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Milk antibiotic: Antibiotic residues in milk: Past, present, and future


Are There Antibiotics in Milk?

Milk is one of the most highly regulated foods, and every glass is guaranteed to be antibiotic-free. In fact, the FDA has been testing dairy foods for antibiotic residue, and zero milk products have tested positive for traces of antibiotics since 2010.

Are cows treated with antibiotics?

Sick cows are sometimes treated with antibiotics (just like sick people are) – but only when necessary to treat specific illnesses. These cows are separated from the healthy cows and, treated by a veterinarian, until they recover and the antibiotics are out of their systems. During that time, they are milked on a different schedule (and often in a completely different area) from the other cows, and their milk is not sold for human consumption.

What if some antibiotics accidentally get into the milk supply?

Milk is tested three or more times before it ever reaches your grocery store.

  • First, at the dairy farm, dairy farmers test each full tank of milk for antibiotic residue before letting their processor know to come pick up the milk.
  • Next, when the processor’s tanker truck gets to the farm, the first thing the driver does is take a sample of milk from the bulk tank and test it again. They make sure there is no antibiotic residue and that the milk is at a safe temperature.
  • Finally, when the truck driver delivers the milk to the processing plant, it is tested once more for antibiotic residue and other imperfections that can cause problems with the machinery at the plant or make the milk unsafe for people to drink. It is also rejected if the tanker truck has become too warm during the trip to the plant. This is also where the milk is tested for milk fat content, protein content and many other quality factors that determine what the milk will be used for (fluid milk, cheese, yogurt or other products) and how much a dairy farmer will be paid for the milk.

Dairy farmers care deeply about the safety of their milk – if antibiotic residue is found in the milk at any point in this journey, the dairy farmer responsible is fined and the milk must be safely dumped. The farmer will receive no payment and will pay a penalty to their processor for having the milk transported when it could not be used.

Who else inspects the milk and farm?

Inspectors from state regulatory agencies and milk processing plants regularly make surprise visits to farms – just one more set of checks and balances to make sure animal living conditions are clean, milking equipment is sanitized and facilities are safe.

Learn more about how milk gets from farm to table here.

Why Milk and Antibiotics Don’t Mix – Healthy Living Center

Q1. Why is taking antibiotics with milk a no-no? Does this apply to all antibiotics, or only certain ones?

— Shirley, Ohio

It’s not just milk — there are many other foods that can interfere with antibiotics, as well as other drugs.

In order for oral antibiotics to be effective, they must be absorbed from the gastrointestinal tract, make their way into the bloodstream, and be delivered to the infected area. Many factors influence the body’s ability to accomplish this feat, including the relative acidity of the stomach, the presence of fat or other nutrients in the stomach, and whether certain elements such as calcium are present. The classic family of antibiotics that cannot be taken with milk are the tetracyclines, because the calcium in the milk binds the antibiotic and prevents gut absorption.

For most antibiotics, food results in either a decrease in absorption or has no effect. However, some antibiotics are actually better absorbed when taken with food, and it is recommended that others be taken while eating, because the food does not have a significant impact on absorption and may decrease any potential stomach upset from the drugs.

It is very important to follow the directions on the prescription bottle, because pharmacists are the experts in these interactions. Not following directions may result in the antibiotic failing to cure the infection.

Q2. My mom is 64 and has had multiple sclerosis for over 30 years. She is totally immobile and has been on a catheter for about one year. She has a problem with kidney stones and recurring urinary tract infections. Is there any way she could take some kind of antibiotic as a preventive measure to keep her from getting these infections so frequently?

Your mother’s situation is complicated. Anyone with an indwelling catheter in the bladder will develop chronic colonization of the urinary tract by bacteria. There is no good way to eradicate such colonization. Furthermore, chronic use of antibiotics in such situations can lead to the development of resistant organisms, which can lead to more severe infections.

A complicating factor is the presence of kidney stones. Some kidney stones are related to the presence of bacteria. Certain bacteria contain an enzyme that breaks down urea, a normal component of the urine. The breakdown product is ammonium, a compound that, in combination with magnesium and phosphate, forms stones. These are often called “infection stones” or “struvite stones. ” Once these struvite stones form, they can be eradicated only by surgical treatment. Antibiotic therapy is not effective. Furthermore, until the stones are removed, there will always be an additional bacterial load in the urine.

Your mother’s problem requires the input of a specialist. If you mother is not being cared for by a urologist, I suggest that you seek one out. Urologists are surgeons who treat both medical and surgical aspects of kidney stone disease and bladder infection and can work with you and your mother to develop a treatment plan.

Learn more in the Everyday Health Healthy Living Center.

Antibiotics in the Dairy Industry: What you need to know

Long gone are the small-scale family farms that provide dairy to local cheese producers and families. This is the era of industrialized agriculture and concentrated animal feeding operations (CAFOs). One of the many dirty secrets of industrialized dairy production is the use of antibiotics. CAFO operators use antibiotics to make up for the concentrated confinement of animals, unsanitary living conditions, and the use of hormones.

Using antibiotics for non-therapeutic purposes, any use of antibiotics in food animals without disease or documented disease exposure, has led to the development of antibiotic resistant (AR) bacteria, which have infiltrated our food system and pose a major risk to human health. According to the Center for Disease Control (CDC) 22 percent of AR infections originate from foodborne pathogens. This was never an unexpected outcome, in fact in his 1952 Nobel Peace Prize acceptance speech Alexander Flemming warned of the creation of superbugs from the misuse of antibiotics, a warning we ignored. The big question is what happens when even our strongest antibiotics no longer win out against the toughest bacteria?

Reasons for Non-therapeutic Antibiotic Use 

Following the “get big or get out” mantra from policy leaders, the agricultural industry adopted heavy use of antibiotics. The most common non-therapeutic uses of antibiotics are for prevention of disease and growth promotion. Of the 29 million pounds of antibiotics used each year 80 percent goes to livestock. Entire herds or flocks are continually given low doses of antibiotics in their feed or water to prevent disease and promote growth, two things that would happen naturally if animals had more natural living conditions and access to pasture.

CAFOs (or factory farms) are large-scale animal housing operations that raise a large number of animals, most commonly cattle, chickens, and pigs. These facilities focus on efficiency, measured by how quickly the operator can raise an animal and send it to market for slaughter. As a result, animals live in extremely crowded conditions with little to no access to the outdoors. These conditions increase animal stress and poor hygiene, which increase pathogen development and decrease growth. With so many animals concentrated in one area there is a vast amount of manure creating the perfect home for the proliferation of bacteria. A 2014 study published in the Proceedings of the National Academy of Sciences highlights the connection between non-therapeutic antibiotic use in animals and an increase in bacteria populations. These situations increase the potential for infections such as environmental mastitis, an udder infection in dairy cows that is caused from environmental conditions rather than a traditional bacterial infection.

The Dangers of Antibiotic Resistance 

The threat of AR to human health starts at the farm and follows the food chain all the way to your dinner plate. Farms serve are as hotspots for AR; in fact anyone who lives near CAFOs or fields fertilized with animal manure is at a greater risk to superbug infections. These fields can pose a risk because bacteria from the manure can be transported from its original source to fruit and vegetable production. Once these products go to market the bacteria can follow them; and if they are not properly cleaned, can transfer to humans. According to the CDC AR causes infections that are more difficult to treat resulting in prolonged and costlier treatments, an increase in healthcare costs of $20 billion a year, and an overall expense to the economy of $50 billion. In 2019, the CDC found that 2.8 million Americans contracted antibiotic-resistant infections and more than 35,000 people were killed by these infections. Clearly, this is a real and imminent threat.

One of the greatest risks of AR genes is that they have a number of ways to enter the environment. AR bacteria can spread to rodents and flies and can be carried from one place to another across borders and seas (think black plague). The bacteria themselves possess the capability to horizontally transfer genes allowing one form to share its new supper genes with all of its friends and family. Since AR bacteria have reached such prevalence in our food system even animals raised without antibiotics or organically may still be carriers of AR bacteria. The CDC, along with many medical organizations, including the American Medical Association, oppose non-therapeutic uses and are calling for changes in farming practices to save antibiotics for humans.

Antibiotics in Dairy

The current dairy sector is one that promotes industrialization and consolidation over the health and wellness of the herd. In an effort to achieve higher levels of so called efficiency, dairy producers predominately use CAFOs and the hormone rBGH to increase milk production. rBGH or recombinant bovine growth hormone is a genetically engineered synthetic hormone created by Monsanto to increase milk production levels. Studies have found that rBGH usage results in increased cases of mastitis infections, which ultimately requires higher levels of antibiotics.

The Food Safety Inspection Service (FSIS) of the USDA is responsible for inspecting meat for contamination with residual antibiotics, pesticides, and heavy metals. “Residue” makes its way into the food supply when producers bring animals to slaughterhouses while they have contaminants still in their system. When dairy cows are culled from the herd due to incurable infections they are processed into ground beef. Often, cows are processed before the proper withdrawal period, therefore the antibiotics are still in their systems when they are converted into meat for human consumption; antibiotics are then passed on to humans. While the cows are being treated with higher levels antibiotics for an infection, their milk is supposed to be pulled from human consumption but is often fed to calves. These calves will likely be processed into veal likely with residue of antibiotics from being fed tainted milk.

