Interview with Dr.Birkeland (Internal medicine specialist)-  Alternative Approaches to Antibiotic Therapy

Biography
Dr. Karoline Birkeland- DVM (Doctor of Veterinary Medicine),  was born and raised in Ørsta, a quaint town in Norway. She earned her Doctor of Veterinary Medicine degree from the Wroclaw University of Environmental and Life Sciences in 2016. Since then, Dr. Birkeland has gained extensive experience in both Sweden and Norway, working in small animal clinics. Her areas of expertise include surgery, ultrasound, and internal medicine. Dr. Birkeland is also dedicated to giving back, completing significant volunteer work as a veterinarian in the Cook Islands.

1.How big is antibiotic resistance in veterinary medicine? 

Antibiotic resistance in veterinary medicine is a serious and expanding issue. The extensive use of antibiotics in animal healthcare and livestock farming has led to the development of resistant bacterial strains. This trend complicates treatment of animal infections and poses risks to human health due to potential transmission of resistant bacteria from animals to people.
Addressing antibiotic resistance in veterinary medicine requires a combination of prudent antibiotic use, alternative therapies, and robust monitoring to ensure effective treatment while minimising the spread of resistance.

2.What are some different ways to treat common animal infections without using antibiotics, and why might these methods be better than antibiotics?

 There are several alternative methods to treat common animal infections without using antibiotics, and they can offer advantages over traditional antibiotic therapy. For instance, in cases like cat abscesses, which often require drainage and treatment, alternative options like manuka honey can be considered. Manuka honey has been used for its potent antibacterial properties and ability to promote wound healing. Additionally, if antibiotics are deemed necessary for the treatment of abscesses, it's recommended to administer them in high doses over a short period rather than low doses over an extended period. This approach helps minimise the risk of developing antibiotic resistance and ensures effective treatment.

3.What should vets think about when choosing between alternative treatments and antibiotics for animal infections?

To choose between alternative treatments and antibiotics for animal infections, veterinarians should consider these key factors:

Type and Severity of Infection: Understand the specific infection and its severity to determine the best treatment approach.

Efficacy of Treatment: Assess which treatment—alternative or antibiotic—is more effective for the given infection, based on scientific evidence and past experiences.

Side Effects and Risks: Weigh the potential adverse reactions and risks associated with each treatment option, considering the animal's health. 

Antibiotic Resistance: Keep in mind the impact of antibiotic use on resistance patterns. Alternative treatments could help reduce reliance on antibiotics.

Client Preferences and Compliance: Factor in the preferences of the animal's owner and their ability to comply with the treatment plan.

Cost and Accessibility: Consider the cost and availability of both alternative treatments and antibiotics, as it may affect the choice.

4.How do probiotics, phage therapy, and immunomodulators help treat animal infections, and which types of infections are they best for?

Probiotics: Probiotics contain beneficial microorganisms that can help restore and maintain a healthy balance of gut bacteria. They can improve gut health and enhance the immune response, making them useful for preventing and treating gastrointestinal infections, such as diarrhea caused by pathogens like Clostridium difficile.

Phage Therapy: Phage therapy involves using bacteriophages, which are viruses that specifically target and infect bacteria. Phages can be tailored to target specific bacterial strains, making them effective against bacterial infections where antibiotics may fail, such as multidrug-resistant bacterial infections like MRSA.

Immunomodulators: Immunomodulators are substances that modulate or regulate the immune system's response. They can enhance the body's immune response to fight off infections more effectively. Immunomodulators can be beneficial for treating viral infections, autoimmune diseases, and conditions where immune function is compromised, such as chronic infections or cancer.

5.How might treatments other than antibiotics become more important in the future for animal health, especially with antibiotic resistance becoming a problem? How effective are these alternative treatments?

With antibiotic resistance on the rise, alternative treatments for animal health are becoming increasingly important. Here's why these treatments are gaining significance and how effective they are:

-Growing Resistance: As traditional antibiotics become less effective due to resistance, alternative approaches can help reduce reliance on antibiotics and slow the development of resistance.

-Popular Alternatives: Common alternative treatments include:

• Probiotics and Prebiotics: Promote gut health, potentially reducing infections.
• Herbal Remedies: Certain herbs have antimicrobial properties.
• Nutraceuticals and Supplements: Support immune function, reducing the need for antibiotics.
• Vaccination: Prevents diseases, reducing antibiotic use.

-Effective Applications: Alternative treatments have shown promise in addressing certain conditions, like:

• Digestive Issues: Probiotics can help maintain gut health.
• Minor Skin Infections: Herbal treatments can be effective.
• Respiratory Health: Nutraceuticals can support immune health

6.How much do alternative treatments cost compared to antibiotics, and what factors should vets consider when deciding if they're worth using economically?

The cost of alternative treatments can vary widely depending on the specific therapy, the severity of the infection, and other factors. While some alternative treatments may be more expensive upfront, they may offer long-term cost savings by reducing the need for repeated antibiotic treatments and associated complications. Vets should consider factors such as the efficacy, safety, and long-term benefits of alternative treatments when evaluating their economic value

7.What are some common conditions that vets reach for antibiotics and probably shouldn’t?

Veterinarians often rely on antibiotics to treat a range of animal health issues, but there are some conditions where antibiotics are frequently used even though they might not be the best or necessary option. Here are some common situations where antibiotics are often prescribed but may be overused or unnecessary:

Viral Infections: Antibiotics are designed to combat bacterial infections, not viral ones. However, some vets might prescribe antibiotics to treat viral infections, such as feline upper respiratory infections or canine distemper, even though they have no effect on the viruses causing these conditions.

Minor Skin Irritations or Allergies: Antibiotics are sometimes used to treat minor skin irritations, rashes, or allergies, which are often caused by allergens or other non-bacterial factors. In these cases, other treatments like antihistamines or anti-inflammatory medications might be more appropriate.

Digestive Disturbances: Conditions like diarrhea or upset stomach are sometimes treated with antibiotics despite the fact that these issues could be caused by dietary indiscretions, parasites, or stress rather than bacterial infections.

Post-Surgical Prophylaxis: While antibiotics are often used to prevent infections after surgery, they are sometimes prescribed more broadly or for longer durations than necessary. Proper surgical technique and aseptic procedures can reduce the need for extensive antibiotic use.

Ear Infections: Ear infections in pets can be caused by a variety of factors, including allergies, yeast, or mites. Antibiotics might not always be the right treatment, especially if the cause isn't bacterial.

Chronic Conditions: Conditions like arthritis or chronic inflammation might be treated with antibiotics, but these are not always effective in addressing the underlying cause. Alternative therapies, such as anti-inflammatory medications or joint supplements, may be more suitable.

By avoiding unnecessary antibiotic use and focusing on more accurate diagnoses, veterinarians can help reduce the risk of antibiotic resistance and provide more effective care. Proper diagnostics, including laboratory tests and thorough physical examinations, can help determine the best course of treatment without over-reliance on antibiotics.

8.Are there any special rules vets need to follow when using alternative treatments, like making sure they're safe and effective, and following the law?

Yes, vets must ensure that alternative treatments are safe, effective, and comply with legal and regulatory requirements. This may involve conducting thorough research, consulting with experts or specialists, and following established guidelines and protocols for the use of alternative therapies. Additionally, vets should maintain accurate records of treatment administration and monitor animals closely for any adverse reactions or complications.