, pharmaceuticals, and pesticides). The calculated COD values, in most cases, agreed, within ~10%, with the experimental ones; for tetracyclines and some chloroaromatic molecules, the measured values were 20-50% lower than the calculated values. The COD/TOC ratios were between 2 and 3: for macrolides, they were ~3; for fluoroquinolones and tetracyclines, they were ~2. The molecular structure dependence of the ratio necessitates the establishing of the correlation on an individual basis. In advanced oxidation processes (AOPs), the ratio changes during degradation, limiting the application of TOC instead of COD.

Young people exposure to antibiotics: Implication for health risk and the impact from eating habits of takeaway food

Exposure to antibiotics, mainly from animal food ingestion, may have adverse effects on human health. Takeaway food is the preferred choice for the dietary of most Chinese young people nowadays, but the relationship between takeaway eating and antibiotic exposure is not yet adequately understood. In the present study, 297 young people were recruited to collect urine samples and questionnaires with an emphasis on their takeaway eating habits. The internal exposure to 16 antibiotics and three metabolites was measured in urine samples by high-performance liquid chromatography-tandem mass spectrometry, as well as a DNA oxidative damage marker, 8-hydroxydeoxyguanosine (8-OHdG). At least one kind of antibiotic was found in over 90 % of urine samples, with total concentrations from 0.667 to 3.02 × 104 ng/mL. High exposure levels of antibiotics were more likely to be found in individuals with a larger body mass index. The concentrations of six antibiotics were significantly different among people with different overall weekly eating frequencies, usually an upward trend. The estimated daily intakes of antibiotics were on the levels of 0.001-1.0 μg/kg/day, mainly contributed by clarithromycin, ciprofloxacin and oxytetracycline, indicating a potential health risk based on the microbiological effect. A significantly positive correlation was found between DNA oxidative damage and exposure for four categories of antibiotics, conformed by both Spearman correlation and multiple linear regression analysis. The levels of 8-OHdG were 355 %, 239 %, 234 %, and 334 % higher with elevated levels of phenicols, macrolides, tetracyclines and sulfonamides from quartiles 2 to 4. Our results suggest that high-frequency consumption of takeaways may exacerbate oxidative stress trends through human exposure to antibiotics.

Light-up split aptamers: binding thermodynamics and kinetics for sensing

Due to their programmable structures, many aptamers can be readily split into two halves while still retaining their target binding function. While split aptamers are prevalent in the biosensor field, fundamental studies of their binding are still lacking. In this work, we took advantage of the fluorescence enhancement property of a new aptamer named OTC5 that can bind to tetracycline antibiotics to compare various split aptamers with the full-length aptamer. The split aptamers were designed to have different stem lengths. Longer stem length aptamers showed similar dissociation constants (Kd) to the full-length aptamer, while a shorter stem construct showed an 85-fold increase in Kd. Temperature-dependent fluorescence measurements confirmed the lower thermostability of split aptamers. Isothermal titration calorimetry indicated that split aptamer binding can release more heat but have an even larger entropy loss. Finally, a colorimetric biosensor using gold nanoparticles was designed by pre-assembling two thiolated aptamer halves, which can then link gold nanoparticles to give a red-to-blue color change.

Recurrence of symptoms may indicate the presence of a Morel-Lavallée lesion of the knee: A case report and literature review

Case

An 81 year old male with four failed aspirations presented with recurrent knee swelling following irrigation and debridement, which suggested the presence of a Morel-Lavallée lesion (MLL). This diagnosis was intraoperatively confirmed by separation of the tissue layers forming a space with accumulated fluid. Treatment consisted of doxycycline sclerodesis and tight closure of the tissue layers. The patient had a satisfactory outcome at 4 months.

Conclusion

Resolution of Morel-Lavallée lesions requires prompt recognition and appropriate treatment. In the presence of a different diagnosis, recurrence of symptoms following treatment may indicate an MLL. Surgical treatment with doxycycline sclerodesis resulted in resolution of symptoms.

Antibacterial 3D-Printed Silver Nanoparticle/Poly Lactic-Co-Glycolic Acid (PLGA) Scaffolds for Bone Tissue Engineering

Infectious bone defects present a major challenge in the clinical setting currently. In order to address this issue, it is imperative to explore the development of bone tissue engineering scaffolds that are equipped with both antibacterial and bone regenerative capabilities. In this study, we fabricated antibacterial scaffolds using a silver nanoparticle/poly lactic-co-glycolic acid (AgNP/PLGA) material via a direct ink writing (DIW) 3D printing technique. The scaffolds' microstructure, mechanical properties, and biological attributes were rigorously assessed to determine their fitness for repairing bone defects. The surface pores of the AgNPs/PLGA scaffolds were uniform, and the AgNPs were evenly distributed within the scaffolds, as confirmed via scanning electron microscopy (SEM). Tensile testing confirmed that the addition of AgNPs enhanced the mechanical strength of the scaffolds. The release curves of the silver ions confirmed that the AgNPs/PLGA scaffolds released them continuously after an initial burst. The growth of hydroxyapatite (HAP) was characterized via SEM and X-ray diffraction (XRD). The results showed that HAP was deposited on the scaffolds, and also confirmed that the scaffolds had mixed with the AgNPs. All scaffolds containing AgNPs exhibited antibacterial properties against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). A cytotoxicity assay using mouse embryo osteoblast precursor cells (MC3T3-E1) showed that the scaffolds had excellent biocompatibility and could be used for repairing bone tissue. The study shows that the AgNPs/PLGA scaffolds have exceptional mechanical properties and biocompatibility, effectively inhibiting the growth of S. aureus and E. coli. These results demonstrate the potential application of 3D-printed AgNPs/PLGA scaffolds in bone tissue engineering.