By purchasing dairy consumers also support the meat industry. In 2009, of the 33.3 million cattle used to produce beef 2.9 million were dairy cows. In 2008, plants processing dairy cows and veal were responsible for 90 percent of the residue violations. This begs to ask the question of who is really looking out for our milk and why antibiotics are not more heavily monitored. FSIS, EPA and FDA jointly monitor residue violations through the national residue program. The USDA’s Office of Inspector General released a report stating that the national residue program “is not accomplishing its mission of monitoring the food supply for harmful residues.”

The CDC suggests that the use of antibiotics for growth promotion should be phased out. Doing so would follow the trend of many European nations. Since implementing the ban they have seen a steady decline in the number of cases of AR.

Take Action

It is time for consumers to call on companies to change their way! Join us in urging Dean Foods and Starbucks to make an organic milk commitment. By doing so, these companies will help transition the current CAFO dairy system to one that does not rely on concentrated confinement and antibiotics. The future of antibiotics in the US depends on it.

FDA Tests Turn Up Dairy Farmers Breaking The Law On Antibiotics : The Salt : NPR

FDA tests have turned up residues suggesting a few dairy farmers are illegally using antibiotics.


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FDA tests have turned up residues suggesting a few dairy farmers are illegally using antibiotics.


When it comes to the current controversy over antibiotic use on farm animals, milk is in a special category.

Lactating cows, unlike hogs, cattle or chickens that are raised for their meat, don’t receive antibiotics unless they are actually sick. That’s because drug residues immediately appear in the cow’s milk — a violation of food safety rules.

Milk shipments are tested for six of the most widely used antibiotics, and any truckload that tests positive is rejected. So when cows are treated, farmers discard their milk for several days until the residues disappear.

Yet a new report from the Food and Drug Administration reveals that a few farmers are slipping through a hole in this enforcement net. These farmers are using antibiotics that the routine tests don’t try to detect, because the drugs aren’t supposed to be used on dairy cows at all.

The FDA looked for 31 different drugs in samples of milk from almost 2,000 dairy farms. About half of the farms — the “targeted” group — had come under suspicion for sending cows to slaughter that turned out to have drug residues in their meat. The other farms were a random sample of all milk producers.

Just over 1 percent of the samples from the “targeted” group, and 0.4 percent of the randomly collected samples, contained drug residues. An antibiotic called Florfenicol was the most common drug detected, but 5 other drugs also turned up. Perhaps most disturbing: None of the drugs that the FDA detected are approved for use in lactating dairy cows.

Because the survey was carried out for research purposes, the samples were collected anonymously, and the FDA cannot send investigators to the farms to find out what happened.

Mike Apley, a researcher at Kansas State University’s College of Veterinary Medicine, says that it is “totally illegal” for dairy farmers to use two of the drugs that the FDA detected: Ciproflaxacin and Sulfamethazine.

In the case of other drugs, he says, the situation is more complicated. It’s illegal for farmers to use those drugs on their own, but veterinarians are allowed to authorize their use in dairy cows under certain strict conditions. Veterinarians also are supposed to ensure that no residues enter the food supply. For whatever reason, that veterinary safeguard didn’t work in these cases.

Dr. William Flynn, deputy director for science policy in the FDA’s Center for Veterinary Medicine, chose to focus on the fact that the violations were uncommon. “These are encouraging findings,” Flynn tells The Salt. The low number of violations indicates that “things are working well.”

Flynn says the FDA is working on plans to stop illegal drug use by dairy farmers. This could include testing all milk for a larger number of antibiotics.

Morgan Scott, a veterinary epidemiologist at Texas A&M University, noted that a small number of farmers, through their reckless use of drugs, may end up imposing substantial costs on all other dairy farmers.

“That, to me, is tragic, that some farmers don’t think that keeping the reputation of the industry intact is a priority,” he says.

Antibiotics in Milk—A Review – ScienceDirect

The widespread use of antibiotics has contributed to the control of diseases and the nutritional well-being of livestock. However, the use of antibiotics in the treatment of mastitis has created problems for the milk processor and consumer. Following treatment of mastitis with antibiotics, they may be found in the milk in sufficient concentrations to inhibit dairy starter microorganisms and cause economic losses to the cheese and fermented milk industries. Penicillin in very small concentrations found in milk may cause reactions in highly sensitive individuals.

Nationwide surveys revealed that penicillin was the primary antibiotic found in the central milk supply. Ten surveys covering a 9-yr. period (prior to 1960) in which 7,201 samples were tested, found 377 (5.2%) to be positive for the presence of antibiotics. The application of testing methods by regulatory and dairy personnel during 1960 resulted in a significant reduction in antibiotic-adulterated milk. Analyses of approximately 770,000 producer milk samples showed an incidence of 0.54%—a tenfold decrease.

When antibiotics are used to treat mastitis, dairymen should follow the prescribed recommendations for withholding milk for human use following treatment. Data compiled on intramammary infusions, intramuscular injections, and oral administration of antibiotics and their vehicles illustrate that wide variations exist concerning the relative persistence of the amount of antibiotics found in milk. The persistence of antibiotics in milk differs in milk from cows in early-, mid-, and late-lactation. Some recent studies using highly sensitive methods indicate that antibiotics are transferred from treated to untreated quarters, but wth penicillin this transfer is slight and of short duration and not likely to present a problem.

When adulterated milk leaves the farm, it is subjected to various processes in the milk plant. Antibiotics in milk are relatively stable to pasteurization temperatures and above, as well as to low temperatures (0–10° F. ). Under refrigeration temperatures up to seven days of storage, in raw and pasteurized milk there tends to be a loss in antibiotic activity. Large quantities of milk are necessary to dilute milk from treated quarters, since cultures may be retarded if the concentration of penicillin is approximately 0.05 unit/per milliliter or greater.

Several substances have been found that will inactivate penicillin. The most promising, penicillinase, can be used to hydrolyze penicillin in milk and in penicillin allergy cases.

Larger quantities of inoculum and use of resistant cultures are an aid in the production of cheese made from milk that contains antibiotics.

The presence of antibiotics in milk constitutes an adulteration under the Federal Food, Drug and Cosmetic Act. Educational and testing programs participated in by the Extension Service, veterinarians, dairy inspectors, sanitarians, fieldmen conferences, dairy schools, and government agencies have been helpful and cooperative, but the primary responsibility continues to rest with dairymen.

Reservoirs of antimicrobial resistance genes in retail raw milk | Microbiome

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  • Detection and determination of stability of the antibiotic residues in cow’s milk


    In the present study, antibiotic residues were detected in milk samples collected from the dairy herds located in Karnataka, India, by microbiological assay. Subsequently, the detected antibiotics were identified as azithromycin and tetracycline, by high-performance liquid chromatography, further both the antibiotics detected in the cow milk samples were found to be at high concentration (9708. 7 and 5460 μg kg-1, respectively). We then investigated the effects of temperature and pH on the stabilities of azithromycin and tetracycline to determine the degradation rate constant k using first-order kinetic equation. Results indicated that significant reduction in stability and antibacterial activity of azithromycin solution when subjected to 70 and 100°C for 24 h. While stability of tetracycline was significantly reduced when subjected to 70 and 100°C for 24 h. However no significant reduction in antibacterial activity of tetracycline was observed at respective temperatures when compared with that of control. In addition, the stabilities of azithromycin and tetracycline were found to be decreased in acidic pH 4–5. The results of the present study revealed the high risk of contamination of milk sample with veterinary antibiotics and also demonstrated the effect of temperature and pH on stability of antibiotics. Therefore the study suggest that the qualitative and quantitative screening of milk for the presence of antibiotics need to be strictly performed to ensure safe drinking milk for consumers.

    Citation: Kurjogi M, Issa Mohammad YH, Alghamdi S, Abdelrahman M, Satapute P, Jogaiah S (2019) Detection and determination of stability of the antibiotic residues in cow’s milk. PLoS ONE 14(10):


    Editor: Zhi Zhou, Purdue University, UNITED STATES

    Received: June 1, 2019; Accepted: September 11, 2019; Published: October 10, 2019

    Copyright: © 2019 Kurjogi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Data Availability: All relevant data are within the manuscript and its Supporting Information files.

    Funding: The authors received no specific funding for this work.

    Competing interests: The authors have declared that no competing interests exist.


    Cow milk, being the richest natural source for nutritional elements, is the most commonly consumed milk in the world [1,2]. However, the cow milk currently available in the market is laced with chemical residues like pesticides and antibiotics. The presence of antibiotic residues in milk not only affects its quality but also constitutes a significant health hazard to the consumers [3]. In most conventional dairies, cows are regularly treated with antibiotics as a preventive measure, and intramammary injection has been proven to be an effective mode of treatments for udder infections [4]. However, the excessive use of antibiotics against intramammary infections in dairy herds affects the quality of milk produced, and subsequently consumers health, due to the presence of the antibiotic residues in milk [5–7]. Such milk may provoke allergies, intestinal alterations and emergence of multidrug-resistant bacteria among consumers [8]. Antibiotic residues may also inhibit the normal microflora of milk, and have an adverse effect on the manufacturing processes of some dairy products, such as yogurt and cheese [1,9,10]. In addition, lack of information on the withdrawal period and the stability of antibiotic residues leads to failure in controlling excessive use of veterinary drugs [11,12]. Some veterinary drugs like tetracycline are reabsorbed through entero-hepatic circulation and persisted in the body for a long time after administration, resulting in photosensitivity reaction with developed pigmentation of the nails [13]. Consumption of tetracycline-contaminated milk for short or long duration may lead to the developments of permanent discoloration of the teeth in children [14]. Similarly, drinking milk contaminated with high levels of azithromycin can severely affect the human immune and cardiovascular system [15].

