A case of fixed drug eruption due to doxycycline and erythromycin present in food

Assessment of Enrofloxacin Usage and Residue Levels of Enrofloxacin-Ciprofloxacin in Breast and Liver Tissues of Commercial Broilers Sold in Kampala-Uganda

Background

Human exposure to veterinary drugs like fluoroquinolones occurs due to the presence of their residues in foods from animal sources in varying concentrations. The existence of antibiotic residues in foodstuffs can pose great public health problems to consumers. This study aimed to assess enrofloxacin use patterns and assess residue levels of enrofloxacin/ciprofloxacin in breast muscle and liver tissues of broiler chickens sold for consumption in Kampala capital city.

Methods

This was a cross-sectional study that involved both field survey and laboratory-based methods. The field study involved the use of qualitative and semi-quantitative data collection tools to interview 34 broiler farmers and 10 veterinary drugs vendors. For the determination of enrofloxacin/ciprofloxacin levels, 68 chicken breast and liver tissue samples were collected from main markets in Kampala over one month and analyzed using HPLC-UV.

Results

Enrofloxacin was the most used antibiotic (100%) for the management of poultry diseases, majorly respiratory diseases (100%), salmonella infections (40%), and disease prevention (60%). Over 76% of the farmers knew the meat withdrawal time (WDT) for enrofloxacin, but none of them adhered to this. Over 70% of the farmers reported that the veterinary drugs vendors were not providing meat WDT information. Enrofloxacin/ciprofloxacin residues were identified in 35.3% (12/34) of the muscle and 38.2% (13/34) of the liver tissues analyzed. Of those muscle and liver tissue samples that tested positive, 25% (3/12) and 38.5% (5/13) respectively had drug concentrations higher than the recommended Maximum Residue Limits. The overall mean enrofloxacin/ciprofloxacin concentration in the chicken muscle and liver tissues was 83.6 (±34.5) µg/kg and 171.5 (±75.9) µg/kg.

Conclusion

This observed presence of enrofloxacin/ciprofloxacin levels above safety requirements is attributable to inadequate medicines use information provided by veterinary drugs vendors to farmers and also to the non-compliance of some farmers to meat WDT due to the economic implications.

Fixed Drug Eruption to Trimethoprim-Sulfamethoxazole and Doxycycline

Fixed drug eruption (FDE) is a common cutaneous drug eruption. We are the first to report a case of polysensitive FDE to both trimethoprim-sulfamethoxazole (TMP-SMX) and doxycycline. Diagnosis of FDE is largely clinical, and it is important to establish a good medication history to identify the causative agent. Treatment depends on avoidance of the implicated drug.

The Effect of Acute Erythromycin Exposure on the Swimming Ability of Zebrafish (Danio rerio) and Medaka (Oryzias latipes)

Erythromycin is a widely used antibiotic, and erythromycin contamination may pose a threat to aquatic organisms. However, little is known about the adverse effects of erythromycin on swimming ability. To quantify erythromycin-induced damage to fish swimming ability, Oryzias latipes and Danio rerio were acutely exposed to erythromycin. The swimming ability of the experimental fish was measured after exposure to varying doses of erythromycin (2 µg/L, 20 µg/L, 200 µg/L, and 2 mg/L) for 96 h. Burst speed (U_burst) and critical swimming speed (U_crit) of experimental fish significantly decreased. In addition, gene expression analysis of O. latipes and D. rerio under erythromycin treatment (2 mg/L) showed that the expression of genes related to energy metabolism in the muscle was significantly reduced in both species of fish. However, the gene expression pattern in the head of the two species was differentially impacted; D. rerio showed endocrine disruption, while phototransduction was impacted in O. latipes. The results of our study may be used as a reference to control erythromycin pollution in natural rivers.

Spectrum of skin diseases presented at LAUTECH Teaching Hospital, Osogbo, southwest Nigeria

BACKGROUND

Patterns of skin disease in developing nations are changing as frequencies of non-communicable diseases continue to increase. Appraisal of the current status of the disease profile is of utmost importance for health planning and resource allocation.

METHODS

A prospective analysis of 895 cases of outpatient consultation during the years 2005-2010 was conducted.

RESULTS

The mean ± standard deviation age of patients was 31.1 ± 19.1 years. Non-infectious skin diseases accounted for 80.9% of all cases. Eczemas/dermatitis (27.0%), urticarias/erythemas (11.0%), fungal infections (9.5%), skin appendage disorders (8.9%), papulosquamous diseases (8.2%), pigmentary diseases (8.2%), viral infections (6.8%), and tumors and malignant skin lesions (5.4%) represented the most common presentations. Atopic dermatitis was the most common type of eczema (29.8%) among children (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.09-2.13; P = 0.013), in whom cornification disorders (OR 3.90, 95% CI 1.73-8.92; P < 0.001) and viral infections (OR 1.80, 95% CI 1.09-3.25; P = 0.021) were also frequent. Adults were more likely to be diagnosed with drug eruptions (OR 3.58, 95% CI 1.09-11.80; P = 0.003), tumors/malignancy (OR 4.97, 95% CI 1.53-16.10; P = 0.030), or autoimmune connective tissue disorders (OR 8.13, 95% CI 1.09-60.20; P = 0.015). Female subjects were significantly affected by urticarias (OR 1.53, 95% CI 1.00-2.33; P = 0.030) and papulosquamous diseases (OR 1.80, 95% CI 1.09-3.03; P = 0.019).

CONCLUSIONS

The present pattern shows that non-infectious skin diseases are predominant. Occurrences of eczemas and urticarias are increasing at similar rates, whereas infectious skin diseases are decreasing in frequency. Resources and research should be directed towards the prevention of non-infectious skin diseases at this time as the campaign for a cleaner environment continues.