<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">Health</journal-id><journal-title-group><journal-title>Health</journal-title></journal-title-group><issn pub-type="epub">1949-4998</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/health.2020.1212119</article-id><article-id pub-id-type="publisher-id">Health-106277</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject><subject> Medicine&amp;Healthcare</subject></subj-group></article-categories><title-group><article-title>
 
 
  The Knowledge of Antibiotics in Veternary Students and Repercution in Human Health
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Silvia</surname><given-names>D. Peña Betancourt</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Silvia</surname><given-names>Denise Posadas Peña</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lyda</surname><given-names>Y. Parra-Forero</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib></contrib-group><aff id="aff2"><addr-line>Instituto de Estudios Superiores de Monterrey, Ciudad de México, México</addr-line></aff><aff id="aff3"><addr-line>Departamento de Producción Agrícola y Animal, Ciudad de México, Mexico</addr-line></aff><aff id="aff1"><addr-line>Departamento de Producción Agrícola y Animal, Laboratorio de Toxicología, Universidad Autonoma Metropolitana, Ciudad de México, Mexico</addr-line></aff><pub-date pub-type="epub"><day>17</day><month>12</month><year>2020</year></pub-date><volume>12</volume><issue>12</issue><fpage>1632</fpage><lpage>1639</lpage><history><date date-type="received"><day>5,</day>	<month>December</month>	<year>2020</year></date><date date-type="rev-recd"><day>28,</day>	<month>December</month>	<year>2020</year>	</date><date date-type="accepted"><day>31,</day>	<month>December</month>	<year>2020</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  The concept of single health is currently undoubtedly one of the most relevant in pandemic times, where humans and animals are together in the same world. Penicillin was discovered in the last century by Alexander Fleming, used against infectious agents mainly of bacterial types, such as 
  <em>Staphylococcus aureus</em>, 
  <em>Corynebacterium</em>, 
  <em>Streptococcus</em>, 
  <em>Brucella</em> and 
  <em>Mycobacterium</em> are examples of cattle pathogens. The bacteria have developed defense mechanisms allowing them to survive in the host cell (mutation) even in the presence of antimicrobials (bacterial selection). The aim of the study was to examine the degree of knowledge of antibiotics through a structured survey of ten questions, addressed to eighty-six students from the Bachelor of Veterinary Medicine and Zootechnics in 2019. Based on the information collected and after analyzing their answers, 63.14% of the students work in Clinics and Universities, 89.47% recognize the need for a quantified prescription, 47.36% mentioned that the Veterinary Medicine can prescribe antimicrobials, 52.63% support the use of antimicrobials for all microorganisms including viruses, 52.63% use the labeling to consult the withdrawal time and 100% identify that it is the withdrawal time and the practices that lead to the development of antimicrobial resistance. It is concluded that most of the students identify malpractice as the trigger for bacterial resistance, however their knowledge is not adequate to avoid antibiotic resistance to humans. It is recommended to reinforce the courses of microbiology, pharmacology and virology in the Veterinary Medicine and Zootechnics degree, as well as to be updated on alternatives such as the use of phytobiotics.
 
</p></abstract><kwd-group><kwd>Antibiotics</kwd><kwd> Resistance</kwd><kwd> Bacteria</kwd><kwd> Veterinary</kwd><kwd> Students</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>The first discovered antibiotic was penicillin by the researcher Alexander Fleming, from a fungus, of the genus Penicillium, which its powerful bactericidal effect was and has been used against Gram+ bacteria. Later, semi-synthetic penicillin such as Ampicillin, Amoxicillin and Cloxacillin, the latter resistant to the “penicillinase” released by Staphylococcus aureus appeared. However, bacteria have developed survival mechanisms such as selection that allows them to infect the host cell and multi-resist antimicrobials [<xref ref-type="bibr" rid="scirp.106277-ref1">1</xref>], such as the case of Mycobacterium tuberculosis, Brucella abortus, Shigella dysenteriae, Listeria monicytogenes and Legionella pneumophila, all with high virulence for cattle. For example, Staphylococcus aureus, the main agent of clinical mastitis, is resistant to Penicillin, Tetracycline and Cephalexin [<xref ref-type="bibr" rid="scirp.106277-ref2">2</xref>].</p><p>On the other hand, the transfer of resistant pathogens to humans through the food chain, such as the consumption of meat and milk [<xref ref-type="bibr" rid="scirp.106277-ref3">3</xref>] [<xref ref-type="bibr" rid="scirp.106277-ref4">4</xref>], leads to the misuse of antibiotics in animals, hence, affecting the public health.</p><p>According to the European Antimicrobial Consumption Surveillance Office, Spain ranks fifth as a consumer of broad-spectrum penicillin. Besides being considered one of the countries with the highest rates of bacterial resistance and exporter of these resistances worldwide [<xref ref-type="bibr" rid="scirp.106277-ref5">5</xref>] [<xref ref-type="bibr" rid="scirp.106277-ref6">6</xref>].