Dihydrostreptomycin or streptomycin in combination with penicillin G in dairy cattle therapeutics: A review and re-analysis of published data Part 1: Clinical pharmacology

Investigation of the Persistence of Penicillin G and Dihydrostreptomycin Residues in Milk of Lactating Buffaloes ( Bubalus bubalis) Using Ultra-High-Performance Liquid Chromatography and Tandem Mass Spectrometry

The purpose of this research was to evaluate the persistence of penicillin G and dihydrostreptomycin in milk of lactating buffaloes following intramuscular injection of procaine penicillin G (200000 IU/mL) and dihydrostreptomycin sulfate (250 mg/mL) every 24 h for 3 days. Milk samples were collected twice daily up to the 13th milking post-treatment and analyzed by ultra-high-performance liquid chromatography coupled to tandem mass spectrometry. The analytical method has been validated according to Commission Decision 2002/657/EC. The highest concentrations of penicillin G (275 μg kg^-1) and dihydrostreptomycin (220.5 μg kg^-1) were detected in the milk of the first milkings post-treatment, and levels were below the maximum residue limit of 4 and 200 μg kg^-1 in all treated buffaloes at milkings 12 and 2, respectively. The results of this study demonstrate that a nine-milking withdrawal time set for bovine milk was not adequate for depletion of penicillin G in lactating buffaloes.

A descriptive analysis of the antimicrobial susceptibility of mastitis-causing bacteria isolated from samples submitted to commercial diagnostic laboratories in New Zealand (2003-2006)

AIM

To describe the antimicrobial susceptibility of mastitis-causing bacteria isolated from milk samples submitted to commercial laboratories over a period of 40 months.

METHODS

The records of reported results of milk samples submitted by veterinary practitioners to five commercial veterinary laboratories in the North and South Islands of New Zealand, between August 2003 and December 2006 were reviewed. Logistic regression was used to analyse the effect of year, island, and the interaction of year and antimicrobial on the probability of antimicrobial susceptibility for each pathogen and antimicrobial combination, where the causative bacteria had >1,000 susceptibility tests in total and the antimicrobials was tested on >500 isolates. A total of 9,262 isolates were included in this study, with an average of nearly seven susceptibility tests per isolate, totalling 62,918 tests.

RESULTS

Streptococcus uberis isolates demonstrated high overall susceptibility (>90.0%) to the majority of antimicrobial agents except ampicillin (81.7%), lincomycin (85.3%), trimethoprim/sulphonamide combination (88.6%), and, as expected, aminoglycosides (<4%). The susceptibility of Strep. dysgalactiae was similar to that of Strep. uberis, except for greater susceptibility to oxacillin (98.1%) and much lower susceptibility to tetracyclines (11.2%). The susceptibility of Staphylococcus aureus isolates was markedly different from that of Strep. uberis for the majority of antimicrobials tested. Susceptibility of Staph. aureus was lower than 90% to ampicillin (73.4%), erythromycin (74.7%), lincomycin (66.1%), penicillin (73.1%), and streptomycin (71.7%). No antimicrobial was effective against all Staph. aureus isolates. Minor changes were found in the overall susceptibility of the main mastitis-causing bacteria between 2003 and 2006.

CONCLUSIONS

The antimicrobial agents intended for treatment of bovine mastitis currently available in New Zealand generally demonstrated good in-vitro efficacy against streptococci and staphylococci, with the exception of aminoglycosides.

CLINICAL RELEVANCE

Analysis of the results of antimicrobial susceptibility of bacterial isolates from milk samples from dairy cows in New Zealand provides useful data for surveillance purposes, and a baseline for identifying changes in antimicrobial sensitivity in this population. However, the variation in antimicrobial susceptibility between individual isolates means that these data are of limited value when determining treatment of mastitis at the farm level.

Dihydrostreptomycin or streptomycin in combination with penicillin G in dairy cattle therapeutics: A review and re-analysis of published data Part 2: Resistance and residues

Combination formulations of penicillin G salts and dihydrostreptomycin were developed during the 1960s and are currently marketed in New Zealand for parenteral and intramammary use in dairy cattle. In this paper, the second part of a two paper series, the mechanisms by which bacteria develop resistance to each of these drugs independently is reviewed and the impact of this resistance on potential for synergy is discussed. Further, the considerable potential for tissue drug residues with dihydrostreptomycin or streptomycin from these formulations is examined by re-analysis of literature data, demonstrating an urgent need to reassess the place for aminoglycoside-containing formulations in dairy cattle therapeutics.

