**4.1 Prevention of antibiotic resistance**

Data clearly demonstrate a rise in the number of resistant organisms as well as in increase in the number of multidrug resistant bacteria. Based on the relative mutation rate and gene transfer rates, there is indeed a global concern over a future inability to treat bacterial infection effectively and without toxic side effects. Today's medical treatments and surgical capabilities have advanced modern medicine just as the discovery and development of penicillin marked a turning point in therapeutics. Emerging resistant mechanisms and organisms place the world on a path not only similar to an era before penicillin, but also to an era where medical surgical procedures become impossible to the risk of infection. New

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Bellis, M. (n.d.) History of Penicillin, In: *About.Com Inventors*, August 12, 2011, Available from: < http://inventors.about.com/od/pstartinventions/a/Penicillin.htm> Biedenbach, D.J., et al. (2004). Occurrence and Antimicrobial Resistance Pattern

Boucher, H.W., et al. (2004). Newer Systemic Antifungal Agents - Pharmacokinetics, Safety and Efficacy. *Drugs*, Vol. 64, No. 18, pp. (1997-2020) ISBN 0012-6667 Cardo, D., et al. (2004). National Nosocomial Infections Surveillance (NNIS) System Report,

Christensen, K.L.Y., et al. (2009). Infectious Disease Hospitalizations in the United States. *Clinical Infectious Diseases*, Vol. 49, No. 7, (Oct), pp. (1025-1035) ISBN 1058-4838

Decre, D., et al. (2004). Outbreak of Multi-Resistant *K. oxytoca* Involving Strains with

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Hays, J.N. (2005). *Epidemics and pandemics: their impacts on human history*. ABC-CLIO, Inc.

edu/xtf-ebc/view?docId=tei/abc/DISWHE/DISWHE.xml&query=&brand

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multidrug resistance elements, in particular, NDM-1, is concerning because of its potential to travel between species and produce "superbugs" at rates well beyond the limit of natural selection. History has demonstrated that organisms have been able to develop resistant mechanisms rapidly once introduced to new antibiotics, and in particular once introduced to a new class of antibiotics. Continued responsible use of antibiotics is currently the best way to attempt to slow down the development of resistant strains. Careful attention should be paid to when antibiotics are prescribed, but even more importantly which antibiotics are prescribed. It is extremely important to reserve new antibiotics for strains that have demonstrated resistance to other drugs. Infatuation with "hot" new drugs has the potential to accelerate the selection of resistant organisms and render the new drugs ineffective as well. Consideration for patient compliance is also important; ensuring that the full course of antibiotic is taken will produce maximal eradication of the bacteria, leaving no remaining cells to pass on their "secret" of survival.

#### **4.2 Spread the research and spread the word**

Financial cutbacks by large drug companies and governmental funding cuts have slowed the potential for development of novel antibiotics. Although the high risk - high payoff drug development programs are waning, smaller research groups and companies are in a position to collaborate and share promising results thereby forming a network of antibiotic development team members. In recent years, the pressure to "develop and sell" outweighed the pressure to "develop and share". Perhaps with the economic setbacks, the "develop and share" model will accelerate design of new drugs. The importance of sharing knowledge with colleagues is evident, but the necessity of correctly explaining our current state to the general public should be equally considered. A clear understanding of the investment, both time and financial, required to bring a drug to market needs to be highlighted so that everyone has the motivation to slow the spread of resistance and give the drug development industry an opportunity to excel.

#### **5. References**


multidrug resistance elements, in particular, NDM-1, is concerning because of its potential to travel between species and produce "superbugs" at rates well beyond the limit of natural selection. History has demonstrated that organisms have been able to develop resistant mechanisms rapidly once introduced to new antibiotics, and in particular once introduced to a new class of antibiotics. Continued responsible use of antibiotics is currently the best way to attempt to slow down the development of resistant strains. Careful attention should be paid to when antibiotics are prescribed, but even more importantly which antibiotics are prescribed. It is extremely important to reserve new antibiotics for strains that have demonstrated resistance to other drugs. Infatuation with "hot" new drugs has the potential to accelerate the selection of resistant organisms and render the new drugs ineffective as well. Consideration for patient compliance is also important; ensuring that the full course of antibiotic is taken will produce maximal eradication of the bacteria, leaving no remaining

