Antimicrobial use in the dairy industry in South Africa: Sustainable food security requires the prudent use of antimicrobial agents

In 2009, the Codex Alimentarius Commission (Codex) circulated a request for comments and information on veterinary drugs used in developing countries. South Africa can be considered a developing or transition country because of the dual nature of its dairy industry, with sophisticated dairy technology existing side by side with small scale and subsistence dairy farmers. Antimicrobials are important for treatment of tropical diseases in South Africa but can also, more controversially, be used to prevent mastitis in dry cows. From the point of view of human health, antimicrobial residues in milk can be toxic or cause allergies in consumers. Antimicrobial resistance (AMR) has emerged over the last 20 years as a consequence of the large scale use of antibiotics in both human and veterinary medicine. It can result in organisms, so-called “super-bugs”, which are refractory to therapeutic doses and cause mortality in both humans and animals. Not only can AMR be transferred to human pathogens, but can also conceivably be transferred to bacteria used as cultures in dairy products, which could in turn transfer resistance to human enteric bacteria. The use and misuse of antimicrobials in the dairy industry in South Africa is reviewed. It is recommended that decision tree analysis and risk analysis be used to evaluate veterinary drugs for use in dairy animals. This is particularly appropriate in developing countries where a higher risk of tropical diseases could motivate in favour of using a wider spectrum of antimicrobials, to maintain health and welfare of dairy animals.