The Knowledge of Antibiotics in Veternary Students and Repercution in Human Health

The concept of single health is currently undoubtedly one of the most rele-vant in pandemic times, where humans and animals are together in the same world. Penicillin was discovered in the last century by Alexander Fleming, used against infectious agents mainly of bacterial types, such as Staphylococcus aureus, Corynebacterium, Streptococcus, Brucella and Mycobacterium are examples of cattle pathogens. The bacteria have developed defense mechanisms allowing them to survive in the host cell (mutation) even in the presence of antimicrobials (bacterial selection). The aim of the study was to examine the degree of knowledge of antibiotics through a structured survey of ten questions, addressed to eighty-six students from the Bachelor of Veterinary Medicine and Zootechnics in 2019. Based on the information collected and after analyzing their answers, 63.14% of the students work in Clinics and Universities, 89.47% recognize the need for a quantified prescription, 47.36% mentioned that the Veterinary Medicine can prescribe antimicrobials, 52.63% support the use of antimicrobials for all microorganisms including viruses, 52.63% use the labeling to consult the withdrawal time and 100% identify that it is the withdrawal time and the practices that lead to the development of antimicrobial resistance. It is concluded that most of the students identify mal-practice as the trigger for bacterial resistance, however their knowledge is not adequate to avoid antibiotic resistance to humans. It is recommended to reinforce the courses of microbiology, pharmacology and virology in the Veterinary Medicine and Zootechnics degree, as well as to be updated on alter-natives such as the use of phytobiotics.


Introduction
The first discovered antibiotic was penicillin by the researcher Alexander Fleming, from a fungus, of the genus Penicillium, which its powerful bactericidal effect was and has been used against Gram+ bacteria. Later, semi-synthetic penicillin such as Ampicillin, Amoxicillin and Cloxacillin, the latter resistant to the "penicillinase" released by Staphylococcus aureus appeared. However, bacteria have developed survival mechanisms such as selection that allows them to infect the host cell and multi-resist antimicrobials [1], such as the case of Mycobacterium tuberculosis, Brucella abortus, Shigella dysenteriae, Listeria monicytogenes and Legionella pneumophila, all with high virulence for cattle. For example, Staphylococcus aureus, the main agent of clinical mastitis, is resistant to Penicillin, Tetracycline and Cephalexin [2].
On the other hand, the transfer of resistant pathogens to humans through the food chain, such as the consumption of meat and milk [3] [4], leads to the misuse of antibiotics in animals, hence, affecting the public health.
According to the European Antimicrobial Consumption Surveillance Office, Spain ranks fifth as a consumer of broad-spectrum penicillin. Besides being considered one of the countries with the highest rates of bacterial resistance and exporter of these resistances worldwide [5] [6].
There are very few works that explore the knowledge about the correct use of antibiotics in those in charge of Animal Health. Therefore, a measure to avoid the misuse of antibiotics is to assess the level of knowledge. In the present study, we conducted a questionnaire to collect information from Veterinary Medicine students and support the subsequent performance of a risk analysis in human health.  (Table 1). For the descriptive analysis of knowledge, four categories were considered: does not know insufficient knowledge, sufficient knowledge and optimal knowledge. For the data analysis, Microsoft Excel was used and the qualitative variables were expressed as percentages.

Results
Of the 86 student surveys, the majority answered all questions. The results of the informative indicators note the student status in which 25% work in veterinary clinics ( Figure 1). From their responses, it was observed that 63.14% of the students work in clinics and universities (Figure 2), 61.45% recognize that antibiotics    20% of the students have a low knowledge about the withdrawal time that must be respected in antibiotics used for production animals (Figure 9).

Discussion
The strategies to identify the knowledge of Veterinary Medicine students about antimicrobials turns out to be a watershed that enables real information in the animal health sector that supports a risk analysis study for human population.
One of the most surprising results obtained in the study was the fact of not knowing that antimicrobials are for the exclusive use of bacteria, as identified in students from China by [7]. The authors exonerate the urgency of prioritizing education in health professionals. Hence, the areas of microbiology in the bachelor's study plan as well as pharmacology should be reinforced. If we compare the efforts made in Human Medicine to identify their degree of knowledge in people [8], it can be noted the poor knowledge or ignorance from most of the sample population. In addition, the importance of the veterinarians in animal health and food safety is relevant, as mentioned by [9] [10]. Currently there are advances to establish a rapid and safe diagnosis to identify the pathogenic agent of a disease. For example, molecular methods are available to detect resistance of bacteria to semi-synthetic penicillin, using the blaZ gene and ermC gene [11].

Conclusion
The administration of antibiotics in production animals has several disadvantages, such as bacterial resistance, which makes disperse into human health. It is estimated that antibiotics will be restricted in most meat and milk importing countries by 2025. Meanwhile, the use of new therapies with products that are harmless to health and the environment should be foreseen. Such is the case of phytobiotics that have given good results as antibacterials.