Termite usage associated with antibiotic therapy: enhancement of aminoglycoside antibiotic activity by natural products of Nasutitermes corniger (Motschulsky 1855)

The ecosystem services provided by social insects: traits, management tools and knowledge gaps

Social insects, i.e. ants, bees, wasps and termites, are key components of ecological communities, and are important ecosystem services (ESs) providers. Here, we review the literature in order to (i) analyse the particular traits of social insects that make them good suppliers of ESs; (ii) compile and assess management strategies that improve the services provided by social insects; and (iii) detect gaps in our knowledge about the services that social insects provide. Social insects provide at least 10 ESs; however, many of them are poorly understood or valued. Relevant traits of social insects include high biomass and numerical abundance, a diversity of mutualistic associations, the ability to build important biogenic structures, versatile production of chemical defences, the simultaneous delivery of several ESs, the presence of castes and division of labour, efficient communication and cooperation, the capacity to store food, and a long lifespan. All these characteristics enhance social insects as ES providers, highlighting their potential, constancy and efficiency as suppliers of these services. In turn, many of these traits make social insects stress tolerant and easy to manage, so increasing the ESs they provide. We emphasise the need for a conservation approach to the management of the services, as well as the potential use of social insects to help restore habitats degraded by human activities. In addition, we stress the need to evaluate both services and disservices in an integrated way, because some species of social insects are among the most problematic invasive species and native pests. Finally, we propose two areas of research that will lead to a greater and more efficient use of social insects as ES providers, and to a greater appreciation of them by producers and decision-makers.

Plant-derived secondary metabolites as the main source of efflux pump inhibitors and methods for identification

The upsurge of multiple drug resistance (MDR) bacteria substantially diminishes the effectiveness of antibiotic arsenal and therefore intensifies the rate of therapeutic failure. The major factor in MDR is efflux pump-mediated resistance. A unique pump can make bacteria withstand a wide range of structurally diverse compounds. Therefore, their inhibition is a promising route to eliminate resistance phenomenon in bacteria. Phytochemicals are excellent alternatives as resistance-modifying agents. They can directly kill bacteria or interact with the crucial events of pathogenicity, thereby decreasing the ability of bacteria to develop resistance. Numerous botanicals display noteworthy efflux pumps inhibitory activities. Edible plants are of growing interest. Likewise, some plant families would be excellent sources of efflux pump inhibitors (EPIs) including Apocynaceae, Berberidaceae, Convolvulaceae, Cucurbitaceae, Fabaceae, Lamiaceae, and Zingiberaceae. Easily applicable methods for screening plant-derived EPIs include checkerboard synergy test, berberine uptake assay and ethidium bromide test. In silico high-throughput virtual detection can be evaluated as a criterion of excluding compounds with efflux substrate-like characteristics, thereby improving the selection process and extending the identification of EPIs. To ascertain the efflux activity inhibition, real-time PCR and quantitative mass spectrometry can be applied. This review emphasizes on efflux pumps and their roles in transmitting bacterial resistance and an update plant-derived EPIs and strategies for identification.

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Active efflux as the main resistance strategy in bacteria.

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Phytochemicals as promising alternatives against efflux pumps-mediated MDR.

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Herbals-based efflux pump inhibitors screening, the methods.

Transference of bioactive compounds from support plants to the termites Constrictotermes cyphergaster (Isoptera)

This study aims to investigate the microbiological potential of the termite species Constrictotermes cyphergaster (Silvestri, 1901) and its support plants. We collected five C. cyphergaster nests from three different support plant species. Microbiological assays were performed on these extracts using the serial microdilution method in triplicate to measure the minimum inhibitory concentration (MIC) of each microorganism for the analysed extract. The ethanol extracts of the termite C. cyphergaster showed no significant activity against strains of Staphylococcus aureus and Escherichia coli, with an MIC >1000 μg mL-1. Only the extracts of the nests and termites with the nest had the same MICs. These results were in contrast to the extracts of Spondias tuberosa (Umbuzeiro), Poincianella pyramidalis (Catingueira), and Amburana cearensis (Cumaru), which demonstrated significant activity against S. aureus with MICs <1000 μg mL-1. The modulating activity of the extracts tested in the present study demonstrated potentiation of most antibiotics across the bacterial strains tested when combined with the extracts for both S. aureus and E. coli. These results indicate that the extracts tested in the present study may be composed of animal and vegetable origins with the potential to modify the activity of antibiotics and thus may aid in antimicrobial therapy.

