Antibiotics aren’t always the answer
https://hoards.com/article-34041-antibiotics-arent-always-the-answer.html
Antibiotics Save Lives
Two years ago, an antibiotic saved my life. A dog bite had unbeknownst to me led to a
systematic infection that destroyed my heart valve, later requiring open-heart surgery.
For months, multiple antibiotics failed to deal with the infection, and I was barely able to
walk.
It wasn’t just “antibiotics” that saved my life, but a particular antibiotic: vancomycin,
which worked after multiple others had failed. I know well this drug as a dairy
veterinarian, because I am not allowed to use it. Vancomycin is only allowed in human
medicine and in small-animal cases where the infection has documented resistance to
other antibiotics. Because it can be so effective, it is protected from widespread use,
especially in food-producing animals.
The next year, my father-in-law’s best friend succumbed to such an antibiotic-resistant
infection and he died. Antibiotics save lives — and remain effective on our farms — only
if we guard their use.
To that end, on June 11 th , 2023, all antibiotics for livestock will require a prescription.
The FDA believes that veterinarian involvement will reduce the unnecessary use of
antibiotics. What is good for society at large is also good for individual farms: Repeated
and sustained use of using an incorrect antibiotic can diminish overall effectiveness and
lead to resistance within your own herd.
Using antibiotics without knowing what the germ is or the most effective antibiotic is like
playing darts: missing the target means losing valuable time while also spending money
needlessly. And it breeds resistance. Dr. Alexander Fleming, who discovered penicillin,
said it is “not difficult to make microbes resistant to penicillin in the laboratory by
exposing them to concentrations not sufficient to kill them,” and described the same in
the body.
We often reflexively reach for an antibiotic when it may not be the right one or even truly
needed. When is the last time you ran milk cultures to see what your cows need at dry-
off? Figure 1 shows the results of DHIA data presented at the 2016 World Buiatrics
Congress comparing matched pairs of conventional and organic farms. USDA NAHMS
data shows that 90% of conventional farms use antibiotics at dry-off. USDA certified-
organic farms cannot. Looking at fresh cows (<40 DIM), there wasn’t any statistical
difference in SCC between the two farm types. The data suggests that there are
methods other than antibiotics to dry off cows.
In cases of pneumonia, metritis and foot rot, ceftiofur can work really well.
Unfortunately, after being FDA-approved in the 1990’s, it has lost some of its “punch”
against pneumonia, likely due to widespread use owing to its original zero milk and zero
meat withholding times.
Additionally, some germs have natural defenses that won’t be killed even in the
presence of a correctly selected antibiotic. These will reproduce and newly minted bugs
won’t be killed by the same antibiotic they were exposed to previously. Pneumonia
(shipping fever) is a life and death situation and thankfully newer more powerful
antibiotics, if given early enough, will often resolve an otherwise fatal case, but the
history of treatment failures as well as basic biology suggest that we will again find
ourselves with resistant bacteria at some point.
Mastitis
Perhaps nowhere are resistant bacteria more a challenge on a dairy farm as in the
udder. Even when the right antibiotic is identified, what shows to work in the lab may not
work within the living animal due to host-pathogen interactions. Additionally, depending
on the milk volume being produced in the udder, a tube of antibiotics can get very
diluted and be present below the threshold of effect. Clearly, there is a place for non-
antibiotic treatment of mastitis on dairy farms, and historical treatments may provide a
way forward in preventing resistant infections.
The Key to Cure: The Immune System
While the discovery of antibiotics was indeed revolutionary, prior to antibiotics obviously
not all infections ended in death, otherwise none of us would be here. The immune
system is truly the key to cure. A correctly prescribed antibiotic essentially buys time for
the immune system to rally and re-establish internal equilibrium. Yet it’s still the immune
system that ultimately returns the cow to health.
In the mid-1880’s Robert Koch and Louis Pasteur identified specific bacteria that
caused infection and the body’s response to conquer the challenge. Treatment with
biologics soon started. Biologics work by stimulating the animal’s immune system by
vaccination or by providing it with immediately usable pre-formed antibodies. Many
common diseases were successfully treated with pre-formed antibodies, among them
shipping fever and calf scours. As a practitioner, I’ve successfully treated numerous
cases of hot coliform mastitis, pneumonia and salmonella using injectable antibodies
(Bovi-Sera, Multi-Serum) and non-specific immune stimulation (AmpliMune).
Autogenous bacterins (custom vaccines) were also used. Autogenous bacterins make
sense since bacteria are harvested from active infection within a specific herd, then
purified and potentized to stimulate the immune system to overcome the challenge.
Using autogenous bacterins, I’ve seen dramatic reduction of Staph aureus in herds
without making any other changes. Vaccinate calves at 6 months, 1 year, then right
before freshening and annually from then on. Your veterinarian needs to be involved per
USDA rules.
Another technique was to subcutaneously reinject the milk of a cow right back into
herself. In “Udder Diseases Of The Cow” by Dr. A.S. Alexander (advertised regularly in
Hoard’s in the 1930’s) the use of raw milk was described: “just as it was taken from the
quarter and this we injected in 20cc doses every 2 days. From this we generally
obtained a marked amelioration on the following day, after the first injection, and often a
cure within 10 days. If the milk contained curds it was filtered through sterilized felt. We
have observed that this method of treatment gives better results and more rapid results
when employed early…” I have seen this approach used successfully.
Plant-derived medicines were also widely used to treat mastitis. In addition to bacterins,
Haver-Glover Laboratories manufactured and sold “H-G Intramammary Disinfectant,” a
mixture that included thymol and oregano. Thymol and oregano have proven
antibacterial properties. Plant-based medicines and biologics have provided mainstream
veterinary medicine many answers to infectious-disease processes. Plant medicines
have the added benefit of not being susceptible to resistance because they contain
thousands of individual compounds that defy microbes’ ability to adapt.
While antibiotics when used strategically can aid dairy farmers long-term with judicious
use, it’s also fair to say that there are successful and historically proven methods of
treating common dairy-cow problems without antibiotics.
Figure 1
2006: 33 matched pairs Conventional Certified-organic P value
SCC < 40 Days In Milk 2.57 3.11 .14
2016: 61 matched pairs
SCC < 40 Days In Milk 3.3 3.7 .11