Unsafe "crossover-use" of chloramphenicol in Uganda: importance of a One Health approach in antimicrobial resistance policy and regulatory action.

Since the introduction of antibiotics into mainstream health care, resistance to these drugs has become a widespread issue that continues to increase worldwide. Policy decisions to mitigate the development of antimicrobial resistance are hampered by the current lack of surveillance data on antibiotic product availability and use in low-income countries. This study collected data on the antibiotics stocked in human (42) and veterinary (21) drug shops in five sub-counties in Luwero district of Uganda. Focus group discussions with drug shop vendors were also employed to explore antibiotic use practices in the community. Focus group participants reported that farmers used human-intended antibiotics for their livestock, and community members obtain animal-intended antibiotics for their own personal human use. Specifically, chloramphenicol products licensed for human use were being administered to Ugandan poultry. Human consumption of chloramphenicol residues through local animal products represents a serious public health concern. By limiting the health sector scope of antimicrobial resistance research to either human or animal antibiotic use, results can falsely inform policy and intervention strategies. Therefore, a One Health approach is required to understand the wider impact of community antibiotic use and improve overall effectiveness of intervention policy and regulatory action

The Antiviral Drug Valacyclovir Successfully Suppresses Salivary Gland Hypertrophy Virus (SGHV) in Laboratory Colonies of Glossina pallidipes

Many species of tsetse flies are infected with a virus that causes salivary gland hypertrophy (SGH) symptoms associated with a reduced fecundity and fertility. A high prevalence of SGH has been correlated with the collapse of two laboratory colonies of Glossina pallidipes and colony maintenance problems in a mass rearing facility in Ethiopia. Mass-production of G. pallidipes is crucial for programs of tsetse control including the sterile insect technique (SIT), and therefore requires a management strategy for this virus. Based on the homology of DNA polymerase between salivary gland hypertrophy virus and herpes viruses at the amino acid level, two antiviral drugs, valacyclovir and acyclovir, classically used against herpes viruses were selected and tested for their toxicity on tsetse flies and their impact on virus replication. While long term per os administration of acyclovir resulted in a significant reduction of productivity of the colonies, no negative effect was observed in colonies fed with valacyclovir-treated blood. Furthermore, treatment of a tsetse colony with valacyclovir for 83 weeks resulted in a significant reduction of viral loads and consequently suppression of SGH symptoms. The combination of initial selection of SGHV-negative flies by non-destructive PCR, a clean feeding system, and valacyclovir treatment resulted in a colony that was free of SGH syndromes in 33 weeks. This is the first report of the use of a drug to control a viral infection in an insect and of the demonstration that valacyclovir can be used to suppress SGH in colonies of G. pallidipes

Determination of valacyclovir hydrochloride in tablets and spiked plasma samples by spectrofluorimetry

A novel, simple and rapid stability-indicating spectrofluorimetric method has been developed for the determination of valacyclovir hydrochloride in tablets and spiked plasma samples. Method based on the reaction between valacyclovir and fluorescamine in borate buffer solution of pH 9.0 to give highly fluorescent derivatives that were measured at 475 nm using an excitation wavelength of 390 nm. The method has linear relation with fluorescence intensity in the concentration range of 0.25-1.25 mu g/mL. The developed spectrofluorimetric method was validated with respect to linearity, precision, sensitivity, accuracy and selectivity. The degradation behavior of the drug was also investigated: the drug solution was subjected to neutral, acid and alkali hydrolysis, oxidation, thermal stress and exposure to the sunlight. The method proved to be selective and useful for the investigation of the stability of valacyclovir. Successful applications of the developed method for the drug determination in tablets and spiked plasma samples were also performed