Vertebrates as a Bactericidal Agent

In Brazil, although a large number of animals are used in traditional medicine (at least 354 species), information about their biological activities is scarce. In this context, the objective of this study was to evaluate the bactericidal potential of zootherapeutic by-products from animals used in Brazilian traditional medicine and discuss the ecological and cultural consequences of such practices. The species analyzed were: Tupinambis merianae (skin), Iguana iguana (skin and body fat), Crotalus durissus (skin and body fat), Boa constrictor (skin), Euphractus sexcinctus (body fat) and Coendou prehensilis (quills). Experiments were performed with standard clinical strains of Escherichia coli (EC-ATCC10536) and Staphylococcus aureus (SA-ATCC 25923). For the microbiological assay, the zootherapeutics were evaluated using serial microdilutions. The results indicate that none of the samples possess inhibitory activity against standard bacterial strains. The in vitro ineffectiveness of the analyzed products demonstrate a necessity for new pharmacological research that encompass a large number of species of medicinal animals as well as highlight the importance of zootherapy in the context of plans for animal conservation.

Antibacterial activity of male and female sperm-storage organs in ants

Bacteria can damage sperm and thus reduce the reproductive success of both males and females; selection should therefore favour the evolution of antimicrobial protection. Eusocial hymenopterans might be particularly affected by such bacterial infections because of their mating ecology. In both sexes, mating is restricted to a short window early in the adult stage; there are no further chances to mate later in life. Males die shortly after mating, but queens use the acquired sperm to fertilise their eggs for years, sometimes decades. The reproductive success of both sexes is, thus, ultimately sperm-limited, which maintains strong selection for high sperm viability before and after storage. We tested the antibacterial activity of the contents of the male and female sperm-storage organs - the accessory testes and the spermatheca, respectively. As our study species, we used the bacterium Escherichia coli and the garden ant Lasius niger, whose queens can live for several decades. Our results provide the first empirical evidence that male and female sperm-storage organs display different antibacterial activity. While the contents of the accessory testes actually enhanced bacterial growth, the contents of the spermatheca strongly inhibited it. Furthermore, mating appears to activate the general immune system in queens. However, antimicrobial activity in both the spermatheca and the control tissue (head-thorax homogenate) declined rapidly post-mating, consistent with a trade-off between immunity and reproduction. Overall, this study suggests that ejaculates undergo an immune 'flush' at the time of mating, allowing storage of sperm cells free of bacteria.

Animals and Human Health

Human health and animal health are closely intertwined. We share hundreds of diseases with animals, and they are vectors for many diseases that assail humans—but, at the same time, they are essential to many treatments and cures. We discuss in this chapter various aspects of intimate relationship between human and animal health, giving examples of the importance of multidisciplinary studies in understanding these connections and the fundamental aspects of strategies for promoting the health and well-being of both groups.

Farmers' perception of termites in agriculture production and their indigenous utilization in Northwest Benin

BACKGROUND

Although termites are considered as agricultural pests, they play an important role in maintaining the ecosystem. Therefore, it matters to investigate the farmers' perception of the impacts of the termites on the agriculture and their indigenous utilization.

METHODS

A semi-structured questionnaire was used to interview 94 farmers through 10 villages of Atacora department, in the northwestern region of Benin, to obtain information for the development of successful strategies of termite management and conservation. Their perceptions on the importance and management of termites along with the indigenous nomenclature and utilization of termite mounds were assessed. Termite species identified by farmers were collected and preserved in 80% alcohol for identification.

RESULTS

Eight crops were identified by farmers as susceptible to termites with maize, sorghum, and yam as being the most susceptible. According to farmers, the susceptibility to termites of these crops is due to their high-water content and sweet taste. A total of 27 vernacular names of termites were recorded corresponding to 10 species, Amitermes evuncifer, Macrotermes subhyalinus, and Trinervitermes oeconomus being the most damaging termite species. All the names given to termite species had a meaning. The drought was identified by farmers as the main factor favouring termite attacks. Demolition of termite mounds in the fields was the most commonly reported control method. Salt and other pesticides were commonly used by farmers to protect stored farm products. The lack of effective control methods is the main constraint for termite management. In northwestern Benin, farmers reported different purpose utilizations of termite mounds and termites.