    India is the world’s largest milk producer with 18 percent global production (Retrieved December 14th 2018, from http://www. fao.org/dairy-production-products/production/en/). The farms in India have been routinely using antibiotics, particularly azithromycin and tetracycline, in cattle husbandry practices [10,16,17]. The occurrence of antibiotic residues in market milk has been frequently reported in India, raising a great concern among the consumers [10,16,18]. The usage of antibiotics varies from region to region and among individual cows within farms, depending on the causative agent and the severity of illness. Hence, it is essential to detect the prevalence of antibiotic residues in milk of each particular region, and perhaps for individual cows within farms, for formulating the proper regional guidelines to ensure safe milk for the consumers. Therefore, screening for antibiotic residues in milk before it reaches the consumers is critical in dairies as it will help to reduce the threat of residual contamination of the food chain. However the proper choice of antibiotic screening test plays an important role in effectiveness and accuracy of detection of antibiotic residues [19]. Various techniques like chemical, microbiological and immunological assays are available to detect antibiotic residues in milk, but most of these methods lack specificity, as they provide only semi-quantitative measurements and produce false positive results [20]. To overcome these problems, chromatographic techniques, such as high-performance liquid chromatography (HPLC), was developed and known to be the most reliable, sensitive and robust method [21–23]. Available litreture showed that, HPLC was able to determine sulfonamides from food samples [24] and also HPLC method was successfully used to detect the antibiotic residues at lower than their respective maximum residue limits values [25]. Thus, in the present study the microbiological assay was first carried out to detect the presence of antibiotic residues in the cow milk samples collected from different farms in Dharwad district of Karnataka, India. Subsequently, the HPLC was used for identification and quantification of the antibiotic residues present in milk samples. Finally, the effects of temperature and pH on stability of antibiotics were evaluated with respect to their antimicrobial activity.

    Materials and methods

    Chemicals and reagents

    Acetonitrile and methanol of HPLC-grade, as well as azithromycin and tetracycline were procured from S D Fine-Chem, Mumbai, India. Millipore water was used in all analyses. Media for antibacterial activity, sterile paper disc and zone inhibition measuring scale were procured from HiMedia.

    Collection of milk samples

    A total of 13 raw cow milk samples (100 mL per sample) were collected from the dairy herds located in the Dharwad district of Karnataka, India, using sterilized container. Samples were stored at 4°C until analyses. No animal research was carried out in the study and also we declare that no animals were sacrificed or anesthesized in the present study.

    Antimicrobial assay of milk samples

    Bacillus subtilis culture was grown in Brain-Heart infusion liquid medium at 37°C. After 6 h of growth, 0.1 mL of broth (106 cells mL-1) was spread on the surface of Mueller-Hinton agar plates. Sterile paper discs of 10 mm size were entirely dipped in 100 mL of milk sample using forceps until the discs were completely impregnated with the milk sample. Milk-wetted discs were air-dried and placed equidistantly around the margin of the inoculated plates. Discs dipped into sterile distilled water (SDW) and pasteurized packet milk were served as control 1 and 2 respectively. Plates were incubated at 37 ± 2°C for 24 h, and zone showing inhibition of the bacterial growth was measured in mm using zone inhibition scale. Each test was performed in triplicate.

    Preparation of milk samples for HPLC

    Milk samples collected from dairy herds were processed as previously described by Khaskheli et al. with some modifications. 100 mL of raw milk sample were treated with 8 mL of 10% aqueous solution of acetic acid, and the mixture was then centrifuged at 3500 rpm for 10 min at 4°C [26]. The clear supernatant was taken by a disposable syringe without disturbing the fat layer, and was filtered through a 0.45-μm nylon filter. Subsequently, the filtered extract (1 mL) was transferred to a 2 mL sterilized vial and used for HPLC to identify azithromycin and tetracycline residues.

    Quantification of azithromycin and tetracycline residues by HPLC

    Ten μL of extract were injected into an HPLC Jasco device equipped with variable wavelength UV detector coupled with a C-18 column (octadecyl silyl, 100Å, 250 × 4.6 mm, 5 μm) at 214 nm and 355 nm for quantification of azithromycin and tetracycline, respectively. Elution was carried out at a flow rate of 1.2 mL min-1 using the isocratic mobile phase consisted of water:acetonitrile:methanol (55:25:20, v:v:v) for azithromycin, and methanol:acetonitrile:aqueous oxalic acid (1:2:4.5, v:v:v) for tetracycline. Azithromycin and tetracycline standard solutions were prepared by accurately weighing 1 mg of azithromycin and tetracycline and transferred to 50 ml HPLC grade water in volumetric flask. An aliquot of 5.0 ml was further diluted with HPLC grade water in 100 ml volumetric flask, to obtain a final concentration of 50 μg mL-1and store at 4°C. Serial dilutions (5, 10, 15 and 20 μg mL-1) were injected and eluted as mentioned above. The quantification of the antibiotic residues was achieved by comparison of the peak area of the sample with that of the standard having the same chromatogram.

    Degradation kinetics of azithromycin and tetracycline

    One mg mL-1 azithromycin or tetracycline was prepared in 0.2 M phosphate buffer (Stock solutions of monobasic and dibasic were prepared by dissolving 27.6 and 28.4 g of monobasic sodium phosphate, monohydrate and dibasic sodium phosphate respectively in 1000 ml distilled water and stored at 4°C. Phosphate buffer of 0.2 M was obtained by mixing 39 ml of dihydrogen sodium phosphate with 61 ml of disodium hydrogen phosphate), and maintained in a thermostat at definite temperatures of 4, 37, 70 and 100°C for different time intervals (0, 1, 3, 6, 12 and 24 h). A series of trisodium citrate buffer solutions of 0.06 M with a different pH range of 4.0–9.0 containing 1 mg mL-1 of azithromycin or tetracycline were prepared and kept at 24°C for different time intervals (0, 1, 3, 6, 12 and 24 h). The deviation of azithromycin and tetracycline concentrations due to the effects of different temperatures and pHs was measured by a Hitachi 2500 spectrophotometer at 214 nm and 355 nm, respectively. The resultant data were inserted into the first-order kinetic equation below to determine the antibiotic degradation rate constant k:

    where Ci is the initial concentration of the antibiotic at time 0, Ct is the concentration of the antibiotic at time t and kt is antibiotic degradation rate constant at time t.

    Evaluation of antibacterial activities of azithromycin and tetracycline at different temperature

    Sterile paper discs were soaked into samples, each had 20 μL phosphate buffer containing 1 mg mL-1 of azithromycin or tetracycline, which were maintained at different temperatures (4, 37, 70 and 100°C) for 24 h. Antibiotic solution-wetted paper discs were air-dried and placed on the surface of inoculated Mueller-Hinton agar medium containing B. subtilis (106 CFU mL-1) prepared as described above. Sterile discs saturated with 20 μL of freshly prepared antibiotic solution or 20 μL of buffer alone were simultaneously used as positive and negative controls, respectively. The plates were incubated at 37°C for 24 h, and inhibition zone was measured in the cultured plate in mm.

    Results and discussion

    Antibiotic residues in the collected cow milk samples

    Testing milk and its products for antibiotic residues is now a part of the routine quality control. All 13 raw milk samples were subjected to an antibacterial assay, out of which two milk samples (S1 and S2) showed a significant (P < 0.001) inhibition of the bacterial growth as compared with control (Fig 1). The positive result of the antibacterial assay indicated the presence of antibiotic residues in the tested raw milk samples (Fig 1). Similarly, Khaskheli et al. [26] detected antibiotic residues in the milk available at the market of Pakistan where B. subtilis was used as a test organism using field disc assay [26]. Movassagh and Karami (2010) also determined the presence of antibiotic residues in bovine milk of Tabriz, Iran [27]. Additionally, a study conducted in Parsbad, Iran, also showed that 14% of the raw cow milk samples were positive in antibiotic residues [28]. Similarly, Padol et al. reviewed that inappropriate uses of antibiotics in the treatment of the animal diseases may lead to the appearance of antibiotic residues in milk, which postures the risk of human health hazards and also interferes with the processing of milk products [18]. The results of the present study revealed that the antibiotic residue contents in the tested milk samples were high enough to inhibit the growth of the tested bacterium (Fig 1), which could also kill the normal microflora of milk that serves as a starter culture in the preparation of fermented milk products [18]. The antibiotics in the milk might also alter the probiotic concentrations through antibiosis, leading to harmful health effects [29].

    Fig 1. Antibacterial assay of the raw milk samples S1 and S2 against Bacillus subtilis using paper disc agar diffusion method.

    (a) Antibacterial plate assay and (b) clear zone inhibition in mm. Values are means ± standard errors of three independent replicates (n = 3). Significantly difference at P < 0.05 was determined using analysis of variance. ND, not detected; Cont 1, disc dipped in sterile distilled water; Cont 2, disc dipped in pasteurized packet milk.