Graphene Oxide-Assisted Aptamer-Based Fluorescent Detection of Tetracycline Antibiotics

Tetracyclines are a group of common antibiotics, but owing to their toxicity, most of them are only used in animal husbandry and veterinary medicine. A DNA aptamer for tetracyclines has recently been reported. Upon aptamer binding, the fluorescence of tetracyclines was enhanced. This unique fluorescence enhancement was used to selectively detect the tetracyclines. The purpose of this study was to use graphene oxide (GO) to suppress the background fluorescence for enhanced detection. First, the adsorption of doxycycline on GO was studied. At pH 8.0, 82.7% of doxycycline was adsorbed by GO, and adding 2 µM aptamer desorbed 55.4% of doxycycline. With GO, the signal increase was comparable from pH 6 to 8, whereas without GO, the increase was significantly lower at pH 8. Under optimized condition, a detection limit of 1.6 nM doxycycline was achieved at pH 8.0 in the presence of GO, whereas without GO, the detection limit was 18.9 nM. This is an interesting example of the use of nanomaterials to enhance the performance of aptamer-based biosensors.

Enhanced adsorption and colorimetric detection of tetracycline antibiotics by using functional phosphate/carbonate composite with nanoporous network coverage

This work presents efficient tetracycline (TC) antibiotics adsorption using a functional porous phosphate/carbonate composite (PCC). The PCC was fabricated by anion-exchange of phosphate on the surface of vaterite-phase calcium carbonate particle scaffolds. The PCC, having dense nanoporous network coverage with large surface area and pore volume, exhibited excellent TC adsorption in solution. Its adsorption isotherm fitted well to the Freundlich model, with a maximum adsorption capacity of 118.72 mg/g. The adsorption process was spontaneous, endothermic, and followed pseudo-second-order kinetics. From the XPS analysis, the hydrogen bonding and surface complexation were the key interactions in the process. In addition, a colorimetric TC detection method was developed considering its complexation with phosphate ions, originating from PCC dissolution, during adsorption. The method was used to detect TC in mg/L concentrations in water samples. Thus, the multifunctional PCC exhibited potential for use in TC removal and environmental remediation.

Depletion of Amoxicillin Residue in Edible Tissue of Broiler Chicken by Different Cooking Methods

A new simple isocratic, RP-HPLC method, was developed and validated to estimate amoxicillin (Amox) residue depletion caused by different cooking methods in broiler chicken tissue. The limit of detection (LOD) and the limit of quantitation (LOQ) were 1.32 and 4.00 µg mL⁻¹, respectively. The calibration plot was linear over the concentration range of 0.05–250 µg mL⁻¹, and the relative standard deviation (RSD) values were less than 8%. The effects of various cooking methods (boiling, pan-frying, and microwaving) on residues of Amox were conducted under different combinations of temperature and time. Moreover, the heat stability of Amox standard solutions under boiling water and cooking oil at 100°C was investigated. Amox remained stable for 5–15 min in boiling water, the concentration was significantly reduced in the range of 70–87%, and additional new peaks of the degraded compounds appeared at 30–45 min. In pan-frying, the residue remained stable for 15 min at 100°C and then depleted to 81–92% after 30–45 min. Due to dehydration, the residue concentration showed an increment from 101 to 112% at 150°C. The total decomposition of Amox was observed at 200°C, 30–45 min due to high temperature and long-time effects. In microwave cooking using 500 W, 0.5–2 min, the depletion was insignificant. This study shows that sufficient cooking temperature and time can have a significant effect on the depletion of Amox residues.

Environmental antibiotics exposure in school-age children in Shanghai and health risk assessment: A population-based representative investigation

BACKGROUND

The widespread use of antibiotics has left extensive residues in the environment and food. Antibiotics can accumulate in human body. As the potential health risks of antibiotic exposure in children are of a great concern in recent years, our study aimed to describe the status of antibiotic exposure in primary school students in Shanghai, China, and to explore the relationships of dietary patterns with internal antibiotic levels.

METHODS

The Shanghai Children's Health, Education, and Lifestyle Evaluation (SCHEDULE) Survey was a cross-sectional study with a staged, cluster random sample of all primary school students in Shanghai, China. In the present study, we randomly selected 2199 children aged 6-12 years old. A total of 10 antibiotics in urine samples were measured by liquid chromatography-tandem mass spectrometry. Multivariable survey logistic regression models were used to investigate dietary patterns associated with detection rates of antibiotics.

RESULTS

The detection rates of individual antibiotics ranged from 4.3% to 30.7%. 68.7% of children were exposed to at least one antibiotic. There was a significant difference in child exposure to overall antibiotics by residential locations (60.9% in urban vs. 71.1% in suburban areas). Principal component analyses suggested that higher unhealthy dietary pattern scores were significantly associated with increased detection rates of tetracyclines [1.27 (95% CI: 1.18, 1.38)] and sulfonamides [1.20 (95% CI: 1.05, 1.36)]. In addition, 9.05% of children had a hazard index (HI) value greater than 1, which was mainly contributed by ciprofloxacin.

CONCLUSIONS

School-age children were widely exposed to antibiotics in Shanghai. Unhealthy diet was associated with a higher level of antibiotic exposure.

The effect of high hydrostatic pressure on tetracycline hydrochloride and sulfathiazole residues in various food matrices - comparison with ultrasound and heat treatment

Antibiotic residues in food pose serious direct and indirect risks for consumers. The aim of this study was to investigate the effect of High Hydrostatic Pressure (HHP) on tetracycline hydrochloride (TCH) and sulfathiazole (STZ) residues in honey, milk, and water. Three different pressures were tested for their efficiency and treatment at 580 MPa for 6 min was finally selected. Qualitative and quantitative determination of antibiotics were performed with HPLC and LC-MS. HHP treatment was compared to ultrasound and heat treatment. HHP treatment was found to be more effective than the other two methods for both antibiotics in water and milk. The reduction of STZ in honey was over 90%, while no reduction was observed for TCH. The highest TCH reduction was recorded after HHP treatment in water (76.4%) and the highest STZ reduction after ultrasound treatment in honey (94.3%). Reduction of the two antibiotics in different matrices did not follow a similar pattern. For the HHP treatment, the effect of the initial concentration of the two antibiotics was studied under two different storage conditions (refrigerated and frozen storage). The effectiveness of the method was found to be affected by the initial concentration, in both storage conditions for STZ, while for TCH significant differences were observed only for refrigerated storage.