CONCLUSIONS

The study has shown that farmers perceived termites as pests of several agricultural crops and apply various indigenous control practices whose efficiency need to be verified. Utilization of termites and termite mound soil as food and medicinal resources underlines the need for a more focused approach to termite control for the conservation of non-pest termite species. The sensitization of farmers on the importance of termites as well as the development of an integrated control method to combat termite pests proved necessary.

Edible and medicinal termites: a global overview

Termites are mainly known for damage caused to human beings, both in urban and rural areas. However, these insects play an important role in the decomposition of organic matter in tropical regions and are important natural resources, which are widely used in traditional medicine and are also consumed by human populations in several parts of the world. This study aimed to catalogue termite species used worldwide through a literature review, characterizing them by its human populations' use. The results showed that at least 45 species of termites, belonging to four families, are used in the world, with 43 species used in human diet and/or in livestock feeding. Nine termite species are used as a therapeutic resource. There is an overlapping use of seven species. The use of termites was registered in 29 countries over three continents. Africa is the continent with the highest number of records, followed by America and Asia. The results suggest that, in addition to their ecological importance, termites are a source of medicinal and food resources to various human populations in various locations of the world, showing their potential for being used as an alternative protein source in human or livestock diets, as well as a source for new medicines.

In vitro antimicrobial and modulatory activity of the natural products silymarin and silibinin

Silymarin is a standardized extract from the dried seeds of the milk thistle (Silybum marianum L. Gaertn.) clinically used as an antihepatotoxic agent. The aim of this study was to investigate the antibacterial and antifungal activity of silymarin and its major constituent (silibinin) against different microbial strains and their modulatory effect on drugs utilized in clinical practice. Silymarin demonstrated antimicrobial activity of little significance against the bacterial strains tested, with MIC (minimum inhibitory concentration) values of 512 µg/mL. Meanwhile, silibinin showed significant activity against Escherichia coli with a MIC of 64 µg/mL. The results for the antifungal activity of silymarin and silibinin demonstrated a MIC of 1024 µg/mL for all strains. Silymarin and silibinin appear to have promising potential, showing synergistic properties when combined with antibacterial drugs, which should prompt further studies along this line.

Phytochemical analysis and modulation of antibiotic activity by Luehea paniculata Mart. & Zucc. (Malvaceae) in multiresistant clinical isolates of Candida spp

The high incidence of fungal infections has led to the continuous search for new drugs. Extracts of Luehea paniculata, a tree of multiple medicinal uses, were evaluated for anti-Candida activity, as well as its modulator potential of the Fluconazole antibiotic. Chemical prospecting of ethanol extracts of leaf and bark was carried out, the quantification of total phenols and flavonoids, characterized by the HPLC-DAD technique. The rosmarinic acid and the vitexin flavonoid were observed as major constituents in ELELP and ESWELP, respectively. Antioxidant activity was also evaluated by the method of scavenging the free radical DPPH, and quercetin was used as standard, obtaining IC₅₀ values: 0.341 (mg/mL) for ELELP and 0.235 (mg/mL) for ESWELP. The microdilution assay was performed for antifungal activity against strains of Candida albicans, C. krusei, and C. tropicalis and showed minimum inhibitory concentrations values ≥1024 μg/mL. In the modulator action of extracts on Fluconazole against multiresistant clinical isolates of Candida (subinhibitory concentration minimum of 128 μg/mL), a significant synergism was observed, indicating that the extracts potentiated the antifungal effect against C. tropicalis, where antioxidant flavonoids could be responsible. This is the first report about modifying activity of the antibiotic action of a species of the genus Luehea.

Enhancement of the antibiotic activity of aminoglycosides by alpha-tocopherol and other cholesterol derivates

Alpha-tocopherol, one of the most abundant isoforms of vitamin E, is a biologically active liposoluble vitamin and potent antioxidant. It occurs naturally in foods of plant and animal origin. Because of its lipophilic character, it can cause perturbations in the bacterial cell membrane, resulting in damage to components essential for the integrity of the membrane, thereby allowing an increase in permeability. This is the first report of the modulatory effect of alpha-tocopherol in multiresistant bacteria. We evaluated alpha-tocopherol against multiresistant strains of Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli, and determined if there was any similarity with the mechanism of modulatory action of cholesterol and ergosterol. When combined with aminoglycosides in a microdilution broth assay, alpha-tocopherol possibly acted through a lipophilic action on the cell envelope, modulating more effectively P. aeruginosa and E. coli, when compared with S. aureus.