</p><p>There are very few works that explore the knowledge about the correct use of antibiotics in those in charge of Animal Health. Therefore, a measure to avoid the misuse of antibiotics is to assess the level of knowledge. In the present study, we conducted a questionnaire to collect information from Veterinary Medicine students and support the subsequent performance of a risk analysis in human health.</p></sec><sec id="s2"><title>2. Participants</title><p>A cross-sectional descriptive observational study with an analytical component was carried out during 2019, in three groups of students (30 students per group) from the BSc in Veterinary Medicine and Zootechnics. The student’s knowledge about antibiotics was considered as the main variable. The structured survey consisted of ten questions that were elaborated as indicators of basic knowledge of the subject, carried out by the National Advisory Technical Council of Animal Health (<xref ref-type="table" rid="table1">Table 1</xref>). For the descriptive analysis of knowledge, four categories were considered: does not know insufficient knowledge, sufficient knowledge and optimal knowledge. For the data analysis, Microsoft Excel was used and the qualitative variables were expressed as percentages.</p></sec><sec id="s3"><title>3. Results</title><p>Of the 86 student surveys, the majority answered all questions. The results of the informative indicators note the student status in which 25% work in veterinary clinics (<xref ref-type="fig" rid="fig1">Figure 1</xref>). From their responses, it was observed that 63.14% of the students work in clinics and universities (<xref ref-type="fig" rid="fig2">Figure 2</xref>), 61.45% recognize that antibiotics</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Evaluated indicators in the survey in 2019</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >No. question</th><th align="center" valign="middle" >Question</th><th align="center" valign="middle" >Possible answers</th><th align="center" valign="middle" >Knowledge indicator</th></tr></thead><tr><td align="center" valign="middle" >1</td><td align="center" valign="middle" >Occupation</td><td align="center" valign="middle" >Veterinary Medicine Student/Intern Certified veterinarian Nursing in Veterinary Medicine Livestock technician</td><td align="center" valign="middle" >Not applicable, informative</td></tr><tr><td align="center" valign="middle" >2</td><td align="center" valign="middle" >Workplace</td><td align="center" valign="middle" >Veterinary clinic Livestock or aquaculture production unit Universities/Research Center Manufacturing and marketing companies of pharmaceutical and food products Government institution</td><td align="center" valign="middle" >Not applicable, informative</td></tr><tr><td align="center" valign="middle"  rowspan="3"  >3</td><td align="center" valign="middle"  rowspan="3"  >Type of prescription required for antimicrobial products due to the level of risk of the active principle</td><td align="center" valign="middle" >Quantified</td><td align="center" valign="middle" >Sufficient and optimal knowledge</td></tr><tr><td align="center" valign="middle" >No required prescription</td><td align="center" valign="middle" >No knowledge</td></tr><tr><td align="center" valign="middle" >Simple</td><td align="center" valign="middle" >Insufficient knowledge</td></tr><tr><td align="center" valign="middle" >4</td><td align="center" valign="middle" >Licensed veterinarians and interns may prescribe antimicrobials</td><td align="center" valign="middle" >True False</td><td align="center" valign="middle" >Sufficient and optimal knowledge</td></tr><tr><td align="center" valign="middle" >5</td><td align="center" valign="middle" >Antimicrobials are used to treat the following microorganisms</td><td align="center" valign="middle" >Parasites Bacteria Mushrooms Virus All of the above</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge and Insufficient knowledge</td></tr><tr><td align="center" valign="middle" >6</td><td align="center" valign="middle" >Is antibacterial treatment a good option in respiratory diseases of viral origin?</td><td align="center" valign="middle" >True False</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge</td></tr><tr><td align="center" valign="middle" >7</td><td align="center" valign="middle" >What is the means you use most frequently to check the withdrawal time of antimicrobials?</td><td align="center" valign="middle" >Books Brochures and technical manuals Scientific articles Internet Labelled</td><td align="center" valign="middle" >Not applicable, informative</td></tr><tr><td align="center" valign="middle" >8</td><td align="center" valign="middle" >Did Mexico sign an agreement declaring the national strategy of action against antimicrobial resistance mandatory?