Current perspective on veterinary drug and chemical residues in food of animal origin

The marked increase in the demand for animal protein of high quality necessitates protecting animals from infectious diseases. This requires increasing the use of veterinary therapeutics. The overuse and misuse of veterinary products can cause a risk to human health either as short-term or long-term health problems. However, the biggest problem is the emergence of resistant strains of bacteria or parasites. This is in addition to economic losses due to the discarding of polluted milk or condemnation of affected carcasses. This paper discusses three key points: possible sources of drug and chemical residues, human health problems, and the possible method of control and prevention of veterinary drug residues in animal products.

Suspect screening of antimicrobial agents transformation products in environmental samples development of LC-QTrap method running in pseudo MRM transitions

The aim of the work was to develop a new HPLC-MS/MS method that allows for the simultaneous detection of antimicrobials agents (targeted analysis) and their transformation products (non-targeted analysis), which enabled the elucidation of their transformation pathways in the environment. Targeted analysis was performed for 16 selected antimicrobials agents (AMs) in wastewater collected at different stages of the treatment process and river water from sections before and after wastewater discharge. The samples were collected in the Łyna sewage treatment plant (Olsztyn, Poland) in three measuring periods at different seasons. Analytes were selected from tetracyclines, fluoroquinolones, β-lactams, macrolides, glycopeptides, lincosamides and synthetic antibiotics. As a part of the targeted analysis, 13 AMs were detected in wastewater samples, and 7 of them in river water samples. However, their presence and concentrations were closely related to the type of the sample and the season in which the sample was taken. The highest concentrations of AMs were detected in samples collected in September (max. 1643.7 ng L^-1 TRI), while the lowest AMs concentrations were found in samples collected in June (max. 136.1 ng L^-1 CLR). The total content of AMs in untreated wastewater was in the range of 1.42-1644 ng L^-1, while in the river water was for upstream 1.22-48.73 ng L^-1 and for downstream 2.24-149 ng L^-1. In the non-target analysis, 33 degradation products of the selected AMs were identified, and the transformation pathways of their degradation were speculated. In the course of the research, it was found that as a result of the processes taking place in wastewater treatment plant, the parent substances are transformed into a number of stable transformation products. Transformation products resulted from hydroxylation, ring opening, oxidation, methylation or demethylation, carboxylation, or cleavage of the CN bond of the parent AMs.

Determination of antibiotic residues in bovine milk by HPLC-DAD and assessment of human health risks in Northwestern Himalayan region, India

Antibiotic residues in milk affects economics of dairy industry and poses health risks to consumers. This study aimed to assess health risks associated with presence of antibiotics in 173 raw and pasteurized milk sampled from northwestern Himalayan state of India. The oxytetracycline and amoxicillin were quantitatively analyzed using validated HPLC-DAD. Methods were selective and linear (R² > 0.99) with decision limit and detection capability of 1.4 and 0.9 µg/kg and 2.5 and 1.5 µg/kg for oxytetracycline and amoxicillin, respectively. Recoveries ranged from 88-98% with relative standard deviation < 10%. Oxytetracycline and amoxicillin were detected in 8.1% and 1.2% samples, with 1.7% and 1.2% samples exceeding the tolerance limits, respectively. Health risk assessment revealed that estimated daily intakes of antibiotics through milk were lower than acceptable daily intakes (ADI). However, children might receive 9-21% of determined ADI through milk consumption only. Therefore, continuous, sub-therapeutic and long term exposures of antibiotics can pose health risk to consumers. Hence, current findings elucidate the need for vigilant monitoring of antibiotics accompanied by educational programs to farmers for adopting good husbandry practices and adherence to withdrawal periods to meet the expectations of food safety and safeguarding human health.

SUPPLEMENTARY INFORMATION

The online version of this article contains supplementary material available at (10.1007/s13197-021-04988-8).

Effects of Oxytetracycline and Gentamicin Therapeutic Doses on Hematological, Biochemical and Hematopoietic Parameters in Cyprinus carpio Juveniles

Simple Summary

Hematological, biochemical and hematopoietic effects of therapeutic doses of oxytetracycline (OTC) and gentamicin (GEN) in clinically healthy common carp juveniles were studied. The fish were divided into four groups: controls 1 and 2 (untreated or injected with 0.6% NaCl solution), and two groups treated with antibiotics (orally with OTC four times every two days or injected with a single dose of GEN dissolved in 0.6% NaCl). Blood and head kidneys were sampled from all fish 3 days post-treatments for hematological, biochemical and hematopoietic tissue analyses. The obtained results showed no considerable hematotoxicity or hepatotoxicity of therapeutic doses of OTC and GEN to carp.

Abstract

Hematological, biochemical and hematopoietic effects of therapeutic doses of two antibiotics, oxytetracycline (OTC) and gentamicin (GEN), in clinically healthy common carp juveniles were studied. The fish were divided into four groups: controls 1 and 2 (untreated or injected with 0.6% NaCl solution), and two groups treated with antibiotics (orally with 75 mg/kg OTC four times every two days or injected with a single dose (4 mg/kg) of GEN dissolved in 0.6% NaCl). Blood and head kidneys were sampled from all fish 3 days post-treatments for hematological, biochemical and hematopoietic tissue analyses. No major alterations in the values of hematological and serum biochemical parameters occurred following administration of OTC or GEN. Glucose concentrations were significantly lower in both groups of fish subjected to injections (Control 2 and GEN), while the oxidative metabolic activity of phagocytes increased in the antibiotic-treated groups (significantly in OTC). More alterations were observed in hematopoietic tissue. Immunocytochemical analysis revealed that G caused a significant increase in the rate of cell proliferation (PCNA-positive cells) and an increase in the frequency of apoptotic cells (caspase-positive). The frequency of lymphoid lineage decreased, which was related to a decrease in the abundance of mature lymphocytes in GEN-treated fish. Percentages of neutrophilic lineage were significantly elevated in OTC and GEN groups compared to controls. The obtained results showed no considerable hematotoxicity or hepatotoxicity of therapeutic doses of OTC and GEN to carp.