In vitro antibacterial screening of six proline-based cyclic dipeptides in combination with β-lactam antibiotics against medically important bacteria

The in vitro synergistic antibacterial activity of six proline-based cyclic dipeptides [cyclo(D-Pro-L-Leu), cyclo(L-Pro-L-Met), cyclo(D-Pro-L-Phe), cyclo(L-Pro-L-Phe), cyclo(L-Pro-L-Tyr), and cyclo(L-Pro-D-Tyr)] in combination imipenem and ceftazidime was investigated in the present manuscript. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the cyclic dipeptides were compared with those of the standard antibiotics (imipenem and ceftazidime). The synergistic antibacterial activities of cyclic dipeptides with imipenem or ceftazidime were assessed using the checkerboard and time-kill methods. The results of the present study showed that the combined effect of six cyclic dipeptides with imipenem predominantly recorded synergistic interaction (FIC index <0.5), whereas combination of certain cyclic dipeptides with ceftazidime recorded additive. The time-kill curve showed that the growth of the test bacteria was completely attenuated after 12-24 h of treatment with a 50:50 ratio of proline-based cyclic dipeptides and antibiotics. These synergistic effects have a potential role in delaying the development of resistance as the antibacterial activity is achieved with the very low concentrations of cyclic dipeptides and antibiotics. The cytotoxicity of cyclic dipeptides was tested against VERO cell line (African green monkey kidney cell line), and no cytotoxicity was recorded for cyclic dipeptides up to 100 μg/mL. These findings suggest that combination of cyclic dipeptides and antibiotics might be a good strategy for the individualization of novel templates for the development of new antimicrobial agents or combinations of drugs for antimicrobial chemotherapy. Moreover, these combinations may lead to the development of a new and vital antimicrobial combination against the infections caused by pathogenic bacteria. The in vitro synergistic activity of cyclic dipeptides with antibiotics against medically important bacteria is reported here for the first time.

The use of the head louse as a remedy for jaundice in Spanish folk medicine: an overview

BACKGROUND

In Spain, head lice are considered a therapeutic resource for the treatment of jaundice. All folk remedies based on the ingestion of these insects meet in the present document, previously dispersed among a large number of references.

METHODS

An overview of the Spanish literature has been carried out. The most important databases have been consulted. All related works have been examined.

RESULTS

Although the method of preparation is diverse and the dose varies, the primary recommendation is a transference ritual consisting of taking nine live lice for nine days on an empty stomach without the patient's knowledge. This traditional knowledge survives in Spanish society, and constitutes an example of the interrelation between Spanish and Latin American folk medicines.

CONCLUSIONS

The survival of this therapy in the worldview of certain rural communities suggests the need to take into account the beliefs, ideas and behaviour patterns of popular culture in relation to health and disease.

Phenolic compounds and interaction between aminoglycosides and natural products of Lygodium venustum SW against multiresistant bacteria

BACKGROUND

The aim of this work was to evaluate the interactions between aminoglycosides and the ethyl-acetate fraction of the fern Lygodium venustum SW (EAFLV) METHODS: The ethyl-acetate fraction was obtained from the ethanol extract of L. venustum and was assayed via the checkerboard method associated with aminoglycosides against two bacterial strains multiresistant to antibiotics.

RESULTS

The antibiotic activity of all drugs, when associated with the ethyl-acetate fraction, was enhanced in an additive manner, except for the association between EAFLV and amikacin, which showed a synergistic interaction against the Escherichia coli strain.

CONCLUSIONS

The results indicated that L. venustum can be a source of secondary metabolites to be used in association with antibiotics like aminoglycosides in antibiotic chemotherapy against resistant bacteria.