</td><td align="center" valign="middle" >True False</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge</td></tr><tr><td align="center" valign="middle" >9</td><td align="center" valign="middle" >Practices that lead to the development of antimicrobial resistance in pathogens are</td><td align="center" valign="middle" >Breach of treatment time Indiscriminate use of broad-spectrum antimicrobials Wrong dosage All of the above</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge Insufficient knowledge</td></tr><tr><td align="center" valign="middle" >10</td><td align="center" valign="middle" >Existing regulation in Mexico that establishes the guidelines for the classification and prescription of veterinary antimicrobials</td><td align="center" valign="middle" >Agreement declaring the mandatory nature of the national action strategy against antimicrobial resistance NOM-064-ZOO-2000 and the agreement NOM-040-ZOO-1995</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge Insufficient knowledge</td></tr><tr><td align="center" valign="middle" >11</td><td align="center" valign="middle" >The withdrawal or storage time is</td><td align="center" valign="middle" >The time required to reach the ideal weight for commercialization of the animals The time established by the farm to comply with the “all in, all out” system Comply with the treatment time of the pharmaceutical product Allow maximum residue levels to be below those allowed by the health authority</td><td align="center" valign="middle" >Sufficient and optimal knowledge No knowledge Insufficient knowledge</td></tr></tbody></table></table-wrap><p>should be prescribed by quantified prescription, while 38.55% do not recognize it as requirement (<xref ref-type="fig" rid="fig3">Figure 3</xref>); 48.27% assure that the Veterinary Medicine intern can prescribe antimicrobials and 51.73% that a student cannot prescribe antimicrobials (<xref ref-type="fig" rid="fig4">Figure 4</xref>); 21.34% use antimicrobials for all microorganisms including viruses which implies an incorrect knowledge (<xref ref-type="fig" rid="fig5">Figure 5</xref>); 20% possess a poor knowledge about the use of antimicrobials in viral diseases (<xref ref-type="fig" rid="fig6">Figure 6</xref>); 18.60% use the labeling to consult the withdrawal time of antimicrobials (<xref ref-type="fig" rid="fig7">Figure 7</xref>) and 88.23% identify the withdrawal time of an antimicrobial and the practices as factors that lead to the development of resistance to antimicrobials (<xref ref-type="fig" rid="fig8">Figure 8</xref>). 20% of the students have a low knowledge about the withdrawal time that must be respected in antibiotics used for production animals (<xref ref-type="fig" rid="fig9">Figure 9</xref>).</p></sec><sec id="s4"><title>4. Discussion</title><p>The strategies to identify the knowledge of Veterinary Medicine students about antimicrobials turns out to be a watershed that enables real information in the animal health sector that supports a risk analysis study for human population. One of the most surprising results obtained in the study was the fact of not knowing that antimicrobials are for the exclusive use of bacteria, as identified in students from China by [<xref ref-type="bibr" rid="scirp.106277-ref7">7</xref>]. The authors exonerate the urgency of prioritizing education in health professionals. Hence, the areas of microbiology in the bachelor’s study plan as well as pharmacology should be reinforced. If we compare the efforts made in Human Medicine to identify their degree of knowledge in people [<xref ref-type="bibr" rid="scirp.106277-ref8">8</xref>], it can be noted the poor knowledge or ignorance from most of the sample population. In addition, the importance of the veterinarians in animal health and food safety is relevant, as mentioned by [<xref ref-type="bibr" rid="scirp.106277-ref9">9</xref>] [<xref ref-type="bibr" rid="scirp.106277-ref10">10</xref>]. Currently there are advances to establish a rapid and safe diagnosis to identify the pathogenic agent of a disease. For example, molecular methods are available to detect resistance of bacteria to semi-synthetic penicillin, using the blaZ gene and ermC gene [<xref ref-type="bibr" rid="scirp.106277-ref11">11</xref>].</p><p>Therefore, an alternative solution to antimicrobial resistance of bacteria according to [<xref ref-type="bibr" rid="scirp.106277-ref12">12</xref>], are natural products. The antimicrobial properties of chemical compounds such as carvacrol, thymol, cineole, linalool, anethole, allicin, capsaicin, allyl isothiocyanate and piperine, have been obtained mainly from oregano, thyme, garlic, cloves, radish, chili, pepper, mint, cinnamon, anise, rosemary and sage [<xref ref-type="bibr" rid="scirp.106277-ref13">13</xref>]</p></sec><sec id="s5"><title>5. Conclusion</title><p>The administration of antibiotics in production animals has several disadvantages, such as bacterial resistance, which makes disperse into human health. It is estimated that antibiotics will be restricted in most meat and milk importing countries by 2025. Meanwhile, the use of new therapies with products that are harmless to health and the environment should be foreseen. Such is the case of phytobiotics that have given good results as antibacterials.</p></sec><sec id="s6"><title>Conflicts of Interest</title><p>The authors declare no conflicts of interest regarding the publication of this paper.</p></sec><sec id="s7"><title>Cite this paper</title><p>Betancourt, S.D.P., Pe&#241;a, S.D.P. and Parra-Forero, L.Y. (2020) The Knowledge of Antibiotics in Veternary Students and Repercution in Human Health. Health, 12, 1632-1639. https://doi.org/10.4236/health.2020.1212119</p></sec></body><back><ref-list><title>References</title><ref id="scirp.106277-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">Goncagul, G. and Ayaz, E. (2010) Antimicrobial Effect of Garlic (Allium sativum). Recent Patents on Anti-infective Drug discovery, 5, 91-93. 