Bone mineral as a drug-seeking moiety and a waste dump

Bone is a dynamic tissue with a quarter of the trabecular and a fifth of the cortical bone being replaced continuously each year in a complex process that continues throughout an individual's lifetime. Bone has an important role in homeostasis of minerals with non-stoichiometric hydroxyapatite bone mineral forming the inorganic phase of bone. Due to its crystal structure and chemistry, hydroxyapatite (HA) and related apatites have a remarkable ability to bind molecules. This review article describes the accretion of trace elements in bone mineral giving a historical perspective. Implanted HA particles of synthetic origin have proved to be an efficient recruiting moiety for systemically circulating drugs which can locally biomodulate the material and lead to a therapeutic effect. Bone mineral and apatite however also act as a waste dump for trace elements and drugs, which significantly affects the environment and human health. Cite this article: Bone Joint Res 2020;9(10):709-718.

Effect of temperature and ultraviolet light on the bacterial kill effectiveness of antibiotic-infused 3D printed implants

Drug eluting 3D printed polymeric implants have great potential in orthopaedic applications since they are relatively inexpensive and can be designed to be patient specific thereby providing quality care. Fused Deposition Modeling (FDM) and Stereolithography (SLA) are among the most popular techniques available to print such polymeric implants. These techniques facilitate introducing antibiotics into the material at microscales during the manufacturing stage and subsequently, the printed implants can be engineered to release drugs in a controlled manner. However, FDM uses high temperature to melt the filament as it passes through the nozzle and SLA relies on exposure to nanoscale wavelength ultraviolet (UV) light which can adversely affect the anti-bacterial effectiveness of the antibiotics. The focus of this article is two-fold: i) Examine the effect of high temperature on the bacterial kill-effectiveness of eluted antibiotics through Polycaprolactone (PCL) based femoral implants and ii) Examine the effect of exposure to ultraviolet (UV) light on the bacterial kill-effectiveness of eluted antibiotics through femoral implants made up of a composite resin with various weight fractions of Polyethylene Glycol (PEG) and Polyethylene Glycol Diacrylate (PEGDA). Results indicate that even after exposing doxycycline, vancomycin and cefazolin at different temperatures between 20oC and 230oC, the antibiotics did not lose their effectiveness (kill radius of at least 0.85 cm). For doxycycline infused implants exposed to UV light, it was seen that a resin with 20 % PEGDA and 80 % PEG had the highest efficacy (1.8 cm of kill radius) and the lowest efficacy was found in an implant with 100 % PEGDA (1.2 cm of kill radius).

Physico-chemical and biological evaluation of doxycycline loaded into hybrid oxide-polymer layer on Ti-Mo alloy

Oxide-polymer coatings were formed on the surface of the vanadium-free Ti–15Mo titanium alloy. The Ti alloy surface was modified by the plasma electrolytic oxidation process, and then, the polymer layer of a poly (D, l-lactide-co-glycolide) with doxycycline was formed. The polymer evenly covered the porous oxide layer and filled some of the pores. However, the microstructure of the polymer surface was completely different from that of the PEO layer. The surface morphology, roughness and microstructure of the polymer layer were examined by scanning electron microscopy (SEM) and a confocal microscope. The results confirmed the effectiveness of polymer and doxycycline deposition in their stable chemical forms. The drug analysis was performed by high-performance liquid chromatography. The ¹H NMR technique was used to monitor the course of hydrolytic degradation of PLGA. It was shown that the PLGA layer is hydrolysed within a few weeks, and the polyglycolidyl part of the copolymer is hydrolysed to glycolic acid as first and much faster than the polylactide one to lactic acid. This paper presents influence of different microstructures on the biological properties of modified titanium alloys. Cytocompatibility and bacterial adhesion tests were evaluated using osteoblast-like MG-63 cells and using the reference S. aureus and S. epidermidis strains. The results showed that the optimum concentration of doxycycline was found to inhibit the growth of the bacteria and that the layer is still cytocompatible.

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Formation of the oxide-polymer layer containing doxycycline is presented.

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Changes in the doxycycline structure and the evaluation of their stability was analyzed using the HPLC.

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Thickness of the polymer layer was determined using the confocal microscopy.

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The coatings showed the antibacterial properties and were cytocompatible with osteoblast-ike MG-63 cells.

Responses of antibiotics, antibiotic resistance genes, and mobile genetic elements in sewage sludge to thermal hydrolysis pre-treatment and various anaerobic digestion conditions

Sewage sludge from wastewater treatment plants (WWTPs) harbours large amounts of antibiotics, antibiotic resistance genes (ARGs), and mobile genetic elements (MGEs), the variation and fate of these emerging pollutants during sludge treatment processes must be thoroughly studied to reduce their potential risks to human health. In this study, 7 pilot-scale CSTR anaerobic digesters were established with the same seed sludge and fed with the same thermal hydrolysis pre-treated sewage sludge, while operating under different conditions. High-throughput quantitative PCR, UPLC-MS/MS and Illumina Hiseq-sequencing were used to systematically evaluate the responses of antibiotics, ARGs, and MGEs in sewage sludge to thermal hydrolysis pre-treatment and various anaerobic digestion (AD) conditions. The results showed that thermal hydrolysis effectively reduced the abundance (>94%) of almost all subtypes of ARGs and MGEs, and it was a powerful technology for reducing tetracyclines, macrolides, and lincosamides. Besides, the abundance of ARGs and MGEs in thermophilic digesters was lower than that in mesophilic digesters, suggesting that thermophilic digesters could be used to avoid the ARGs rebounding. In addition, the thermophilic system further reduced the concentrations of quinolones. For the digesters operated under the mesophilic conditions, a longer hydraulic retention time (HRT) facilitated the removal of antibiotics, ARGs, and MGEs. Furthermore, the microbial community and MGEs had important effects on the persistence and proliferation of ARGs in AD process. The findings of this study provide effective clues for controlling the spread of antibiotic resistance and suggest the optimal operating conditions of digesters.

