IADR Abstract Archives
Patient Self-medication with Non-prescribed Antibiotics: A Fishy Loophole
Objectives: Multiple patients at our dental clinic have reported using non-prescribed antibiotics to self-treat for pain and infection. These antibiotics were marketed for use in fish and were purchased by the patients online or via local pet stores. Fish antibiotics are not regulated by the Food and Drug Administration or the United States Department of Agriculture, meaning there are no federal mandates for quality control or restricted access. This study determined whether several fish antibiotic brands contained their alleged amount of amoxicillin or cephalexin and whether adulterating agents were present.
Methods: Two commercially available antibacterial fish medications, amoxicillin and cephalexin, were supplied by two different vendors (Thomas Labs and Fish Aid). These were analyzed by HPLC-UV-Vis following United States Pharmacopeia protocols. The contents of 20 capsules of each drug were individually pooled and dissolved. For amoxicillin, 50 mM potassium phosphate buffer (pH 5.0, amoxicillin, KPB) was used. For cephalexin, DI water was used as the solvent.
A concentration of 1 mg/ml of each sample was subjected to chromatography (flow rate=1.5 ml/min) using C18 L1 columns. Isocratic mobile phase conditions of acetonitrile:KPB (1:24) were used for amoxicillin; 5.6 mM sodium 1-pentasulfonate, acetonitrile, methanol, trimethylamine and water (20:10:3:170, pH 3.0) were used for cephalexin.
Results: All four products tested contained the equivalent of not less than 90.0% and not more than 120.0% of their labeled amount of amoxicillin or cephalexin. No major impurities were identified.
Conclusions: Antibiotic overuse is a shared concern among modern healthcare practitioners due to increased prevalence of antibiotic-resistant bacterial strains, potential drug allergies, or drug interactions. While problems of antibiotic overuse and non-adherence are well documented, comparably less is known about use of drugs labeled for animal use, particularly fish. This easy circumvention of professional healthcare oversight is concerning.
Methods: Two commercially available antibacterial fish medications, amoxicillin and cephalexin, were supplied by two different vendors (Thomas Labs and Fish Aid). These were analyzed by HPLC-UV-Vis following United States Pharmacopeia protocols. The contents of 20 capsules of each drug were individually pooled and dissolved. For amoxicillin, 50 mM potassium phosphate buffer (pH 5.0, amoxicillin, KPB) was used. For cephalexin, DI water was used as the solvent.
A concentration of 1 mg/ml of each sample was subjected to chromatography (flow rate=1.5 ml/min) using C18 L1 columns. Isocratic mobile phase conditions of acetonitrile:KPB (1:24) were used for amoxicillin; 5.6 mM sodium 1-pentasulfonate, acetonitrile, methanol, trimethylamine and water (20:10:3:170, pH 3.0) were used for cephalexin.
Results: All four products tested contained the equivalent of not less than 90.0% and not more than 120.0% of their labeled amount of amoxicillin or cephalexin. No major impurities were identified.
Conclusions: Antibiotic overuse is a shared concern among modern healthcare practitioners due to increased prevalence of antibiotic-resistant bacterial strains, potential drug allergies, or drug interactions. While problems of antibiotic overuse and non-adherence are well documented, comparably less is known about use of drugs labeled for animal use, particularly fish. This easy circumvention of professional healthcare oversight is concerning.