Treatment of mastitis during lactation

Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

Clinical and bacteriological response to treatment of clinical mastitis with one of three intramammary antibiotics

AIM

To compare the proportions of clinical and bacteriological cure of glands of dairy cows diagnosed with clinical mastitis, following treatment with one of three different intramammary antibiotic preparations.

METHODS

Cows from dairy cow herds (n=28) across New Zealand which were diagnosed with clinical mastitis in one or more glands at any stage of lactation were randomly assigned at the cow level within sequentially presented groups of three animals to be treated with one of three intramammary antibiotics. The treatments were 1 g procaine penicillin, 0.25 g cefuroxime, and a combination of 1 g procaine penicillin and 0.5 g dihydrostreptomycin (DHS). All treatments were infused on three occasions at 12-hourly intervals. Duplicate milk samples were collected for bacteriology before initial treatment, and 21-42 days later. Logistic regression or generalised linear mixed models were used to analyse the proportion of cows or quarters retreated for mastitis within 30 days of initial treatment ('clinical treatment failure'), and the proportion of glands from which bacteria were isolated initially but from which the same bacterial species was not re-isolated ('bacteriological cure').

RESULTS

The annual herd average cumulative incidence rate of clinical mastitis was 12.7 cases/100 cows. The incidence rate was higher in young (2-year-old) and old (> or = 9-year-old) cows relative to 3- and 4-year-old cows, and was higher in Friesian than Jersey or crossbred cows. Streptococcus uberis was the pathogen most commonly isolated, and its relative prevalence declined with time postpartum. Cows treated with cefuroxime were more likely (p<0.01) to be re-treated for clinical mastitis in the 30 days after initial treatment than cows treated with procaine penicillin or procaine penicillin and DHS. Bacteriological cure occurred in 74% of treated glands and there was no difference in the proportion of cures among the treatments (p=0.4). The proportion of cures was lower when treatment occurred 28-72 days after calving (p<0.01) and if a major pathogen was isolated (p<0.001).

CONCLUSIONS AND CLINICAL RELEVANCE

There was no benefit in terms of clinical or bacteriological cure rate in treating clinical mastitis cases with the combination of procaine penicillin and DHS compared to treatment with procaine penicillin alone. The proportion of clinical mastitis cases re-treated differed among herds, and more cows treated with cefuroxime were retreated within 30 days of initial treatment. However, the bacteriological cure proportion was the same among the treatments. Cure proportions were lower in cows from which major mastitis pathogens were isolated and when treatment commenced 28-72 days after calving.

Efficacy of intramammary treatment with procaine penicillin G vs. procaine penicillin G plus neomycin in bovine clinical mastitis caused by penicillin-susceptible, gram-positive bacteria--a double blind field study

The efficacy of intramammary treatments containing procaine penicillin G alone (treatment A) or a combination of procaine penicillin G and neomycin (treatment B) was compared in treating clinical bovine mastitis caused by gram-positive bacteria susceptible in vitro to penicillin G. Both treatments were supplemented with a single intramuscular injection of procaine penicillin G on the first day of treatment. The study was carried out using a double blind design on commercial dairy farms in Southern Finland. A total of 56 quarters were treated with treatment A and 61 with treatment B. The cure rates for both treatments were equal, which suggests that the use of the penicillin G-aminoglycoside combination does not increase the efficacy of the treatment over that achieved by using penicillin G alone in bovine clinical mastitis caused by penicillin-susceptible, gram-positive bacteria.

Dihydrostreptomycin or streptomycin in combination with penicillin G in dairy cattle therapeutics: A review and re-analysis of published data Part 1: Clinical pharmacology

Combination formulations of penicillin G salts and dihydrostreptomycin were developed during the 1960s and are currently marketed in New Zealand for parenteral and intramammary use in dairy cattle. In this paper, the clinical indications and efficacy, pharmacokinetics and potential for antimicrobial synergy of penicillin and dihydrostreptomycin or streptomycin, when combined, are discussed.