Time dependent screening of antibiotic residues in milk of antibiotics treated cows

Objective:

To analyze the presence of selective antibiotic residues (oxytetracycline, amoxicillin, and ciprofloxacin) in milk during the antibiotic treatment course, and to evaluate the thermal effect on antibiotics residual status in milk of antibiotic-treated cows.

Materials and Methods:

The raw fresh milk was collected from 18 lactating cows before antibiotics treatment, which were brought to the veterinary hospital and suffered from either mastitis, foot and mouth disease, fever, local wound, or non-specific diarrhea, and so on. Out of the 18 lactating cows, six were treated with oxytetracycline, six were treated with amoxicillin, and six were treated with ciprofloxacin parenterally. Milk samples were also collected at 2nd day during treatment and final collection was done after maintaining the withdrawal period. Since milk is heated before consumption, it was boiled at 100°C for 20 min to evaluate the thermal effect on antibiotics residual status. Thin-layer chromatography was done for screening of antibiotics residue before and after boiling of the milk.

Results:

At day 0 (before antibiotic treatment), no antibiotics (oxytetracycline, ciprofloxacin and amoxicillin) residue was detected in raw milk of antibiotic treated cows. In contrast, on day 2 (during antibiotic treatment), 100% raw milk samples showed positive for antibiotics residue. After boiling, all milk samples showed positive for such specific antibiotics residue. On the other hand, no antibiotics residues were detected on day 9, which indicates the completion of the withdrawal period of the respective antibiotic. The intensities of bands for antibiotic on thin-layer chromatography plate of antibiotic residues in milk samples (oxytetracycline, amoxicillin, and ciprofloxacin) expressed that the respective antibiotic residual status was higher in the boiled milk compare to the raw milk.

Conclusion:

Proper maintenance of withdrawal period after antibiotic treatment would minimize the risk of antibiotic residues in milk, and boiling does not change these specific antibiotics residual status in milk. Therefore, awareness regarding the proper maintenance of withdrawal period after antibiotic treatment in lactating cows is one of the best strategies that may positively reduce the risk of antimicrobial drugs residue in milk.

Detection and determination of stability of the antibiotic residues in cow's milk

In the present study, antibiotic residues were detected in milk samples collected from the dairy herds located in Karnataka, India, by microbiological assay. Subsequently, the detected antibiotics were identified as azithromycin and tetracycline, by high-performance liquid chromatography, further both the antibiotics detected in the cow milk samples were found to be at high concentration (9708.7 and 5460 μg kg^-1, respectively). We then investigated the effects of temperature and pH on the stabilities of azithromycin and tetracycline to determine the degradation rate constant k using first-order kinetic equation. Results indicated that significant reduction in stability and antibacterial activity of azithromycin solution when subjected to 70 and 100°C for 24 h. While stability of tetracycline was significantly reduced when subjected to 70 and 100°C for 24 h. However no significant reduction in antibacterial activity of tetracycline was observed at respective temperatures when compared with that of control. In addition, the stabilities of azithromycin and tetracycline were found to be decreased in acidic pH 4–5. The results of the present study revealed the high risk of contamination of milk sample with veterinary antibiotics and also demonstrated the effect of temperature and pH on stability of antibiotics. Therefore the study suggest that the qualitative and quantitative screening of milk for the presence of antibiotics need to be strictly performed to ensure safe drinking milk for consumers.

Fe3+ enhanced degradation of oxytetracycline in water by pseudomonas

The application and fate of antibiotics are closely related to human health and the ecological balance, which has gradually aroused the widespread global concerns. Long-term antibiotic residues can easily induce antibiotic resistance and antibiotic resistance genes (ARGs) in the environment. Although many studies have investigated the metabolic pathways of biosynthesis or degradation of oxytetracycline (OTC) and its influencing factors under laboratory or controlled conditions, the understanding of OTC degradation pathways and influencing factors in the environment is still poor. In the present study, the role of Pseudomonas (T4) in OTC biodegradation were investigated with different carbon sources, metal ions, substrate concentrations, temperatures, and pH values, as well as the temporal changes in the relative abundance of OTC ARGs. It was found that OTC could be degraded by T4 as a sole carbon source. Comparison with Cu²⁺, the addition of Fe³⁺ could significantly promote the growth of T4, and then increased the OTC degradation percentage to 65.3%. The initial concentration of OTC, temperature, and pH had significant impacts on OTC degradation. At the initial OTC concentration of 50 mg L^-1, the percentage degradation of OTC by T4 could reach 81.0% at the presence of Fe³⁺, and at 40 °C and pH = 7. Common tetracycline ARGs were not found during the OTC degradation by T4 in the present study. The eight main putative OTC degradation byproducts were identified by ultra-high definition accurate-mass quadrupole time-of-flight tandem mass spectrometry (QTOF/MS). Six different reaction types and seven possible degradation pathways were proposed, including enol-ketone conversion, hydroxylation, dehydration, deamination, demethylation and decarbonylation. Under optimal conditions, the OTC degradation percentages by T4 could reach to 88.2%, 91.6% and 92.0% in pond water, fish wastewater and industrial wastewater, respectively. These results demonstrate the high effectiveness of T4 at the presence of Fe³⁺ for the enhanced biodegradation of OTC in water environment, without resulting in the occurrence of ARGs. This has important implications for the removal of OTC from aquatic environments by the technology proposed from this study.

