An English language version of the Swedish Veterinary Association's
guideline on the clinical use of antibiotics:

<http://www.wormsandgermsblog.com/uploads/file/Policy%20ab%20english%2010b.pdf>

As everyone knows by now there are antibiotic resistant infections.
Where confusion happens for many people who are not in a biological
or medical field is the people think that they themselves or the pets
develop the resistance. Not so. What develop the resistance are the
bacteria. Now, this can mean trouble in more than one way. First off,
all of us mammals, two or four footed, have a large number of non- us
beings living on and in us. We have parasites and symbiotic life forms,
and even some which are just hitchhikers and don't help or hurt us
inside us and on our skin all the time, and quite a lot of them.

Here are some of the things which can go wrong when antibiotics are
used wrong:

1. When a symbiotic form becomes resistant you'd think that would be
a good thing and sometimes it is, but other times it can lead to a
population explosion which causes health problems, sometimes serious
ones. So, then you are in a hard place because you want those life
forms but you want fewer of them. Some of these are not a problem if
they are where they belong but are a major problem if they get where
they do not belong, such as a normal vaginal bacterium in some mammals,
beta hemolytic strep, which is good for vaginal pH in the right
proportion but bad for it if over-populated, and which really cause
woes by getting into the bladder where they cause bleeding and from
which they can sometimes move upward toward the kidneys.

2. When one of the other types of bacteria in you or your animals
develops antibiotic resistance infections can start, wane and start
again over and over from the same population of that type of bacterium.
So, you can think that you are getting infected over and over but
actually the population is crashing and then blooming repeatedly. It
can knock the stuffing out of anyone, furred or not, when that happens.

3. Contagious bacterial species will also form resistance, and in that
case the individuals who catch those communicable illnesses will be
harder to treat. That's more commonly the pets' people for some of
those diseases but not all illnesses. (That, BTW, is why there is so
much noise on the human health sites about salmonella these days
because it is harder and harder to treat and the forms are more and
more resistant largely due to the heavy antibiotic use needed for
poultry survival in industrial farming.) That is not to say that the
illnesses are easier to catch, though humans get salmonella pretty
easily, because ferrets are less likely to contract it. For example, in
ferrets salmonella is still an illness mostly of compromised ferrets
such as sick ones, old ones, very young ones, ones on steroids or
chemotherapy, basically ones whose immune systems are messed up. So,
there are other types of food borne ills which are a greater concern
for ferrets' ease of contacting them, although those diseases are not
as common. So, with ferrets the concern with salmonella is more that it
is becoming so hard to treat when it is caught. Yes, there are other
examples and probably better ones that slip my mind right now, but the
mistakes of the huge industrialized poultry farms (and less often the
smaller, private ones for any type of animal) have really contributed
heavily to this problem so make it a example all should remember
reading about at times in relation to any poultry products, hence
relatable as an example.

Now, how do the bacteria become resistant to antibiotics? Bacteria
manage evolution in what appear to be short periods of time for a
human. In just a day's time many generations can be created and
replicate. That means that the survivors who are replicating have
survived a number of challenges, including the medical ones we put
them through. They are tougher than the bacteria which were killed
off in relation to those challenges, including the specific antibiotics
that were used.

If antibiotics are used incorrectly then some of the bacteria are
killed off BUT there are survivors who were not killed by the
medications and those are what go on to replicate. Their tougher
genetics are what get passed on. So, afterward the population of
bacteria are less likely to be affected by the medication because they
inherited their resistance.

There are multiple ways this can happen including:

1. Medicating when medication is not needed. For example, viral
diseases are not affected by antibiotics. The reasons that ferrets and
other beings like humans are sometimes treated with antibiotics when a
bacterial illness is present are:
A. It isn't yet known to be a viral disease and might be bacterial.
B. There may be a high risk of secondary bacterial infection, or may
already be a secondary bacterial infection.
C. (and this may be the most common at least in human med)
The clients or patients agitate to "do something".

2. The medication is not suited to the infection. A culture with
challenge testing is the way to go to find out which antibiotics will
work best but that sometimes takes time and is not always easy to do.

3. Certain medications also are better for infections in different
locations. That depends on how the body processes them and spread them
around, which differs among med types, so now you know one of the
reasons why there some antibiotics which are better suited for tackling
a UTI, for example, compared to some alternatives.

4. The people give or take the medication wrong, using the wrong timing
which allows the more resistant bacteria windows in which to replicate
more, or stopping the medication too early which allows the surviving
bacteria which are more antibiotic resistant to repopulate. Remember
that what is just a few hours for us can be quite a few generations for
some bacteria.

5. The medication itself may be compromised,
A. for example the old drugs past expiration dates which we have all
read of being sold by some disreputable places, often for less money.
(There especially has been a lot in the media on internet sales of
such drugs through the years.)
B. There are other ways that medication can be compromised. Some should
not be given with certain food types. Some must be shielded from water
or saliva. Many can not be exposed to much light. Some can not be
stored in a refrigerator, while others can not be stored at room
temperature. Many can not deal with more than a short time of high heat
exposure. Many can not deal with humidity. The drugs differ on these
scores. What is right for one drug is not right for another one.

6. Some medications can not be given with certain supplements or
certain herbs, or certain other medications without compromising them.
(and in some cases the effect is increased which can also cause trouble
so be sure the vet knows everything that is given.

7. The medication is compromised by being given wrong. Here are some
easy examples and you will think of more: One that should not be given
with iron should not be given with meat. One that should not be given
with calcium should not be given with milk. One that should not be
exposed to water should not be given with baby food. One that should
not be given with fats should not be given with oils. The list can go
on, and varies depending on the med type since they differ.

8. The dose may be wrong.
A. If a medication does not have a cutting line on it then that
medication is NOT designed to be split and will not have the medication
evenly distributed, That means that if someone splits an antibiotic
which is like that the doses will sometimes be low enough to allow the
resistant bacteria to begin replicating well and taking hold. Such
medications have to be ground and then very, very, very well mixed,
then given in the right measurement in the right type of medium for
that drug.
B. There are certainly other ways that doses can be wrong, for example,
some syringes used to list BOTH ml and other units, but
C. more commonly people do not understand decimal points and think that
0.1 is the same as 1.0 or vice versa. Doses can also be wrong if the
concentration is different than the dose is calculated for. For example
if a med has 1 mg of the med in each ml of fluid but the dosing amount
given is the amount which should be given for a different concentration
that has 3 mgs of med in each ml then the result will be the ferret
getting only 1/3 of the medication needed.

Anyway, that is just a little bit on antibiotic resistance for those
who did not previously understand it, and I am sure that the guidelines
will be read by many here to pull out useful help. I look forward to
getting to them myself.

I hope that this is helpful and that my trying to create it rapidly did
not compromise the write-up.

Sukie (not a vet)

Recommended ferret health links:
http://pets.groups.yahoo.com/group/ferrethealth/
http://ferrethealth.org/archive/
http://www.afip.org/ferrets/index.html
http://www.miamiferret.org/
http://www.ferrethealth.msu.edu/
http://www.ferretcongress.org/
http://www.trifl.org/index.shtml
http://homepage.mac.com/sukie/sukiesferretlinks.html
all ferret topics:
http://listserv.ferretmailinglist.org/archives/ferret-search.html
"All hail the procrastinators for they shall rule the world tomorrow."
(2010, Steve Crandall)

[Posted in FML 6909]