    Contamination levels of azithromycin and tetracycline residues in the examined cow milk samples

    Based on the previously published literature and information obtained from the farmers of the examined areas, three antibiotics viz azithromycin, tetracycline and penicillin were suspected and further screening revealed that penicillin residue was not detected in our milk samples. Whereas two milk samples were found to be contaminated with azithromycin and tetracycline residues. We knew that azithromycin and tetracycline antibiotics are commonly used in animal husbandry practices [15,10,18]. however, the levels of contaminations and stabilities of these two antibiotics remained elusive. To verify this hypothesis, we used azithromycin and tetracycline antibiotics as standard controls in an HPLC to detect and quantify these antibiotic residues in the two contaminated milk samples (S1 Fig). Indeed, the peak signals detected from the milk samples at 214 nm and 355 nm matched well to those of the authentic controls, verifying the presence of azithromycin and tetracycline respectively as antibiotic residues in these two milk samples. Similarly after complete run of HPLC azithromycin standard and S1 samples were eluted at 8.5 mins. Alike, the sample analyzed for tetracycline was eluted at 7.1 mins which was corresponding to its standard. (Fig 2a and 2b). The antibiotic residues of azithromycin and tetracycline in the S1 and S2 milk samples were found to be 9708.7 and 5460.0 μg Kg-1, respectively. Quantification analysis indicated that the detected antibiotic levels were found to be remarkably higher than the maximum residue limit for antibiotic residues in milk set by Food Drug Administration (FDA) of the United States and European Union [30] [http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2009:152:0011:0022:en:PDF; http://eur-lex.europa.eu/legalcontent/EN/ALL/?uri=CELEX%3A32002D0657].

    Fig 2. Identification and quantification of antibiotic residues in S1 and S2 raw milk samples using high-performance liquid chromatography (HPLC).

    (a and b) HPLC chromatogram of S1 and S2 milk samples correlated with authentic standard.


    Available reports suggest that large amount of azithromycin and other macrolide residues present in milk not only affect the quality of milk but also cause serious changes in the function of cardiac contraction [31], and sometimes may result in permanent hearing loss or vertigo in humans [32]. The rate of metabolism of tetracycline in cows has been estimated to 25–75%, and a significant percentage of the administrated tetracycline is excreted in bovine milk [33]. The antibiotics and their metabolites may end up in milk and may cause harmful effects to consumers, if the withdrawal period of antibiotics has not been passed [34]. Penicillin G residue was reported in raw cow milk in Pakistan and Venezuela [35,26]. Erskine et al., (1995) also observed longer excretion of ceftiofur in the milk of cows with induced Escherichia coli mastitis when compared with healthy cows [36]. Polymyxin B was not efficiently absorbed after intramammary treatment of healthy cows, or from cows with chronic mastitis, and 90% of the applied amount of polymyxin B were later found in the milk [37]. The detection of antibiotic residues in the milk revealed that the antibiotics used for the treatment of intramammary infection were still persisted in the cows at the time of milking, indicating the lack of knowledge of antibiotic withdrawal period. Therefore, the results from our study suggest that the cows treated with an antibiotic should not be milked before the complete withdrawal of the antibiotic used in treatment.

    Thermal kinetics of azithromycin and tetracycline

    Several studies investigated the effects of temperature on stability of antibiotics and presented their findings in terms of degradation of antibiotic residues or reduction of antimicrobial activity in the food product in response to thermal treatment. However the results of degradation of antibiotics reported in available litreture vary depending upon the selection of temperature for treatment, the solvent and the pH. The thermal kinetics of azithromycin and tetracycline were investigated, and the antibiotic degradation rate constant k was summarized in Tables 1 and 2. The degradation rate constant k of azithromycin at 4°C was 1000 ± 8.10−4 after 1 h, which later drastically decreased to 62 ± 2.10−4 after 24 h (Table 1). On the other hand, at 37°C the azithromycin constant k sharply increased from 50 ± 1.10−4 to 966 ± 9.10−4 after 3 h of incubation, then gradually decreased (Table 1). In addition, a significant increase in the degradation rate constant k from 50 ± 2.0−4 to 4033 ± 22.10−4 was recorded at 70°C after 3 h of incubation, which drastically decreased to 537 ± 5·10−4 after 24 h incubation (Table 1). Likewise, changes in constant k at 100°C were recorded revealing a significant increase from 200 ± 3.10−4 to 3900 ± 18.10−4 after 3 h of incubation, followed by a gradual decrease (Table 1).

    The degradation rate constant k of tetracycline at 4°C was 20 ± 4.10−4 after 1 h, which remarkably increased to 256 ± 32.10−4 after 3 h of incubation, and then gradually decreased to 50 ± 8.10−4 at 24 h of incubation (Table 2). At 37°C constant k significantly increased from 50 ± 6.10−4 to 400 ± 46.10−4 after 3 h of incubation, respectively, and then gradually decreased to 135 ± 20.10−4 at 24 h of incubation period (Table 2). However, a substantial increase in the constant k was recorded at 70 and 100°C (from 30 ± 6.10−4 to 630 ± 81.10−4 and from 60 ± 15−4 to 860 ± 61−4, respectively) after 3 h of incubation, which later drastically decreased to 160 ± 18.10−4 and 160 ± 2.10−4 after 24 h incubation, respectively (Table 2). Our results indicated that the stabilities of azithromycin and tetracycline were temperature-dependent, and these antibiotics were relatively stable at 4 and 37°C during the 24 h time period (Tables 1 and 2). The obtained results were correlated with the good antibacterial activities of azithromycin and tetracycline at 4 and 37°C (Fig 3). However, no zone of inhibition was observed with B. subtilis when azithromycin in phosphate buffer was subjected to 70 and 100°C for 24 h which indicates that azithromycin lost its antibacterial activity when treated at 70 and 100°C for 24 h (Fig 3a), whereas the buffer containing tetracycline antibiotic subjected to the different temperature had a major effect on its antimicrobial activity. As the temperature of the buffer solution increased, decrease in the zone of inhibition was observed. Antibacterial activity of buffer solution after subjecting to different temperature with subsequent holding time period exhibited the differential inhibitory response against B.subtilis (Fig 3b). The results of present study were in agreement with results of previous reports, which showed that the heat treatment of cow milk or its processing into other milk products neither effectively eliminated nor reduced tetracycline residue [38–39]. Kitts et al. [40] studied the inactivation of oxytetracycline residues at a temperature range from 60 to100°C, and they recorded an increase in degradation rate in correlation with the increase in temperature and incubation time [40]. Similarly several researchers found that first order kinetics is an appropriate model for degradation study of β-lactams, quinolones, sulfonamides and tetracyclines [41–45]. β -lactam antibiotic such as penicillin and cephalosporins residues are commonly reported in milk as they are widely used veterinary drugs [46]. Thermal kinetics of β -lactam antibiotics was also observed to follow first order kinetic model and showed that, stability of β -lactam antibiotics is temperature dependent [43]. Further studies indicate that β -lactams can be significantly reduced in milk or water when subjected to 120°C for 15–20 min [43,47]. Macrolides such as erythromycin and azithromycin often used as an alternative to penicillin [48], are also known to be susceptible to heat treatment. Studies revealed that antimicrobial activity of erythtromycin was reduced when subjected to heat treatment [49]. However antimicrobial activity may not directly indicate the structural degradation of antibiotic but to date no sufficient kinetic data available for macrolides. Therefore in the present investigation we applied the degradation rate constant k to know the thermal kinetic of azithromycin, which was known to be an appropriate model for degradation study of antibiotics. Tetracycline is broad spectrum antibiotic most commonly used as veterinary drug and its residue is commonly reported in food produced from animal derivatives [50]. Various studies showed that tetracyclines are susceptible to heat treatment and degradation rate of tetracyclines depends upon the type of food matrix and cooking method. Oxytetracycline was highly susceptible to heat treatment when it was present in a food mitrix, buffer or water system [45,51]. Further the present study indicated that antibacterial activity of azithromycin and tetracycline were relatively stable at 4 and 37 °C even after 24 h, these results were in corroboration with the study of Lynda et al., reported that no loss of tetracycline was observed even after 48 h of storage at 4 °C and 24 h at 25 °C [52]. The results of present study on thermal kinetics of azithromycin and tetracycline would allow us to estimate the effect of sterilization and heating procedures on stability of antibiotic residues in milk and other food products.

    Fig 3. Box plot showing changes in (a) azithromycine and (b) tetracycline antibacterial activities at different temperature treatments against Bacillus subtilis.

    Values represent the maximum, third quartile, median, first quartile and minimum of three independent replicates (n = 3). Different letters indicate statistically significant differences at P < 0.05 according to a Tukey’s honest significant difference post hoc test.