Variation of antibiotics in sludge pretreatment and anaerobic digestion processes: Degradation and solid-liquid distribution

Degradation and solid-liquid distribution of antibiotics in three sludge pretreatments (ultrasonic, alkaline and thermal hydrolysis pretreatment) and subsequent anaerobic digestion processes were investigated. The contamination of fluoroquinolones (FQs) was most serious in the raw sludge, while sulfonamides (SAs) were negligible. Obvious solubilization of antibiotics was observed after sludge pretreatments. The intracellular antibiotics were released after thermal hydrolysis pretreatment, meanwhile tetracyclines (TCs) were thermally decomposed. Compared to TCs and macrolides (MLs), FQs were hardly degraded in anaerobic digestion with removal efficiencies lower than 42.02%, and the residual FQs were mostly adsorbed on the digested sludge. The limiting step for FQs reduction was the biodegradation, rather than desorption of adsorbed antibiotics. Addition of pretreatments had no obvious effect on the degradation and distribution of antibiotics in the anaerobic digested sludge, except that the thermal hydrolysis enhanced the migration of antibiotics to the liquid phase.

3D printed Polycaprolactone scaffolds with dual macro-microporosity for applications in local delivery of antibiotics

Advanced scaffolds used in tissue regenerating applications should be designed to address clinically relevant complications such as surgical site infection associated with surgical procedures. Recognizing that patient-specific scaffolds with local drug delivery capabilities are a promising approach, we combined 3D printing with traditional salt-leaching techniques to prepare a new type of scaffold with purposely designed macro- and micro-porosity. The dual macro/micro porous scaffolds of medical-grade polycaprolactone (mPCL) were characterized for their porosity, surface area, mechanical properties and degradation. The use of these scaffolds for local prophylactic release of Cefazolin to inhibit S. aureus growth was investigated as an example of drug delivery with this versatile platform. The introduction of microporosity and increased surface area allowed for loading of the scaffold using a simple drop-loading method of this heat-labile antibiotic and resulted in significant improvement in its release for up to 3 days. The Cefazolin released from scaffolds retained its bioactivity similar to that of fresh Cefazolin. There were no cytotoxic effects in vitro against 3 T3 fibroblasts at Cefazolin concentration of up to 100 μg/ml and no apparent effects on blood clot formation on the scaffolds in vitro. This study therefore presents a novel type of scaffolds with dual macro- and micro-porosity manufactured by a versatile method of 3D printing combined with salt-leaching. These scaffolds could be useful in tissue regeneration applications where it is desirable to prevent complications using local delivery of drugs.

Effect of temperature (cooking and freezing) on the concentration of oxytetracycline residue in experimentally induced birds

Aim

The objective of this study was to determine the effect of varying temperatures (different cooking methods and freezing) on the concentration of oxytetracycline (OTC) residues in tissues of broiler birds.

Materials and Methods

Fifty, 5-week-old birds were purchased and acclimatized for 3 weeks while being fed antibiotic-free feed and water. Four birds were then tested for residue and in the absence; the remaining birds were injected intramuscularly with oxytetracycline at its therapeutic dose. Muscle and liver samples of the treated birds were harvested and checked for OTC residues before subjecting them to boiling, microwaving, and roasting. The three plate test was used for the residue detection.

Result

OTC was detected at both pH 6.0 and pH 7.2 but not detected at pH 8.0. Roasting and boiling significantly reduced the concentration of oxytetracycline in muscle by 53.6% and 69.6%, respectively, at pH 6.0, microwaving reduced the concentration by 49.1% but was not statistically significant. The same pattern was followed at pH 7.2 with reduction of 34.3%, 53.2%, and 67.7% for microwaved, roasted, and boiled. For the liver tissues, there was a significant reduction in the concentration for both pH: 6.0 (57.75%, 79.75%, and 89%; pH 7.2 (48.06%, 79.6%, and 88.79%) for boiled, microwaved, and roasted samples. Boiling had a greater reduction effect for muscle samples while roasting had a greater reduction in liver samples at both pHs. Freezing at -10°C had no effect on the concentration of OTC even after 9 days.

Conclusion

The significant reduction of OTC concentration by cooking indicates that consumers may not be at risk of the effects of OTC residues in meat, but microwaving meat may not reduce the concentration below the maximum residue limit if the initial concentration is very high. Therefore, routine monitoring of drug residues in farms and abattoirs is still advocated.

Tetracycline antibiotics transfer from contaminated milk to dairy products and the effect of the skimming step and pasteurisation process on residue concentrations

The presence of antibiotics in raw milk and milk derivatives poses a threat to human health and can negatively affect the dairy industry. Therefore, the main object of this study was to investigate the transfer of oxytetracycline (OTC), tetracycline (TC), chlortetracycline (CTC) and doxycycline (DC) from raw, experimental milk contaminated with tetracyclines (TCs) to different dairy products: cream, butter, buttermilk, sour milk, whey, curd and cheese. Additionally the effect of the skimming process on TCs concentrations was tested, as well as the influence of low-temperature long-time pasteurisation. The analyses of TCs in milk and dairy products were performed by an LC-MS/MS method. In order to determine TCs residues in dairy products, an analytical method was developed with the same extraction step for all matrices. TCs molecules were inhomogenously distributed between the milk derivative fractions. The highest concentrations were determined in curd and cheese in the ranges 320-482 µg/kg and 280-561 µg/kg, respectively. Low levels of TCs in butter and whey were observed (11.8-41.2 µg/kg). TCs were found in sour milk (66.0-111 µg/kg), cream (85.0-115 µg/kg) and buttermilk (196-221 µg/kg) at much higher levels than in butter and whey, but lower than in curd and cheese. During the skimming process, the highest yield of cream was obtained after the raw milk was held at 2-8°C for 24 h. The differences in concentrations of TCs between whole milk and skimmed milk, expressed as percentages of recovery, were below 19% (recoveries in excess of 81%). The highest content was observed in milk and cream skimmed at 2-8°C. The degradation percentages for TCs during the pasteurisation process (63°C for 30 min) were below 19%.

