by George Looby, DVM
The Food and Drug Administration has issued a warning regarding the use of animal antibiotic Micotil 300 because of possible adverse effects to individuals who may accidentally inject themselves when working with the product.
Micotil 300 is the trade name of tilmicosin phosphate, which was developed by and is sold and distributed by the Elanco Co. Elanco is the division of Eli Lilly and Co. whose mission is the development and production of products related to animal health. The product was developed for the treatment of respiratory diseases in cattle and sheep. The major contributors to the Bovine Respiratory Disease (BRD) complex are Mannheimia hemolytica, Pasteurella multocidia and Histophilus somni.
One of the main uses of the product is treating cattle in feedlots or livestock sales barns where there may be a considerable variation in weights in a given group of animals to be treated. Since there is a fairly wide allowance in the recommended dosage animals with a rather wide range in weight can be safely and effectively treated. It can also be safely used in sheep. It is not for use in other species.
In some instances it is administered by the attending veterinarian on a given farm or ranch but in most cases it is given by the livestock owner or employee. Too often these individuals are under undue pressure and they tend to sacrifice safety for speed ending up with unnecessary injuries. The 2002 census of agriculture reported 80,743 U.S. farms with almost 15,000,000 head of cattle. Thousands of workers on these farms are candidates for accidents. This is where the reality check comes in. In the eight year period from 1992 to 2000 Elanco received 2,392 reported cases of human exposure to the product worldwide. Since 1995 there have been 13 confirmed human fatalities attributed to Micotil, sadly most due to suicides.
Those working with this product are at risk and all due precautions should be adhered to in order to avoid possible serious injuries and even death. This product has cardiotoxic effects when injected accidentally, through pre-existing open wounds and even skin and mucous membranes. Its effects on the heart include reduced cardiac contractility and Tachycardia (rapid heart beat).
To avoid accidents checklists have been developed to insure that each member of the injection team is kept as safe as possible. These lists were not developed casually or to put unnecessary restraints on the workers, they are result of experiences both good and bad designed to avoid mistakes of the past.
The list for veterinarians includes the following; consider using animal medications that do not have toxic effects on humans, do not administer Micotil if animal restraint is not adequate or if there are concerns over the operator’s skill level and ensure every client is fully aware of the information on the client information sheet attached to each bottle of Micotil. This sheet details the hazards associated with the product and identifies safe administration methods, appropriate first aid treatment and emergency phone numbers, provide suggestions to clients as to which equipment is most appropriate.
Employers should adhere to a detailed list of do’s and don’ts designed to ensure that the safety of all team members be protected. These measures were developed by the Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.
- Store Micotil 300 in a safe location that is not readily accessible by untrained individuals especially children.
- There are several training aids available from Elanco to assist in training workers as to its proper handling and usage. Visit Elanco’s website at www.elanco.com for details.
- Be certain that training materials are available at the worksite to be reviewed by all personnel prior to beginning actual work. They should be printed in the primary language of the workforce.
- Animals should be properly and adequately restrained. There can be no compromising this most important part of the operation. The advice and direction of the participating veterinarian should be strictly adhered to.
- Provide a sharps disposable container for safe handling and disposal of syringes and needles, and goggles and impermeable, needle-puncture-resistant gloves for personal protection.
- Ensure that only persons trained in the hazards of Micotil300 and safe handling procedures are allowed to handle this drug and that workers do not work alone when handling.
- Ensure that coldpacks and icepacks are available at the worksite where injections are given. They are applied to the injection site until trained responders arrive.
- Ensure that telephones are available for workers and emergency telephone numbers are readily available.
Instructions to workers:
- Keep children and bystanders out of the area in which the product is being used.
- Wear goggles and impermeable, needle-puncture-resistant gloves, and wash hands after using.
- Do not give the drug to an animal that cannot be adequately restrained.
- Determine that the chute used for restraint is adequate in every way for the animals being treated
- Have a well-defined exit route in mind in the event of an escape.
- Inject Micotil 300 by holding the syringe in one hand while injecting the needle subcutaneously at a top down angle, avoiding the underlying muscle.
- Do not replace the protective cap over the needle after use.
- Immediately after use place the syringe with the needle attached in a puncture proof sharps disposal container. Take the container to the preparation area for final disposal.
The product is an effective one but should be used in such a way as to insure that no one is harmed in any way.