Financial cutbacks by large drug companies and governmental funding cuts have slowed the potential for development of novel antibiotics. Although the high risk - high payoff drug development programs are waning, smaller research groups and companies are in a position to collaborate and share promising results thereby forming a network of antibiotic development team members. In recent years, the pressure to "develop and sell" outweighed the pressure to "develop and share". Perhaps with the economic setbacks, the "develop and share" model will accelerate design of new drugs. The importance of sharing knowledge with colleagues is evident, but the necessity of correctly explaining our current state to the general public should be equally considered. A clear understanding of the investment, both time and financial, required to bring a drug to market needs to be highlighted so that everyone has the motivation to slow the spread of resistance and give the drug development

The Choice of Antibacterial Drugs. (2001). *Medical Letter on Drugs and Therapeutics*, Vol. 43,

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cells to pass on their "secret" of survival.

industry an opportunity to excel.

**5. References** 

**4.2 Spread the research and spread the word** 

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Characterized Isolates, Mutants, and Transconjugants and Resistance Selection Potential. *Antimicrobial Agents and Chemotherapy*, Vol. 48, No. 8, (Aug), pp. (3086-

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Summary of Notifiable Diseases, United States, 1998 (1999) *MMWR: Morbidity and Mortality* 

Summary of Notifiable Diseases, United States, 1997 (1998) *MMWR: Morbidity and Mortality* 

Summary of Notifiable Diseases, United States, 1996 (1997) *MMWR: Morbidity and Mortality* 

Summary of Notifiable Diseases, United States, 1995 (1996) *MMWR: Morbidity and Mortality* 

Summary of Notifiable Diseases, United States, 1994 (1995) *MMWR: Morbidity and Mortality* 

Summary of Notifiable Diseases, United States, 1993 (1994) *MMWR: Morbidity and Mortality* 

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Saravolatz, L.D., et al. (2009). Telavancin: A Novel Lipoglycopeptide. *Clinical Infectious* 

Saravolatz, L.D., et al. (2011). Ceftaroline: A Novel Cephalosporin with Activity against

Schwaoer, M.J., et al. (2005). High Levels of Antimicrobial Coresistance among Extended-

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**14** 

*Greece* 

**The Prophylactic Use of** 

V. G. Papatsiros and C. Billinis *School of Veterinary Medicine,* 

*University of Thessaly,* 

**Acidifiers as Antibacterial Agents in Swine** 

In recent decades, acidifiers have emerged as viable alternatives to antibiotics in swine diets, in order to stimulate optimal growth performance and prevent various enteric diseases. Antimicrobials have been used for more than 50 years to enhance growth performance and prevent various pig diseases (Gustafson & Bowen, 1997). There is growing public awareness of the relationship between the feed medication with antimicrobials as growth promoters in livestock diets and the risk of developing cross-resistance of pathogens to antibiotics, threatening animals and human health (Corpet, 1996; Mathew et al. 2007; Hunter et al. 2010). During the last few years, as the use of antibiotics in pig diets has decreased, the use

Acidifiers can be in organic or inorganic acids or associated salts. As a group of chemicals, organic acids are considered to be any organic carboxylic acid of the general structure R-COOH (including fatty acids and amino acids) (Partanen & Mroz, 1999). Organic acids are widely distributed in plants and animals. They are also produced by microbial fermentation of carbohydrates and other fermentable material, predominantly in the large intestine of pigs. Table 1 shows the common name, chemical name, formula and first pKa- the pH at which the acid is half dissociated - of organic acids that are commonly used as dietary

The activity of most common acids, as well as their beneficial effects is shown in Table 2. Acidifiers have received much attention in pig production due to their beneficial effects on growth performance of pigs (Mahan et al. 1996; Partanen, 2001; Papatsiros et al. 2011). Many acids are available as sodium, potassium or calcium salts and several researchers have proposed their use because of their convenient application and their better effects than those of pure state acids. Table 3 shows a list of the most common salts of acids and their properties. The advantage of salts over free acids is that they are generally odourless and easier to handle in the feed manufacturing process due to their solid and less volatile form. Salts of acids are also less corrosive and may be more soluble in water than free acids (Partanen & Mroz, 1999). Although beneficial effects have been reported from trials using supplements of salts in pig diets (Table 3), other studies have not introduced any

**1. Introduction** 

of acidifiers has increased.

acidifiers in pigs (Partanen & Mroz, 1999).

positive effects (Biagi et al. 2007; Weber & Kerr, 2008).