Veterinary antibiotics in food, drinking water, and the urine of preschool children in Hong Kong

Due to the harmful effects of veterinary antibiotics (VAs) residues in food on children's health, urine samples from 31 preschool and primary school children were analyzed for 13 common VAs. Samples of raw and cooked pork, chicken, fish, milk and drinking water from the children's living areas were also analyzed for residual VAs. Urinalysis revealed one to four target antibiotics in 77.4% of the sample group, with concentrations as high as 0.36ng/mL. Norfloxacin and penicillin had the highest detection rates (48.4% and 35.5%, respectively), with median concentrations of 0.037 and 0.13ng/mL, respectively. The VA burden of children in HK was lower than that in Shanghai. Enrofloxacin, penicillin, and erythromycin were the most detected VAs in raw and cooked food. Only oxytetracycline was detected in terminal tap water, and none were detected in milk. Tetracycline and doxycycline hyclate were detected in organic eggs (up to 7.1ng/g) and regular eggs (up to 6.6ng/g), which were common in children's diets. Traditional Chinese cooking processes did not completely eliminate VAs, and the concentrations of some VAs increased, especially after frying and roasting. The estimated daily intake (EDI) results show that the contribution of dietary intake and that based on the urine concentrations of VAs were far below the acceptable daily intake (ADI). The EDIs from urine were significantly lower than those based on cooked foods. The highest level of achievement percentage (LAP) based on dietary consumption and urine concentrations were 39.7% and 1.79%, respectively, and thus current levels of exposure to VAs would not seem to pose a risk to children's health. However, harmful effects of residual VAs during developmental periods may occur with exposure to much lower doses than those considered harmful to adults, and further investigation of these emerging pollutants is urgently encouraged.

Oxytetracycline recovery from aqueous media using computationally designed molecularly imprinted polymers

Polymers for recovery/removal of the antimicrobial agent oxytetracycline (OTC) from aqueous media were developed with use of computational design and molecular imprinting. 2-Hydroxyethyl methacrylate, 2-acrylamide-2-methylpropane sulfonic acid (AMPS), and mixtures of the two were chosen according to their predicted affinity for OTC and evaluated as functional monomers in molecularly imprinted polymers and nonimprinted polymers. Two levels of AMPS were tested. After bulk polymerization, the polymers were crushed into particles (200-1000 μm). Pressurized liquid extraction was implemented for template removal with a low amount of methanol (less than 20 mL in each extraction) and a few extractions (12-18 for each polymer) in a short period (20 min per extraction). Particle size distribution, microporous structure, and capacity to rebind OTC from aqueous media were evaluated. Adsorption isotherms obtained from OTC solutions (30-110 mg L(-1)) revealed that the polymers prepared with AMPS had the highest affinity for OTC. The uptake capacity depended on the ionic strength as follows: purified water > saline solution (0.9 % NaCl) > seawater (3.5 % NaCl). Polymer particles containing AMPS as a functional monomer showed a remarkable ability to clean water contaminated with OTC. The usefulness of the stationary phase developed for molecularly imprinted solid-phase extraction was also demonstrated. Graphical Abstract Selection of functional monomers by molecular modeling renders polymer networks suitable for removal of pollutants from contaminated aqueous environments, under either dynamic or static conditions.

New Synthesis of Gold- and Silver-Based Nano-Tetracycline Composites

A new synthetic methodology of water-soluble gold and silver nanoparticles (AuNPs@TC and AgNPs@TC), using the antibiotic tetracycline (TC) as co-reducing and stabilizing agent, is reported. Both colloids exhibit high water stability. The average sizes obtained were 25±10 and 15±5 nm, respectively. Both composites were tested against TC-resistant bacteria, presenting an increasing antibacterial effect in the case of AgNPs@TC. The sensing towards metal ions was also explored. An interesting and reversible affinity of AuNPs@TC towards AlIII cations in an aqueous system was also observed.

Autoclave treatment of pig manure does not reduce the risk of transmission and transfer of tetracycline resistance genes in soil: successive determinations with soil column experiments

The increasing use of antibiotics, especially tetracycline, in livestock feed adversely affects animal health and ecological integrity. Therefore, approaches to decrease this risk are urgently needed. High temperatures facilitate antibiotic degradation; whether this reduces transmission risk and transfer of tetracycline-resistant bacteria (TRBs) and tetracycline resistance genes (TRGs) in soil remains unknown. Successive experiments with soil columns evaluated the effects of autoclaving pig manure (APM) on soil TRB populations and TRGs over time at different soil depths. The data showed sharp increases in TRB populations and TRGs in each subsoil layer of PM (non-APM) and APM treatments within 30 days, indicating that TRBs and TRGs transferred rapidly. The level of TRBs in the upper soil layers was approximately 15-fold higher than in subsoils. TRBs were not dependent on PM and APM levels, especially in the late phase. Nevertheless, higher levels of APM led to rapid expansion of TRBs as compared to PM. Moreover, temporal changes in TRB frequencies in total culturable bacteria (TCBs) were similar to TRBs, indicating that the impact of PM or APM on TRBs was more obvious than for TCBs. TRBs were hypothesized to depend on the numbers of TRGs and indigenous recipient bacteria. In the plough layer, five TRGs (tetB, tetG, tetM, tetW, and tetB/P) existed in each treatment within 150 days. Selective pressure of TC may not be a necessary condition for the transfer and persistence of TRGs in soil. High temperatures might reduce TRBs in PM, which had minimal impact on the transmission and transfer of TRGs in soil. Identifying alternatives to decrease TRG transmission remains a major challenge.

Distribution of Animal Drugs between Skim Milk and Milk Fat Fractions in Spiked Whole Milk: Understanding the Potential Impact on Commercial Milk Products

Seven animal drugs [penicillin G (PENG), sulfadimethoxine (SDMX), oxytetracycline (OTET), erythromycin (ERY), ketoprofen (KETO), thiabendazole (THIA), and ivermectin (IVR)] were used to evaluate the drug distribution between milk fat and skim milk fractions of cow milk. More than 90% of the radioactivity was distributed into the skim milk fraction for ERY, KETO, OTET, PENG, and SDMX, approximately 80% for THIA, and 13% for IVR. The distribution of drug between milk fat and skim milk fractions was significantly correlated to the drug's lipophilicity (partition coefficient, log P, or distribution coefficient, log D, which includes ionization). Data were fit with linear mixed effects models; the best fit was obtained within this data set with log D versus observed drug distribution ratios. These candidate empirical models serve for assisting to predict the distribution and concentration of these drugs in a variety of milk and milk products.