    Effects of pH on the stability of azithromycin and tetracycline

    The effects of different pH ranges on azithromycin stability were detected and shown in Table 3. A significant increase in azithromycin degradation rate constant k was detected at acidic pH of 4 and 5 (1820 ± 15.10−4 and 1010 ± 5.10−4, respectively) after 1 h of incubation, which later drastically decreased to 391 ± 2.10−4 and 221 ± 2.10−4, respectively, after 24 h incubation (Table 3). On the other hand, the constant k values of azithromycin were low at both pH of 8 and 9 at different incubation times (Table 3). The effects of pH on the stability of tetracycline were detected, and degradation rate constant k values were summarized in Table 4. At room temperature and at 1 h, the constant k of tetracycline was found to be 740 ± 82.10−4, 520 ± 53.10−4 and 50 ± 24.10−4 at pH of 9, 8 and 7 respectively, which then remarkably increased to 720 ± 34.10−4, 1420 ± 32.10−4 and 1170 ± 09.10−4 at pH of 6, 5 and 4, respectively. Similar changes were noted at all the time points where constant k values gradually increased with the decrease in pH level (Table 4). Likewise, Dehghani et al. (2013) demonstrate that the decrease in pH from 11 to 3 has a significant reduction in penicillin G stability, however the alkaline pH was more efficient for the antibiotic stability [53]. Similarly Loftin et al reported that stability and degradation pathway of tetracycline residues in food products largely depends on the pH of the food [54]. Kitts et al., found that the degradation rate of tetracycline compound was higher in buffer systems at different pH like 3 and 6.9 [40]. Whereas Xuan et al., showed that degradation of oxytetracycline in neutral solution was faster when compared with that of acidic or alkaline pH [55]. Similarly, tetracycline compounds showed increased degradation at higher temperature at neutral solution compared to acidic solutions [46]. Another antibiotics Lasalocid was stable in neutral and acidic pH but completely broken down when exposed to alkaline pH [56]. In addition, Seral et al. (2003) indicate that the acidic pH has an adverse effect on azithromycin stability with significant reduction in its antibacterial activity against Staphylococcus aureus [57]. Our results indicate that stability of antibiotics not only depend on temperature but also pH of the food has significant effect on the degradation of antibiotics.


    The present study detected a high concentration of azithromycin and tetracycline residues in raw milk samples than prescribed limits by FDA, leading to inhibition of growth of B. subtilis. High temperatures of 70 and 100°C were sufficient to affect the stability and subsequent antibacterial activity of azithromycin. However, tetracycline was not completely eliminated at the same respective temperatures. Also, the acidic pH has shown a significant reduction effect on azithromycin and tetracycline in comparison with alkaline pH.

    The detected antibiotics in the present study are at alarming level posing high risk to public health, inaddtion the study also revealed that the stability of antibiotics can be reduced by appropriate action in order to ensure safe drinking milk and milk products for consumers. Further the study concludes that screening of milk for antibiotics residues need to be strictly performed before it reaches the consumers as it will help to reduce the threat of residual contamination of the food chain.

    Compliance with Ethical Standards

    All the authors ensure that manuscript complies with the Ethical Standards for this journal.


    Authors are grateful to the facilities of Laboratory of Plant Healthcare and Diagnostics, provided at P. G. Department of Microbiology and Biotechnology, Karnatak University, Dharwad, India.


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    90,000 Experts talked about why traces of antibiotics are found in milk – Rossiyskaya Gazeta

    A pilot project has been launched in several regions of the country to reduce the use of antibiotics in the agro-industrial complex. Antimicrobial control system (SCAMP) is being introduced at the enterprises, and the label “No antibiotics” may appear on the products.

    – The effects of antibiotic use in agriculture have been traced back in the 90s of the last century. Residual amounts of antibiotics used to treat and prevent diseases in farm animals ended up in milk and dairy products, eggs, and meat.Microbes acquired resistance, so antibiotic treatment could become ineffective if the disease occurred. Studies have shown that even microdoses are dangerous, – said Svetlana Shchepetkina, chairman of the research center of the St. Petersburg Union of Scientists “The Social Significance of Veterinary Medicine”, head of the scientific consulting center for the development and transfer of systemic technologies in veterinary medicine and agriculture of the Animal Health Group.

    Unfortunately, antibiotics given to animals for prophylactic or therapeutic purposes are not destroyed even during thermal processing of the product.To change the psychology of farmers, many European countries needed decades of work to prove it was possible to raise animals without antibiotics and without economic losses. In 2018, the European Parliament approved a ban on the use of antibiotics in animal husbandry for prophylactic purposes.

    In our country, work is also underway to eradicate antibiotics, products of animal origin are tested for antibiotics. Dairy factories, meat processing plants have their own laboratories, and if the parameters are exceeded, the products are rejected.For their part, large agricultural producers also control the content of residual antibiotics.

    -It is impossible to prohibit antibiotics in agriculture, as this will lead to massive morbidity in animals and a threat to food security. But another solution is possible: in an industrial environment, develop a technology in which animals and birds would not experience stress, have good immunity and would not get sick, which means that antibiotics would not be needed, says Shchepetkina. The pilot regions in the development of such technologies were the Leningrad and Belgorod regions, and the Krasnodar Territory.

    In 2019, equipment was purchased in the Leningrad region, which provides free of charge for manufacturers to check samples of meat, eggs, milk for more than 90 antibiotics. This is important both for checking incoming raw materials and for examining antibiotic residues after animal treatment so that even safer products can be produced. The number of enterprises that have implemented an antimicrobial control system (SCAMP) is increasing. Labeling means that the company has organized a technology that ensures the production of high-quality and safe products “from stall to table”, that antibiotics are used only for treatment and are not used to stimulate the growth and productivity of animals.The products of such enterprises may have a special label “No antibiotics”.

    But how profitable is it for producers?

    – My farm cannot be called organic, in my conditions it is impossible. One of the reasons is the insufficient amount of land for keeping animals and the lack of its own food base. But we pay great attention to disease prevention and use antibiotics only when they become the only measure that can cure an animal.The antibiotic is used after determining the sensitivity of the microbe – the causative agent of the disease to it, milk from the cow undergoing treatment is disposed of. To make sure that the antibiotic has completely disappeared from the animal’s body, further tests are carried out. They can be made free of charge, – says Tatiana Pugacheva, a farmer from Priozersky district.

    Speaking of milk. It turns out that the consumer will not be able to taste by taste, whether there are traces of antibiotics in it or not. The bitter taste is a consequence of completely different reasons (some diseases in a cow, poor-quality feed).The only method that is available to all of us is to buy sourdough and make curdled milk, yogurt, from purchased milk.

    – In this area hasty decisions should not be made. Yes, antibiotics enter the human body with food. Yes, this is fraught with microbial resistance to antibiotics in the future. It’s like saying: take such and such an antibiotic against infectious diseases, for the same dysentery, as a prophylaxis. Then it will no longer work when people really start to get sick.But the shift to technologies that eliminate antibiotics to prevent disease progression must be deliberate to avoid impacting food security. If a massive death of animals begins, what will we eat? As for the use for medicinal purposes, yes, separate the sick animal from the herd, treat it, and return it back only after curing and thoroughly checking for traces of the antibiotic, – emphasized Anatoly Golov, co-chairman of the Union of Consumers of the Russian Federation.

    Rosselkhoznadzor explained why it is difficult to introduce GOST banning antibiotics in milk – Economy and Business

    MOSCOW, March 15./ TASS /. The appearance in Russia of GOST, which introduces a standard for the content of antibiotics in dairy products, can be a difficult process, since such requirements must be spelled out in the technical regulations of the Customs Union. This was announced to TASS by the official representative of the Rosselkhoznadzor Yulia Melano.

    “Research and conformity assessment of dairy products is carried out in strict accordance with the legally established procedure and norms in the technical regulations of the Customs Union.Therefore, it can be difficult to establish a ban on any content of antibiotics in dairy products in GOST, because any established standard must be scientifically substantiated, assessed and enshrined in the technical regulations of the Customs Union, “she said.

    The Izvestia newspaper wrote on Friday that Russia is developing GOST, which will completely ban antibiotics in raw materials and, as a result, in finished dairy products.

    Melano recalled that all dairy products in circulation in the customs territory of the Customs Union within the established expiration date must be safe when used for their intended purpose.At the same time, according to her, the presence of drug residues in food raw materials and products made from it is not allowed, however, talking about “zero” concentrations or a complete ban on the content of antibiotics is appropriate only for drugs that are not on the list of approved ones.

    “The argument about the complete prohibition of the presence of antibiotics or” zero concentrations “is a delusion, since a number of medicinal products are subject to registration and are included in the state register of medicinal products for veterinary use, and, accordingly, are allowed for use by productive animals that are the source food raw materials of animal origin, “she explained.

    In addition, according to her, such drugs are in free circulation on the territory of the EAEU and can be used by milk producers to treat productive animals.

    An integrated approach is needed to solve the problem

    Melano noted that GOST alone cannot solve the problem with antibiotics in milk. “Rosselkhoznadzor undoubtedly welcomes any initiatives related to the reduction of substances harmful to human health in milk, including antibiotics.At the same time, the service is confident that the creation of GOST is not capable of solving the problem on its own, because it requires an integrated approach, which implies building a system of full traceability of the production and processing of dairy products in Russia, “she believes.

    The representative of the Rosselkhoznadzor reminded that now such a system does not exist in Russia and suggested that it could be created on the basis of the electronic system of veterinary certification “Mercury”.

    “Rosselkhoznadzor is convinced that the inclusion of finished dairy products in Mercury will have a positive effect by the end of the year, including in terms of reducing the amount of antibiotics in milk,” she added.

    Control of livestock products

    Melano also reported that monitoring studies to control residues of prohibited and harmful substances in livestock products over the past few years have shown significant excess concentrations of drugs in animal products, which is unacceptable and unsafe.

    As a result of this, according to her, manufacturers of medicinal products, based on requests from Rosselkhoznadzor and manufacturers of livestock products, are forced to revise both the permissible concentrations of drugs used and the timing of their removal from the body of live animals.

