{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:52:00Z","timestamp":1781855520071,"version":"3.54.5"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"CGIAR Initiative-Protecting human health through a One Health approach and the CGIAR Sustainable Animal and Aquatic Foods (SAAF) Science Program"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Vet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Fixed-dose combination (FDC) antibiotics are commonly used in animal health; however, their use faces increasing scrutiny due to concerns about unproven efficacy, inappropriate dosing, safety and limited regulatory oversight. We reviewed veterinary drug registries from Kenya, Uganda, Tanzania, Rwanda and Zimbabwe, identifying 2339 registered products, of which 867 (37.1%) contained antibiotics. Among these, 238 (27.5%) were FDCs, representing 45 unique combinations \u2013 most commonly two-antibiotic formulations such as penicillin\/dihydrostreptomycin, tylosin\/doxycycline and trimethoprim\/sulfadiazine. Most formulations (77.8%,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935) contained two antibiotics, while 15.5% and 6.7% contained three and four antibiotics, respectively. Nearly half of FDC brands (47.1%, 112\/238) contained antibiotics from both the Caution and Prudence categories, while 39.5% (94\/238) contained antibiotics from the Prudence category alone. Notably, 8.4% (20\/238) of FDC brands contained colistin, with or without enrofloxacin, and 5% (12\/238) included vitamin combinations. Some antimicrobial FDCs may be clinically justified, for example, by broadening spectrum or achieving pharmacological synergy, but many lack a clear therapeutic rationale, underscoring the need for an evidence-based regulatory review and clearer criteria for appropriate veterinary FDCs.\n                  <\/jats:p>","DOI":"10.1186\/s13567-026-01797-9","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:38:51Z","timestamp":1781793531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Veterinary fixed-dose antibiotics in Africa: a need for evidence-based regulation"],"prefix":"10.1186","volume":"57","author":[{"given":"Dishon M.","family":"Muloi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildah","family":"Kirimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Mwaura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugine L.","family":"Ibayi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshnee","family":"Moodley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"1797_CR1","unstructured":"WHO (2005) Guidelines for registration of fixed-dose combination medicinal products."},{"key":"1797_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30093-6","volume":"4","author":"A Ahmad","year":"2016","unstructured":"Ahmad A, Khan MU, Balkrishnan R (2016) Fixed-dose combination antibiotics in India: global perspectives. Lancet Glob Health 4:e521. https:\/\/doi.org\/10.1016\/S2214-109X(16)30093-6","journal-title":"Lancet Glob Health"},{"key":"1797_CR3","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s13756-023-01238-8","volume":"12","author":"K Vliegenthart-Jongbloed","year":"2023","unstructured":"Vliegenthart-Jongbloed K, Jacobs J (2023) Not recommended fixed-dose antibiotic combinations in low- and middle-income countries \u2013 the example of Tanzania. Antimicrob Resist Infect Control 12:37. https:\/\/doi.org\/10.1186\/s13756-023-01238-8","journal-title":"Antimicrob Resist Infect Control"},{"key":"1797_CR4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s40545-022-00428-w","volume":"15","author":"G Sulis","year":"2022","unstructured":"Sulis G, Pradhan R, Kotwani A, Gandra S (2022) India\u2019s ban on antimicrobial fixed-dose combinations: winning the battle, losing the war? J Pharm Policy Pract 15:33. https:\/\/doi.org\/10.1186\/s40545-022-00428-w","journal-title":"J Pharm Policy Pract"},{"key":"1797_CR5","volume-title":"Categorisation of antibiotics used in animals promotes responsible use to protect public and animal health","author":"EMA","year":"2020","unstructured":"EMA (2020) Categorisation of antibiotics used in animals promotes responsible use to protect