The trade in medicinal animals in northeastern Brazil

Over the centuries, a significant part of the Brazilian fauna is widely sold, more specifically in retail stores or street markets. The objective was to characterize the sale of medicinal animals in five large northeast cities. Information about the sale of zootherapeutic items was obtained in the cities of Aracaju-SE, Fortaleza-CE, Maceio-AL, Recife-PE, and Salvador-BA. A total of 68 animal species were sold for medicinal purposes in the cities studied; these are the first results on the use and sale of zootherapeutics in the markets of Aracaju, Fortaleza, and Salvador and first recorded on the medicinal use of the Achatina fulica, Trachycardium muricatum, Philodryas olfersii, Desmodus rotundus, and Leptodactylus vastus. Knowledge of the fauna utilized popular medicine is indispensable for conservation, demonstrating that research on this subject is necessary to determine appropriate practices for the management of the fauna.

Natural products from ethnodirected studies: revisiting the ethnobiology of the zombie poison

Wade Davis's study of Haitian “zombification” in the 1980s was a landmark in ethnobiological research. His research was an attempt to trace the origins of reports of “undead” Haitians, focusing on the preparation of the zombification poison. Starting with this influential ethnopharmacological research, this study examines advances in the pharmacology of natural products, focusing especially on those of animal-derived products. Ethnopharmacological, pharmacological, and chemical aspects are considered. We also update information on the animal species that reportedly constitute the zombie poison. Several components of the zombie powder are not unique to Haiti and are used as remedies in traditional medicine worldwide. This paper emphasizes the medicinal potential of products from zootherapy. These biological products are promising sources for the development of new drugs.

Evaluation of the Antimicrobial Activity of the Decoction of Tropidurus hispidus (Spix, 1825) and Tropidurus semitaeniatus (Spix, 1825) Used by the Traditional Medicine

Tropidurus hispidus and Tropidurus semitaeniatus are two lizard species utilized in traditional medicine in Northeast Brazil. Their medicinal use includes diseases related with bacterial infections such as tonsillitis and pharyngitis. They are used in the form of teas (decoctions) for the treatment of illnesses. In this work, we evaluated the antimicrobial activity of the decoctions of T. hispidus (DTH) and T. semitaeniatus (DTS) against bacterial strains, namely, standard and multiresistant Escherichia coli, Staphylococus aureus, and Pseudomonas aureuginosa, alone and in combination with aminoglycoside antibiotics. The decoctions were prepared using the whole body of the dried lizards, and the filtrate was frozen and lyophilized. When tested alone, the samples did not demonstrate any substantial inhibition of bacterial growth. However, in combination with antibiotics as aminoglycosides, decoctions reduced the minimal inhibitory concentration (MIC) of the assayed antibiotics against multiresistant strains of S. aureus and P. aureuginosa. Chemical prospecting tests revealed the presence of alkaloids in DTS. This is the first study evaluating the medicinal efficacy of T. hispidus and T. semitaeniatus and contributes to the list of new sources of medicines from natural products of animal origin.

The faunal drugstore: animal-based remedies used in traditional medicines in Latin America

Zootherapy is the treatment of human ailments with remedies made from animals and their products. Despite its prevalence in traditional medical practices worldwide, research on this phenomenon has often been neglected in comparison to medicinal plant research. This review discusses some related aspects of the use of animal-based remedies in Latin America, identifies those species used as folk remedies, and discusses the implications of zootherapy for public health and biological conservation. The review of literature revealed that at least 584 animal species, distributed in 13 taxonomic categories, have been used in traditional medicine in region. The number of medicinal species catalogued was quite expansive and demonstrates the importance of zootherapy as an alternative mode of therapy in Latin America. Nevertheless, this number is certainly underestimated since the number of studies on the theme are very limited. Animals provide the raw materials for remedies prescribed clinically and are also used in the form of amulets and charms in magic-religious rituals and ceremonies. Zootherapeutic resources were used to treat different diseases. The medicinal fauna is largely based on wild animals, including some endangered species. Besides being influenced by cultural aspects, the relations between humans and biodiversity in the form of zootherapeutic practices are conditioned by the social and economic relations between humans themselves. Further ethnopharmacological studies are necessary to increase our understanding of the links between traditional uses of faunistic resources and conservation biology, public health policies, sustainable management of natural resources and bio-prospecting.

Topical anti-inflammatory activity of body fat from the lizard Tupinambis merianae

AIM OF THE STUDY

Tupinambis merianae is one of the most frequently used animals in traditional medicine in Brazil as its body fat has many different therapeutic indications as a folk remedy. The present study evaluated the topical anti-inflammatory activity of Tupinambis merianae fat in treating ear edema in an animal model.