    “It should be noted that violations of the requirements of technical regulations are unacceptable and constitute a certain threat, since regulations have been developed to protect human life and health, the environment, the life and health of animals, to prevent actions that mislead consumers of milk and dairy products regarding their purpose and security, “she said.

    Changes were made to the news (15:30 Moscow time) – information on the text was added, the lead is transferred in a new edition.

    90,000 Treatment regimens containing antineoplastic antibiotics for metastatic breast cancer

    Advanced (metastatic) breast cancer is cancer that has spread outside the breast. Treatment for metastatic disease usually includes some types of chemotherapy (anticancer drugs) to try and shrink the cancer. Chemotherapeutic agents can be prescribed as a one-way therapy or in combination with other chemotherapeutic agents.This is done according to a plan or course of a drug called a treatment regimen. There are many types of chemotherapy drugs that work in different ways. Anticancer antibiotics work by damaging cancer cells, thereby preventing these cells from multiplying. Chemotherapy generally causes a number of treatment-related side effects and adverse events. Known side effects of anticancer antibiotics include nausea, vomiting, decreased white blood cell count (known as leukopenia), and, in some cases, a toxic reaction that affects heart function (called cardiotoxicity).

    This review aims to identify and analyze randomized evidence comparing courses of chemotherapy containing anti-tumor antibiotics versus courses without anti-tumor antibiotics. This review identified 34 eligible trials, involving 5605 women. This review found that, for women with advanced breast cancer, taking anti-tumor antibiotics does not lead to better survival than women taking other types of chemotherapy.Despite the lack of evidence for a benefit in survival rates, this review found that women taking these drugs had an advantage in time to progression (the length of time that cancer progresses after taking the drug) and tumor response (tumor shrinkage) compared to with women who have not taken anticancer antibiotics. However, the risk of side effects, including cardiotoxicity, leukopenia, and nausea / vomiting, was significantly higher in women taking anticancer antibiotics.Given that this review did not show a survival benefit for women taking this group of drugs, but a higher incidence of side effects, the use of these drugs in the treatment of metastatic breast cancer must be carefully weighed against the risk of these side effects.

    Milk tooth extraction | Children’s dental clinic №4

    Extraction of a milk tooth in children in the Children’s Dental Clinic No. 4 is carried out only as a last resort and using modern materials and technologies.Our experts will remove your baby’s milk tooth with minimal discomfort.

    Extraction of a milk tooth – this operation very often raises many questions from parents. Why remove a baby tooth if it will fall out by itself after a while? Can tooth extraction damage the growth of permanent teeth?

    Unfortunately, there are a number of indications for which it is necessary to remove a milk tooth.

    Indications for the extraction of a milk tooth are:

    • Delayed root resorption – their correct placement relative to the bone crest of the jaw during tooth growth;
    • High degree of tooth mobility during root resorption – second and third degree, with half-length root system resorption;
    • Severe periodontitis threatening the rudiment of a permanent tooth;
    • Advanced caries that cannot be treated;
    • Trauma to the teeth – crown chipping or root fracture;
    • Supernumerary teeth;
    • Incorrect bite.

    Timely extraction of a milk tooth not only does not harm the little patient, but in many cases also prevents problems with the growth of molars: such as their displacement in the jaw, caries damage at an early stage of growth.

    Is it dangerous to remove milk teeth?

    There is a permanent rudiment under the milk tooth. In order to prevent injury during removal, the doctor uses special forceps, the design of which does not allow the tooth to move downward when loosening and guarantees the preservation of the rudiment.Forceps also do not allow you to pinch the tooth too tightly, since milk teeth have thinner enamel compared to permanent teeth. Pediatric dentists of our clinic have vast experience in the treatment and extraction of milk teeth and the necessary psychological training. All this, combined with the use of modern and safe means of anesthesia, makes this operation as comfortable and safe for the child as possible.

    After milk tooth extraction

    After the extraction of a milk tooth for several days, parents should carefully monitor the hole and ensure that the child observes oral hygiene.Immediately after a simple extraction of a milk tooth, the child should refrain from eating for 2 hours. During the day, you should refrain from physical activity, strictly follow the doctor’s recommendations. If the removal was difficult, the doctor may prescribe additional medications of local or general action.

    Extraction of a milk tooth Kirovsky district, in the Children’s Dental Clinic No. 4, this operation will be carried out without complications and psychological trauma for a little patient.

    LACTOSTASIS: causes, mechanism of development, treatment and prevention

    Home> Articles> LACTOSTASIS: causes, mechanism of development, treatment and prevention

    Lactostasis is a consequence of dysfunction of the mammary glands in women during breastfeeding between milk production and excretion, leading to milk stagnation.

    Lactostasis is considered by many experts as a quantitative discrepancy between increased or often normal milk production and insufficient outflow.

    Make an appointment with a mammologist.


    I. Increased milk secretion

    Excess milk production is when more milk is produced than is required for the baby. Usually, the normalization between milk production and milk flow occurs within the first 2 weeks after the baby is born.

    II. Anatomical and physiological factors of lactostasis

    1. Variants of the structure of the mammary glands. This applies primarily to women with large, sagging breasts.The baby cannot completely empty the milk ducts, which leads to the formation of milk stagnation.

    2. Abnormal structure of the nipple of the mammary gland. Indistinct, especially flat nipples prevent the baby from gripping and holding the nipple properly. In this case, the mammary glands of the nursing mother are not sufficiently emptied, which can ultimately lead to lactostasis.

    3. Anatomical structure of the mammary gland ducts. With narrow and tortuous milk ducts, especially their combination, the likelihood of developing lactostasis increases sharply.

    4. “Milk plug”. Blockage of one or more milk ducts by a “milk plug” leads to a mechanical cessation of the outflow of milk and is the cause of lactostasis against the background of breastfeeding.

    5. Cracks in the nipple and areola. Damage to the integrity of the skin on the nipples of the mammary glands leads to difficulty in breastfeeding, up to the rejection of it, the likelihood of developing not only lactostasis increases.

    6. Diffuse fibrocystic mastopathy.It is noted that with mastopathy, fibrous tissue grows in the mammary glands, which has a very dense structure and can squeeze the ducts of the mammary glands, disrupting the outflow of milk during breastfeeding.

    7. Injuries of the mammary glands. Various types of injuries (bruises, blows as a result of falls, etc.) of the mammary gland lead to a violation of the morphology and functioning of the flow-lobular system and the formation of milk stagnation.

    8. Hypothermia of the mammary glands. Severe hypothermia leads to the fact that the milk ducts are greatly narrowed, which sharply complicates the outflow of milk and can contribute to the development of lactostasis.

    III. Behavioral factors of lactostasis

    1. Improper attachment of the baby to the breast, when not all lobules are in the same “physiological position” can lead to squeezing of the milk ducts. This leads to the rapid development of not only lactostasis, but also to injury to the nipple with the appearance of cracks.

    2. Insufficient breast emptying, as well as irregular breast emptying, is highly likely to result in milk stagnation.

    Breastfeeding times that are too long, exceeding 3 hours, often lead to congestion.

    3. Additional expression of milk can lead to additional milk production, which the child cannot master, which can lead to lactostasis.

    IV. Other factors

    1. Tight underwear. Wearing tight underwear, especially a bra, leads to constriction of the milk ducts and milk stagnation.

    2. Stress and lack of sleep can lead to physiological narrowing of the ducts, impaired outflow, resulting in foci of stagnant milk in the mammary glands.

    3. Heavy physical labor can lead to clamping of the milk ducts, to the obstruction of the outflow of milk from the nursing mother, which can result in lactostasis.

    4. Sleeping on the stomach can also lead to constriction of the milk ducts and stagnation of milk.


    The formation of lactostasis is characteristic of primiparous women in the first weeks and months after childbirth. Moreover, lactostasis in the first days after childbirth is pathogenetically different from milk stagnation with regular breastfeeding.

    In the first days after childbirth, a rapid decrease in the level of placental steroids against the background of a sharp increase in prolactin secretion leads, on the one hand, to the accumulation of milk in the alveoli of the mammary gland, on the other hand, it causes edema of the breast tissue and compression of its ducts. The situation is complicated by the lack of stimulation of the nipple-areola zone, early attachment of the child in the first hours after childbirth and expression of the mammary glands, which in total is reflected in low oxytocin production and paresis of the lactiferous ducts.As a result of a lack of oxytocin, milk stagnates in the alveoli and does not enter the milk ducts. All these phenomena ultimately lead to swelling, engorgement and tenderness of the mammary glands.

    It has been established that, regardless of the cause of its occurrence, uncropped lactostasis pathogenetically proceeds according to the standard scheme and, as a rule, ends with mastitis.


    The therapy of lactostasis is complex and includes changing the regimen and frequency of feeding, conducting conservative therapy.

    Mode and method of breastfeeding with lactostasis.

    It should be abandoned for a while from alternate breastfeeding in favor of feeding by two breasts every 1.5-2 hours, if necessary, the feeding interval should be shortened to an hour. Night feedings are compulsory.

    Role, pumping technique.

    Expression remains an important link in the struggle and during lactostasis should be carried out not only accurately, but also technically correctly.

    For this purpose, to overcome lactostasis, a breast pump has shown its effectiveness, before using which it is necessary to carry out a soft and gentle massage of problem areas, thermal procedures.

    In lactostasis, pumping is carried out to a state of comfort, and not to the “last drop”, so as not to increase the production and flow of milk.

