Antimicrobial Use in Dromedary Camels: Off-Label Practices, Welfare Implications, and Antimicrobial Resistance Within...

Camelus dromedarius (the dromedary camel) plays a vital role in the lives, food security, and culture of pastoral people in many arid and semi-arid areas of Africa, the Middle East, and South Asia. Despite their economic and nutritional value, camels are poorly represented in veterinary pharmacology, with limited numbers of antimicrobial agents formally licensed for use in this species. These practitioners and owners therefore depend heavily on off-label and extra-label administration of drugs developed and dosed for cattle, small ruminants or humans. This narrative review synthesizes published work related to antimicrobial use in dromedary camels, highlighting the pharmacokinetic uncertainties of extrapolating doses from other species. This review distinguishes between direct dromedary data and indirect evidence from other camelids, as well contextual practices within mixed livestock systems to fill evidence gaps. It addresses the non-clinical aspect of suboptimal antimicrobial use, such as under-analgesia, irrational dosing and untimely or off-formal treatment. It also discusses the ever-expanding literature on antimicrobial-resistant bacteria found in camel-derived products, camel ticks and camel feces, such as the presence of ESBL and MDR E. coli, Klebsiella pneumoniae, and Staphylococcus spp. The findings are discussed in the context of the One Health paradigm, and possible routes of camel-to-human exposure through raw milk and meat, as well as environmental dissemination of resistance genes, are recommended for surveillance and stewardship.