MATERIALS AND METHODS

Oil (OTM) was extracted from body fat located in the ventral region of Tupinambis merianae using hexane as a solvent. Ear edema provoked by the application of croton oil (single and multiple application), arachidonic acid, phenol and capsaicin to Swiss mice was used to evaluate the potential anti-inflammatory value of the topical use of OTM. Topical applications of these irritants were made to the right ears of animals that were pre-treated with a acetone (control), dexamethasone, or OTM.

RESULTS

Our results indicate that Tupinambis merianae fat demonstrates significant topical antiinflammatory activity that reduces inflammation related to ear edema caused by croton oil (single and multiple application), arachidonic acid, phenol. While the inflammation caused by capsaicin, OTM did not significantly reduce the edema.

CONCLUSION

This represents the first evidence of anti-inflammatory activity of Tupinambis merianae fat in in vivo models, confirming its usefulness in traditional medicine as a remedy for skin diseases (dermatitis). The fatty acids present in OTM most likely inhibit the response pathway of arachidonic acid and its metabolites, thus reducing the production of pro-inflammatory mediators.

The medicinal animal markets in the metropolitan region of Natal City, northeastern Brazil

AIM OF THE STUDY

This study investigates the trade of animals for medicinal purposes in Natal metropolitan area, northeastern Brazil, to document which animal species are used, how and for what purposes. This study also discusses the implications of the use of zootherapeutics for wildlife conservation.

MATERIALS AND METHODS

Based on interviews with merchants of medicinal animals in all open fairs of the metropolitan region of Natal City, we calculated the informant consensus factor (ICF) to determine the consensus over which species are effective for particular ailments, as well as the species relative importance to determine the extent of potential utilization of each species.

RESULTS

We describe the therapeutic effects of 23 animal species used medicinally. The zootherapeutical products sold commercially are used to treat 34 health problems that were classified into 14 broad categories. We also highlight those species valued for their effectiveness against a range of ailments. The highest ICF value (1.0) was cited for diseases of the circulatory system, which include relief of symptoms such as stroke, hemorrhage, varicose veins and edema.

DISCUSSION AND CONCLUSION

Our study indicated that the local population holds a great deal of ethnomedical knowledge about their local animal resources, and highlights the need for clinical investigations of these traditional remedies to test the safety and efficacy. The animal species identified in this study not only hold high medicinal value for local populations, but could potentially be a source of healing compounds that could aid pharmaceutical research. While the impact of these practices on animal populations is unknown, the high extractive value of these animal populations and the associated medicinal traditional knowledge, needs to be considered in any conservation strategy aimed at the faunistic resources of this area.

Animals to heal animals: ethnoveterinary practices in semiarid region, northeastern Brazil

BACKGROUND

Animal-based remedies constitute an integral part of Traditional Medicine and this is true in Brazil as well both in rural and urban areas of the country. Due to its long history, zootherapy has in fact become an integral part of folk medicine in the country. The use of these natural resources for medical purposes, however, is not restricted to human diseases treatment, being also widely used for the treatment of animal illnesses. Ethnoveterinary is a science that involves the popular practical knowledge used to treat and prevent animal diseases. This study documents ethnoveterinary practices in one local semi-arid region in Northeast Brazil and discusses the findings in the surveyed area.

METHODS

Information was obtained through the use of semi-structured questionnaires. A total of 20 respondents (09 men and 11 women) provided information on animal species and body parts used as medicine, information concerning the illnesses to which the remedies were prescribed were also obtained.

RESULTS AND CONCLUSION

Eleven animal species were used in the treatment of 11 diseases in the surveyed area. The species inventoried comprise 3 taxonomic categories: mammals (05), reptiles (04) and birds (02). The obtained results proves that the use of animals or their derived products as therapeutic resources to the treatment of animal diseases represent a common practice and is culturally important in the studied area. It is evident that the popular knowledge about the ethnoveterinary practices is, frequently, passed through generations. We also noticed that, besides the cultural aspects, the socio-economic context permeates the use of zootherapics, since these practices constitute an alternative to the medicines acquired in veterinarian pharmacies, which have a high cost.