    Rules for expressing with lactostasis. It is necessary to clasp the mammary gland with a seal with the hand of the same name so that it lies on the palm of your hand, the thumb is on top, the rest support and raise it. In this case, the milk will flow out painlessly, the nipple will not be injured. At the same time, with the other free hand, massage the area of ​​compaction in the direction from the periphery to the center of the breast, freeing it from milk.

    Facilitates pumping by taking a no-shpa tablet 20-30 minutes before feeding, a warm heating pad applied to the breast and pumping after feeding the baby. You can carry out these activities and do it under a warm shower.

    It should be noted that strong squeezing of the mammary glands during rough expression can lead to trauma to the lobular-ductal system of the mammary glands and can lead to the development of mastitis.

    Changing the posture of the child and mother during feeding with lactostasis

    With lactostasis, it is necessary to use postures that contribute to the release of the mammary gland from milk in those areas where it has stagnated.In such cases, hand-feeding is often effective.

    Breast massage

    When carrying out a massage of the mammary glands, all movements should be soft, smooth, in the direction from the base of the breast to the nipples.

    Heat and cold procedures

    To achieve the effect, before feeding and expressing, it is recommended to take a warm shower, or apply moist warm wipes to the mammary glands, which helps to improve the outflow of milk. After feeding, cold applications are used for 10-15 minutes, which reduces milk production.

    Ointments and compresses

    The task of all ointments and compresses is to reduce the edema of the mammary gland and improve the outflow of milk, relieving the spasm of the milk ducts. Magnesia sulfate, ointments are used: traumeel C, malavit.

    Application of ultrasound

    To stop lactostasis, ultrasound is used, usually 3-4 procedures are prescribed, the sensor of the ultrasound apparatus for physiotherapy massage the breast over the seal, after which it is necessary to immediately express the milk.

    Drug reduction of milk secretion

    Lactostasis treatment regimen 1. Bromocriptine (parlodel) is prescribed at 2.5 mg 2 times a day. within 2-3 days. Gentle expression of the mammary glands is added 2-3 hours after the start of taking the drug for 1-2 days, breastfeeding – after 1 hour.

    Lactostasis treatment regimen 2. Dostinex 1 mg is prescribed? tab. 1 time per day for 1-2 days, breastfeeding after 1 hour.

    Lactostasis treatment regimen 3.Cutaneous applications of 2.5 g of 1% progestin gel once a day for 2 days, additionally, the mammary glands are expressed – 15–20 minutes after the application, breastfeeding – after 1 hour.

    Optimal combination: bromocriptine + progestin, dostinex + oxytocin.

    Oxytocin with lactostasis

    With pronounced lactostasis, sublingual administration of the drug, 2 drops per 15 minutes, can be used. before feeding. In rare cases, intramuscular administration of oxytocin is used in a single dose of 0.2–0.3 ml.

    Antibiotics are not indicated for lactostasis.

    NSAIDs. Taking paracetamol and other drugs of non-steroidal anti-inflammatory drugs (NSAIDs) is possible, especially with severe pain syndrome and does not affect breastfeeding.

    Drug suppression of lactation

    In the absence of the expected effect within 1.5–2 days, a thorough differential diagnostic procedure should be carried out to exclude lactational mastitis. For this purpose, it is imperative to repeat an ultrasound of the mammary glands with a puncture biopsy of the problem area of ​​the mammary gland with a thick needle.

    If the use of all measures for lactostasis is ineffective, moreover, there is a threat of development or mastitis has developed, the question arises about the complete cessation of lactation.

    It is better known and most often in practice for this purpose, bromocriptine is used according to the scheme: 2.5 mg 2-3 times a day for 3-5 days. Lactation stops in a couple of days when taking the pills according to the scheme.

    Of modern drugs, dostinex is used for this purpose in a dosage of 1 tab. Once a day for 2 days.Lactation usually stops within 1 day. Rarely, due to ineffective suppression of lactation, it is necessary to extend the course of treatment up to 3 days.


    1. The correct position of the baby at the breast allows a nursing woman to avoid many problems and complications.

    Signs of correct attachment:

    • Silence during feeding (except for sounds accompanying the baby swallowing a portion of milk). Other sounds, such as “clatter” or “smack”, indicate a broken vacuum and insufficient sucking.
    • The child’s mouth is wide open (angle not less than 130–140?), The chin is tightly pressed to the mother’s chest, the lower lip is completely turned out, the tongue covers the lower gum and is visible in the corner of the mouth.
    • It is not painful for the mother to feed, the nipple at the end of feeding is evenly stretched, has the shape of a cylinder. A deformed nipple indicates a broken attachment technique.

    2. Criteria for correct sucking:

    • The baby sucks slowly, rhythmically, deeply.
    • No air intake (with sound) and cheek puffing.
    • The baby’s ears move rhythmically while sucking.

    3. Signs of improper sucking:

    • The baby sucks (“chews”) only the nipple; the tongue of the newborn only interacts with the tip of the nipple.
    • Lips (gums) only press on the nipple, not on the entire areola.
    • The lips are absorbed into the oral cavity.

    4. Feeding at the request of the child. It is necessary to apply it to the breast for any reason, giving the opportunity to suckle the breast when he wants and how much he wants.This is very important not only for the saturation of the child, but also for his feeling of comfort and security.

    5. The duration of feeding is regulated by the baby. The baby should not be lifted from the breast before he releases the nipple himself. This can lead to insufficient breast emptying.

    6. Night feedings of the baby provide stable lactation and protect the woman from milk stagnation. In addition, night milk is considered the most complete.

    7. In case of separate breastfeeding in turn with two breasts, the time interval between feedings should not exceed 3 hours, including the night period.When stagnation occurs, the interval should be shortened to 2 hours, or even switch to breastfeeding with two breasts.

    8. In case of a tendency to develop lactostasis, each feeding should be carried out from both mammary glands, while feeding is completed with the same breast with which you started. This feeding technique promotes better emptying and drainage of the mammary glands, eliminates injury to the nipples, and also prevents the baby from swallowing air.

    9. Do not transfer the baby to the second breast before he sucks the first breast, this can lead to stagnation of milk.

    10. In the presence of cracks, agents should be used to promote early healing (bepanten, purelan 100, avent, etc.)

    11. To prevent the formation of cracks, frequent washing of breasts before and after feeding should be excluded.

    Frequent washing of the breasts removes the protective layer of fat in the areola and nipple, which leads to the formation of cracks. The mammary glands should be washed no more than 1 time a day during a hygienic shower. If a woman takes a shower less often, then in this case it should be wiped before feeding with a damp cloth without using soap.

    12. Additional expression of milk. With properly organized breastfeeding, milk is produced exactly as much as the baby needs, so there is no need to express after each feeding. The need for expression appears when the baby does not suck it out enough and / or milk stagnation.

    90,000 Antibiotics in milk – antibiotics in milk, all about antibiotics PionerProdukt / PionerProdukt Antibiotiks in Milk

    How do antibiotics get into milk?

    Animals just like people get sick and they have to be treated, including with antibiotics.Cows give milk all year round, which is unnatural for their biological nature, and this causes inflammatory processes in their bodies.

    One of the serious problems of modern animal husbandry is the disease of dairy cows with mastitis. Due to crowding of animals, crowding, various infections often occur, which are quickly transmitted from one animal to another. Prevention of animal diseases is also done. So one of the sources of antibiotics in milk is the treatment and prevention of diseases.Each antibiotic has a defined period of elimination from the body (with milk, from tissues, etc.), an average period of 2 to 3 weeks. As a rule, 3-5 days are enough to remove penicillin from the animal’s body, but in some cases for sick animals this period can increase to 6-11 days.

    According to sanitary rules, milk from treated cows within 5-10 days (depending on the drug used) must be disposed of. But with a general lack of milk, when large producers buy up literally everything, farmers simply dilute milk from normal cows with milk with antibiotics.Yes, the concentration has decreased, but the antibiotics have not gone anywhere.

    In addition to treatment, antibacterial drugs can be used to stimulate the growth of an animal (weight gain increases by 30%). Unscrupulous farmers can add antibiotics to canning feed, but this is also illegal. It is the second source of antibiotics in milk.

    What antibiotics can be found in milk?

    In animal husbandry, more than 70 types of antibiotics are used, but the most widely used are the long-known and inexpensive beta-lactams (penicillins), tetracyclines, sulfonamides, streptomycin, fluoroquinolone derivatives, chloramphenicol.

    Tetracycline is the cheapest and one of the most dangerous antibiotics, with a broad spectrum of antibacterial action. According to the instructions for use, tetracycline can cause gastritis and proctitis, not to mention decreased appetite. Tetracycline and other drugs in this family can increase the sensitivity of the skin to the action of sunlight (photosensitivity). Recently, due to the prevalence of tetracycline-resistant strains of microorganisms and frequent side effects, the use of tetracycline for medical purposes has become limited.

    Why are antibiotics in milk and food in general dangerous for humans?

    Of course, when we talk about the presence of antibiotics in store-bought milk, we are talking about microscopic doses of these substances. But, according to experts, due to the specific features of these drugs, even minimal doses of antibiotics negatively affect the intestinal microflora, and also increase the risk of resistance (or resistance) of pathogens to drugs.All this ultimately reduces the body’s immunity. Prolonged use in food of products containing residual amounts of antibiotics can cause adverse consequences for human health – allergic reactions, dysbiosis.