public and animal health. European Medicines Agency, Amsterdam"},{"key":"1797_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.onehlt.2025.100987","volume":"20","author":"DM Muloi","year":"2025","unstructured":"Muloi DM, Kasudi MR, Murungi MK, Lusanji Ibayi E, Kahariri S, Karimi C, Korir M, Muasa B, Mwololo D, Ndanyi R, Ndungi R, Njiru J, Omani R, Owada R, Omulo S, Azegele A, F\u00e8vre EM (2025) Analysis of antibiotic use and access to drugs among poultry farmers in Kenya. One Health 20:100987. https:\/\/doi.org\/10.1016\/j.onehlt.2025.100987","journal-title":"One Health"},{"key":"1797_CR7","doi-asserted-by":"publisher","DOI":"10.1016\/j.prevetmed.2024.106263","volume":"230","author":"SM Ngunguni","year":"2024","unstructured":"Ngunguni SM, Moodley A, Msefula C, Mkakosya R, Muloi DM (2024) Patterns and drivers of antibiotic use in small-scale broiler production systems in Lilongwe District, Malawi. Prev Vet Med 230:106263. https:\/\/doi.org\/10.1016\/j.prevetmed.2024.106263","journal-title":"Prev Vet Med"},{"key":"1797_CR8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241899","volume":"16","author":"B Bortone","year":"2021","unstructured":"Bortone B, Jackson C, Hsia Y, Bielicki J, Magrini N, Sharland M (2021) High global consumption of potentially inappropriate fixed dose combination antibiotics: analysis of data from 75 countries. PLoS One 16:e0241899. https:\/\/doi.org\/10.1371\/journal.pone.0241899","journal-title":"PLoS ONE"},{"key":"1797_CR9","doi-asserted-by":"publisher","first-page":"1430587","DOI":"10.3389\/fvets.2024.1430587","volume":"11","author":"YT Mekasha","year":"2024","unstructured":"Mekasha YT, Nigussie S, Mekonen AW, Berrie K, Mulaw A, Feleke MG (2024) A narrative review of veterinary pharmacovigilance situations and prospects in East African countries. Front Vet Sci 11:1430587. https:\/\/doi.org\/10.3389\/fvets.2024.1430587","journal-title":"Front Vet Sci"},{"key":"1797_CR10","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40545-020-00281-9","volume":"14","author":"BM Ncube","year":"2021","unstructured":"Ncube BM, Admire D, Ward K (2021) Establishment of the African Medicines Agency: progress, challenges and regulatory readiness. J Pharm Policy Pract 14:29. https:\/\/doi.org\/10.1186\/s40545-020-00281-9","journal-title":"J Pharm Policy Pract"},{"key":"1797_CR11","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1038\/s41579-018-0141-x","volume":"17","author":"M Tyers","year":"2019","unstructured":"Tyers M, Wright GD (2019) Drug combinations: a strategy to extend the life of antibiotics in the 21st century. Nat Rev Microbiol 17:141\u2013155. https:\/\/doi.org\/10.1038\/s41579-018-0141-x","journal-title":"Nat Rev Microbiol"},{"key":"1797_CR12","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1001\/archinte.163.4.402","volume":"163","author":"PA Masters","year":"2003","unstructured":"Masters PA, O\u2019Bryan TA, Zurlo J, Miller DQ, Joshi N (2003) Trimethoprim-sulfamethoxazole revisited. Arch Intern Med 163:402\u2013410. https:\/\/doi.org\/10.1001\/archinte.163.4.402","journal-title":"Arch Intern Med"},{"key":"1797_CR13","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1007\/s40262-018-00733-1","volume":"58","author":"EJ Thompson","year":"2019","unstructured":"Thompson EJ, Wu H, Maharaj A, Edginton AN, Balevic SJ, Cobbaert M, Cunningham AP, Hornik CP, Cohen-Wolkowiez M (2019) Physiologically based pharmacokinetic modeling for trimethoprim and sulfamethoxazole in children. Clin Pharmacokinet 58:887\u2013898. https:\/\/doi.org\/10.1007\/s40262-018-00733-1","journal-title":"Clin Pharmacokinet"},{"key":"1797_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.psj.2024.104200","volume":"103","author":"M Boulanger","year":"2024","unstructured":"Boulanger M, Taillandier JF, Henri J, Devreese M, De Baere S, Ferran AA, Viel A (2024) Pharmacokinetic modeling of sulfamethoxazole-trimethoprim and sulfadiazine-trimethoprim combinations in broilers. Poult Sci 103:104200. https:\/\/doi.org\/10.1016\/j.psj.2024.104200","journal-title":"Poult Sci"},{"key":"1797_CR15","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/avj.13311","volume":"102","author":"JK