Cytotoxic effects of oxytetracycline residues in the bones of broiler chickens following therapeutic oral administration of a water formulation

Tetracyclines, which represent one of the most commonly used antibiotics for poultry, are known to be deposited in bones, where they can remain, despite the observation of appropriate withdrawal times. The aim of the study was to determine the concentration of oxytretracycline (OTC) residues in the bone and muscle of chickens, following the oral administration of a commercially available liquid formulation, and to test their cytotoxic effects on an in vitro cell culture model. Seventy-two 1-day-old broiler chickens were randomly allotted into 2 groups (control and treated animals). OTC (40 mg/kg BW) was administered via drinking water during the 1 to 5 and 20 to 25 days of life periods. At the end of the trial, the birds were slaughtered and the OTC residues in the target tissues were measured by means of liquid chromatography (LC) - tandem mass spectrometry (MS/MS). Cytotoxicity was assessed by evaluating the pro-apoptotic effect of the bone residues on the K562 erythroleukemic line and on the peripheral blood mononuclear cells (PBMC). In all the animals, the OTC residues in the muscle were far below the established MRL of 100 μg/kg. The OTC levels in the bones of the treated animals were instead found in the parts per million (ppm) range. Cell cytotoxicity was assessed by evaluating the pro-apoptotic effect of OTC bone residues on the haematopoietic cell system. This in vitro system has revealed a significant pro-apoptotic effect on both the K562 cell line and PBMC cultures. This result suggests potential human and animal health risks due to the entry of tetracycline residues contained in the bones of treated livestock into the food-chain. This could be of concern, particularly for canine and feline diets, as meat, bone meal, and poultry by-products represent some of the main ingredients of pet foods, especially in the case of dry pet food. Further studies are needed to define the underlying mechanisms of cytotoxicity and to evaluate the in vivo toxicological implications due to the observed in vitro effects.

Effect of pasteurization on the residues of tetracyclines in milk

The main aim of this work was to determine the effect of high pasteurization of milk (85 °C/3 s) on the residues of tetracycline and oxytetracycline. The samples of raw cow’s milk, purchased from a vending machine, were spiked with standard solutions of tetracycline and oxytetracycline. The content of the residues of tetracycline antibiotics was measured before and after heating. Pre-cleaned samples were extracted by a mixed-mode solid phase extraction technique and analysed using high performance liquid chromatography/diode array detection. Whereas the residues of tetracycline decreased only by 5.74% and were not significantly different (P > 0.05), the residues of oxytetracycline decreased by 15.3% and this distinction was highly significant (P ≤ 0.01). Based on the results of our study, the tetracycline antibiotics were proved to have differences in the thermostability of particular substances at pasteurisation temperatures.

Simultaneous determination of 38 veterinary antibiotic residues in raw milk by UPLC-MS/MS

A selective and rapid method has been developed to determine, simultaneously, 38 veterinary antibiotic residues in raw milk by ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). One milliliter of raw milk was diluted with 0.5 mL water and 3 mL acetonitrile, then purified using an Oasis HLB cartridge. The eluates were evaporated by nitrogen drying and then reconstituted to 4 mL with water/acetonitrile (8:1) before being injected into the UPLC-MS/MS system. The results indicated recoveries of 68-118% for 14 β-lactams, 79-118% for eight quinolones, 71-106% for eight sulfonamides, 76-116% for four tetracyclines, 78-106% for three macrolides, and 88-103% for one lincosamides, with coefficients of variation less than 15% for intraday and interday precisions. The limit of quantification for all antibiotics was 0.03-10 μg kg(-1). This methodology was then applied to field-collected real raw milk samples and trace levels of four antibiotics were detected.

Use of Metagenomics and Isolation of Actinobacteria in Brazil's Atlantic Rainforest Soil for Antimicrobial Prospecting

Modern techniques involving molecular biology, such as metagenomics, have the advantage of exploiting a higher number of microorganisms; however, classic isolation and culture methods used to obtain antimicrobials continue to be promising, especially in the isolation of Actinobacteria, which are responsible for the production of many of these compounds. In this work, two methodologies were used to search for antimicrobial substances—isolation of Actinobacteria and metagenomics of the Atlantic Rainforest soil and of the cultivation of cocoa intercropped with acai berry in the Atlantic Rainforest. The metagenomic libraries were constructed with the CopyControl Fosmid Library kit EPICENTRE, resulting in a total of 2688 clones, 1344 of each soil sample. None of the clones presented antimicrobial activity against the microorganisms tested: S. aureus, Bacillus subtilis, and Salmonella choleraesuis. A total of 46 isolates were obtained from the isolation of soil Actinobacteria: 24 isolates from Atlantic Rainforest soil and 22 isolates from the intercrop cultivation soil. Of these, two Atlantic Rainforest soil isolates inhibited the growth of S. aureus including a clinical isolate of S. aureus MRSA—a promising result, since it is an important multidrug-resistant human pathogen.

A case of fixed drug eruption due to doxycycline and erythromycin present in food

A fixed drug eruption (FDE) is not difficult to diagnose, given its clinical characteristics. However, the causative agent can be difficult to identify, particularly when the patient denies ingestion of any drugs. To the best of our knowledge, we present herein the first reported case of an FDE caused by antibiotics taken in food; doxycycline and erythromycin contained in pork and fish. A 57-year-old female experienced repeated episodes of well-demarcated erythematous patches covering her entire body. She denied taking any medications, but she thought that the lesions appeared after consuming pork and/or fish. An oral provocation test showed positive results for doxycycline and erythromycin, commonly used antibiotics in live-stock farming and in the fishing industry. Because of the antibiotics' thermostability, cooking does not guarantee the elimination of residual drugs. From the patient's history, we concluded that doxycycline and erythromycin contained in the pork and fish that she ate were the cause of the FDE.