    For example, tetracycline antibiotics have a cumulative effect. Accumulating in the body, they can negatively affect the hearing organs, cause a decrease in the number of platelets, and cause toxic reactions in the liver. Accumulating in bone tissue, tetracyclines can disrupt its formation, it is especially dangerous for children, because their growth may slow down.In adults, regular intake of tetracycline leads to tooth decay.

    Streptomycin sulfate has a nephropathic effect and causes a violation of the central part of the auditory receptor.

    Fluoroquinolone derivatives in children under 14 accumulate in the cartilage tissue, which leads to skeletal disorders. It turns out a paradox: we drink milk because of calcium useful for teeth and bones, but we get a completely opposite result.

    On store shelves, you can find milk with different shelf life – from 2 months to six months.Does this mean long-term milk contains antibiotics?

    No, in this case the reason is in the way the milk is processed and the properties of the packaging.

    Heat treatment of milk is pasteurization or sterilization. The task of heat treatment is to destroy microorganisms and thereby extend the shelf life of the product. Pasteurization is called heat treatment at a temperature below the boiling point, or simply heating to a temperature below 100 ° C.In the classical sense, pasteurization of milk is heating it to 74-76 ° C with an exposure time of 15-20 seconds or instant heating to 85 ° C without exposure. During pasteurization, microorganisms that do not form spores die, including the causative agents of dysentery, typhoid, and cholera. Escherichia coli and lactic acid bacteria do not withstand pasteurization. Spores that survive pasteurization during milk storage “germinate” – begin to multiply actively, which causes spoilage of milk.

    Sterilization is heat treatment of milk at temperatures above 100 ° C.With such heating, not only microorganisms die, but also their spores, due to which milk can be stored for quite a long time even without a refrigerator. In addition, sterilization can also be performed in different ways: sometimes it is just high-temperature sterilization, sometimes it is under pressure, where the processing temperatures of products are higher. One manufacturer can give a more gentle regime, the other uses pressure sterilization. Hence the differences in shelf life. Why are they in no rush to sterilize all the milk? Because high temperatures lead to significant undesirable changes in milk, including taste changes.Therefore, manufacturers are trying to find a “golden” mean between the shelf life and the preservation of the original properties of milk.

    In addition, the shelf life depends on the packaging. The leader here is the Tetra-Pak company, products are stored in it for a very long time. The plastic bottle gives a shorter shelf life.

    However, some manufacturers provide extended shelf life by adding … the antibiotic nisin. This is the only antibiotic, the addition of which to food is not prohibited by Russian law, as it is decomposed by our body.But! This does not apply to milk. It is forbidden to add lowlands to milk.

    Do boiling milk destroy antibiotics?

    Boiling and sterilization have practically no effect on the antibiotic content in milk. After boiling, from 90 to 95% of the initial amount of antibiotics remains in milk, that is, from 5 to 10% of their amount is destroyed. After sterilization, 92 to 100% of the original amount of antibiotics remains in milk. Such data allow us to draw conclusions about the unsuitability of the boiling and sterilization parameters for the destruction of antibiotics in milk.

    The greatest decrease in the amount of antibiotics in the samples occurs during prolonged pasteurization. Perhaps this is due to the longest effect of high temperature on antibiotics, which leads to coagulation of proteins and their deposition along with the antibiotic on the walls of containers.

    Are antibiotics preserved in dairy products – milk powder, kefir, cheeses, etc.?

    Fortunately for the consumer, it is difficult to make fermented milk products from antibiotic milk.Microorganisms used in fermented milk production are very sensitive to antibiotics. Their presence in milk leads to technological problems in a dairy enterprise. Antibiotics lead to a lag or complete retardation of enzymatic processes in the production of cheeses, cottage cheese and fermented milk drinks. A change in the ratio of microorganisms in starter cultures negatively affects quality indicators, in particular, the appearance of the product (for example, the absence of eyes in the cheese).

    Most antibiotics are converted from liquid milk into powdered milk.Unfortunately, they are not destroyed during drying. If butter is made from milk with antibiotics, then the antibiotics will remain in it. To a lesser extent, of course. But fat-soluble antibiotics remain there.

    That is, in many products made from milk, antibiotics can be present, which is the danger.

    How is the content of antibiotics in food and, in particular, in milk controlled in our country?

    More than 70 types of antibiotics are used in animal husbandry, as mentioned earlier, several basic groups are controlled in our country: chloramphenicol, streptomycin, tetracycline, sulfonamides, quinolones, nitrofurans and penicillin.The maximum permissible levels of these antibacterial drugs are standardized by SanPiN In addition, chloramphenicol, streptomycin and tetracycline are standardized by the Technical Regulations of the Customs Union 021/2011

    According to the regulations, there is a three-level system of raw milk quality control, designed to prevent the milk of sick animals from entering the consumer’s table. Raw milk must be subject to production laboratory control, laboratory safety monitoring in veterinary institutions and quality control when accepted at dairy plants.Ideally, this system should ensure that there is no unsafe milk in the total milk yield, but in practice it can fail.

    In addition, as part of the annual veterinary monitoring of residues of veterinary drugs in food, raw milk is tested for residual amounts of five antibiotics (chloramphenicol, streptomycin, tetracycline, nitrofuran, sulfonamides)

    Also read:

    90,000 The dangers of the uncontrolled use of antibiotics in the dairy industry are described by G.T. Kholmogorova in the program “Conspiracy Theory”

    It is more profitable for traders of dairy products to trade not milk, but its cheap replacement. Palm oil, thickeners, emulsifiers.

    Too expensive and perishable product is made from natural milk. Therefore, by all means they are trying to slip us a surrogate. But at the same time, no one is going to reduce the price. We’ve uncovered a conspiracy of dairy merchants.

    For half a year Russia has been living without Lithuanian, Dutch and Finnish cheeses.
    Is it possible to double or even triple the production of domestic cheese? With this question, we came to the city of Uglich at the Research Institute of Cheese Making. Everyone here knows about Russian cheese production.

    Experts do not exclude that the number of falsifications will increase in the pursuit of profit. For example, milk will be replaced with palm oil, which significantly speeds up cheese production, cuts costs and solves the problem of lack of raw materials. To check this, we submitted several samples of Russian cheese for examination.

    The usual varieties from Europe have disappeared from the shelves. But instead, many new varieties from Switzerland have appeared. Buyers are not yet very familiar with the new names. We will help. Together with the “cheese sommelier” we will go to the store, he will tell you which Swiss cheeses are analogous to Italian, French and other cheeses.

    Now real Caucasian cheeses began to appear on the shelves. Eyes run up from the variety. What should a real suluguni or feta cheese look like? To figure out how to choose the right Caucasian cheese, we turned to an expert from the Caucasus, his family of hereditary cheese makers has their own small cheese dairy in the mountains.

    The National Milk Producers Union conducted a butter test. It turned out that half of the butter on the shelves in the store is not creamy! And it is made from vegetable fats – palm and coconut oil. According to experts, products using these oils are 20-40% cheaper. We will tell you how to distinguish butter made from milk from counterfeit. And the youth hockey team will help us in this. Instead of a washer, they will use packs of oil.The fact is that frozen natural oil and palm “spreads” withstand impact in different ways.

    The normal shelf life for yoghurt after all thermal treatments is no more than 1 month. But there are yoghurts on the shelves, which can lie for six months or a year. We purchased yoghurts with the longest shelf life and sent them for examination to find out where the least amount of milk is.

    Homemade yoghurt can be stored for no more than a day. It is unrealistic to manage to bring live yogurt to the store, and also sell it.Therefore, manufacturers use preservatives, thickeners and colorants.

    It turns out that the producers are deceiving us by substituting surrogates for milk. But perhaps in their greed they are doing a good deed? We found out whether dairy products are as useful as they are said to be, and whether an adult needs milk.

    Milk that is sold in stores – pasteurized, sterilized or ultra-pasteurized – is processed at such high temperatures that it contains negligible trace elements and vitamins.But it contains a large amount of residual antibiotics. Almost all animals, when kept in large quantities, suffer from various diseases that are instantly spread throughout the barn. To protect animals from diseases and subsequent deaths, they are almost constantly kept on antibiotics. We, without knowing it, drink these medicines almost every day.

    If a small amount of antibiotics gets into the body every day, it will soon become addictive. That is, if you get bronchitis or sore throat, then medications may not help.
    Manufacturers say there is no way antibiotics can get into milk. We verified this by testing milk from popular brands.
    Milk is the cause of mass poisoning every year. Thus, in June 2013, 26 children with acute intestinal infection were hospitalized in St. Petersburg. One girl died. According to the investigation, all the children on the eve of the poisoning consumed milk from milk machines.

    Milk often serves as a transmitter of infection, due to the fact that it is a good medium for the preservation and mechanical transfer of pathogenic microbes.Ruslan does not digest milk in the literal sense of the word. He started having such problems when he was 10 years old. After taking just one sip, he immediately becomes covered with red spots and runs to the toilet. What is an allergy? Food Intolerance? We took him to the doctor. It turned out that the reason is lactose intolerance, which is observed in 30% of the adult population of the planet.

    One can argue about whether milk is useful or not, but the indisputable fact is that making cheeses, butter and yoghurts from surrogates is cheaper.If manufacturers sold such products cheaper and honestly wrote what they were made of, then no problem: we ourselves could choose.