House","year":"2024","unstructured":"House JK, Izzo MM, Page SW, Browning GF, Norris JM, Australian Veterinary Association Ltd, Animal Medicines Australia (2024) Antimicrobial prescribing guidelines for dairy cattle. Aust Vet J 102:143\u2013186. https:\/\/doi.org\/10.1111\/avj.13311","journal-title":"Aust Vet J"},{"key":"1797_CR16","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1186\/s12916-022-02677-7","volume":"20","author":"DM Muloi","year":"2022","unstructured":"Muloi DM, Hassell JM, Wee BA, Ward MJ, Bettridge JM, Kivali V, Ndinda C, Gitahi N, Ouko T, Imboma T, Akoko J, Murungi MK, Njoroge SM, Muinde P, Alumasa L, Kaitho T, Amanya F, Ogendo A, van Bunnik BAD, Kiiru J, Robinson TP, Kariuki S, Pedersen AB, F\u00e8vre EM, Woolhouse MEJ (2022) Genomic epidemiology of Escherichia coli: antimicrobial resistance through a One Health lens in sympatric humans, livestock and peri-domestic wildlife in Nairobi, Kenya. BMC Med 20:471. https:\/\/doi.org\/10.1186\/s12916-022-02677-7","journal-title":"BMC Med"},{"key":"1797_CR17","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2024.1304318","volume":"11","author":"DM Muloi","year":"2024","unstructured":"Morang\u2019a AK, Muloi DM, Kamau SM, Onono JO, Gathura PB, Moodley A (2024) Mapping the flow of veterinary antibiotics in Kenya. Front Vet Sci 11:1304318. https:\/\/doi.org\/10.3389\/fvets.2024.1304318","journal-title":"Front Vet Sci"},{"key":"1797_CR18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjph-2024-002355","volume":"3","author":"I Mugezi","year":"2025","unstructured":"Mugezi I, Twemanye V, Isingoma E, Nyolimati CA, Mayito J, Walwema RN, Kakooza F, Fitzgerald R, Ademun ARO, Opira W, Muwonge A (2025) Antibiotic use in the commercial poultry sector of Uganda and its public health implications: a cross-sectional survey. BMJ Public Health 3:e002355. https:\/\/doi.org\/10.1136\/bmjph-2024-002355","journal-title":"BMJ Public Health"},{"key":"1797_CR19","unstructured":"EMA (2021) Guideline on pharmaceutical fixed combination products EMA\/CVMP\/83804\/2005-Rev.1. European Medicines Agency."},{"key":"1797_CR20","doi-asserted-by":"publisher","first-page":"487","DOI":"10.56808\/2985-1130.3053","volume":"50","author":"TE Ihedioha","year":"2020","unstructured":"Ihedioha TE, Asuzu IU, Nwanta JA (2020) Trends in the clinical use of antibiotics in a veterinary hospital in Nigeria, 2013\u20132017. Thai J Vet Med 50:487\u2013494. https:\/\/doi.org\/10.56808\/2985-1130.3053","journal-title":"Thai J Vet Med"},{"key":"1797_CR21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13756-023-01235-x","volume":"12","author":"MD Ndahi","year":"2023","unstructured":"Ndahi MD, Hendriksen R, Helwigh B, Card RM, Fagbamila IO, Abiodun-Adewusi OO, Ekeng E, Adetunji V, Adebiyi I, Andersen JK (2023) Determination of antimicrobial use in commercial poultry farms in Plateau and Oyo States, Nigeria. Antimicrob Resist Infect Control 12:30. https:\/\/doi.org\/10.1186\/s13756-023-01235-x","journal-title":"Antimicrob Resist Infect Control"},{"key":"1797_CR22","doi-asserted-by":"publisher","first-page":"6669036","DOI":"10.1155\/2021\/6669036","volume":"2021","author":"M Etefa","year":"2021","unstructured":"Etefa M, Beyi AF, Ayana D, Beyene TJ, Tufa TB (2021) Veterinary drug prescribing practices at selected district veterinary clinics of Rift Valley areas of Ethiopia. Vet Med Int 2021:6669036. https:\/\/doi.org\/10.1155\/2021\/6669036","journal-title":"Vet Med Int"}],"container-title":["Veterinary Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13567-026-01797-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13567-026-01797-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13567-026-01797-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:03:12Z","timestamp":1781852592000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13567-026-01797-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1797"],"URL":"https:\/\/doi.org\/10.1186\/s13567-026-01797-9","relation":{},"ISSN":["1297-9716"],"issn-type":[{"value":"1297-9716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"assertion":[{"value":"10 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"112"}}