https://doi.org/10.2174/157489110790112536</mixed-citation></ref><ref id="scirp.106277-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Moore, B.S., Carter, G.T. and Bronshhrup, M. (2017) Are Natural Products the Solution to Antimicrobial Resistance? Natural Product Reports, 34, 685-686. 
https://doi.org/10.1039/C7NP90026K</mixed-citation></ref><ref id="scirp.106277-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Vieiria, S.Y., Ferreira, M, Boniface, O.L, Godoy, S.F. and Silva M.A. (2019) Characterisation of Antibiotic Resistance Genes in the Species of Rumen Microbiota. Nature Communications, 10, Article No. 5252.</mixed-citation></ref><ref id="scirp.106277-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">Kristensson, J., Modig, S., Midlov, P., Rahm, I. and Jakobsson, U. (2010) Health Care Utilisation and Knowledge Concerning Prescribed Drugs among Older People. European Journal of Clinical Pharmacology, 66, 1047-1054. 
https://doi.org/10.1007/s00228-010-0837-y</mixed-citation></ref><ref id="scirp.106277-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">García, P., Gastelurrutia, M.A., Baena, M.I., Fisac, F. and Martínez, F. (2009) Validación de un cuestionario para medir el conocimiento de los pacientes sobre sus medicamentos. Atención Primaria, 41, 661-668.  
https://doi.org/10.1016/j.aprim.2009.03.011</mixed-citation></ref><ref id="scirp.106277-ref6"><label>6</label><mixed-citation publication-type="other" xlink:type="simple">Bernabé, M.E., Macarena Flores, D. and Fernando Martínez M. (2015) Grado de conocimiento del antibiótico prescrito en pacientes ambulatorios. Atención Primaria, 47, 228-235. https://doi.org/10.1016/j.aprim.2014.04.014</mixed-citation></ref><ref id="scirp.106277-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">Xiao, M.W., Xu, D.Z. and Herskebth, T. (2016) Massive Misuse of Antibiotic by University Students in China. Lancet, 388, S94.</mixed-citation></ref><ref id="scirp.106277-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">Silley, P., Simjee, S. and Schwarz, S. (2012) Surveillance and Monitoring of Antimicrobial Resistance Antibiotic Consumption in Humans and Animals. Revue Scientifique et Technique, 31, 105-120. https://doi.org/10.20506/rst.31.1.2100</mixed-citation></ref><ref id="scirp.106277-ref9"><label>9</label><mixed-citation publication-type="other" xlink:type="simple">Adriaenssens, N., Coenen, S., Versporten, A., Muller, A., Minalu, G. and Faes, C. (2011) European Surveillance of Antimicrobial Consumption (ESAC): Outpatient Antibiotic Use in Europe (1997-2009). Journal of Antimicrobial Chemotherapy, 6, 3-12. https://doi.org/10.1093/jac/dkr453</mixed-citation></ref><ref id="scirp.106277-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">Doyle, M. (2012) Veterinary Drug Residues in Processed Meats-Potential Health Risk. Food Research Institute (FRI Briegfings).  
http://fri.wisc.edu/docs/pdf/t-RIBrief_vetDrgres.pdf</mixed-citation></ref><ref id="scirp.106277-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">Cota, E., Hurtado, L., Pérez, E. and Alcántara, L. (2014) Resistencia a antibióticos de cepas bacterianas aisladas de animales destinados al consumo humano. Revista Iberoamericana de Ciencias, 1, 75-85.</mixed-citation></ref><ref id="scirp.106277-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">Morris, S. and Cerceo, E. (2020) Trends, Epidemiologty and Management of Multi-Drug Resistant Gram Negative Bacterial Infections. Antibiotics, 91, 196. 
https://doi.org/10.3390/antibiotics9040196</mixed-citation></ref><ref id="scirp.106277-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">Munita, J.M. and Arias, C.A. (2016) Mechanisms of Antibiotic Resistance. Microbiology Spectrum, 4, 1-24. https://doi.org/10.1128/microbiolspec.VMBF-0016-2015</mixed-citation></ref></ref-list></back></article>