UK Calf Cryptosporidiosis: Paromomycin Sales Double in Five Years as Resistance Concerns Grow

Sales of paromomycin — the antibiotic licensed to reduce Cryptosporidium parvum-associated scour in pre-ruminant calves — have surged 143% over five years from 96kg to 233kg in the UK, according to government sales data, raising alarm among veterinary experts about resistance selection pressure at a time when cryptosporidiosis remains the leading enteric pathogen in neonatal cattle and a UK Ruminant Antibiotic Stewardship Roadmap is expected later this year.

Cryptosporidiosis remains the second most common bovine diagnosis in the UK and the primary enteric pathogen in neonatal and pre-weaned calves, according to the government’s latest Veterinary Investigation Diagnosis Analysis report. Against that backdrop, paromomycin sales have more than doubled — a trend reflecting sustained disease pressure but raising legitimate questions about antimicrobial stewardship.

Two paromomycin products are currently licensed in the UK. Parofor Crypto (Huvepharma) is licensed specifically for diagnosed C. parvum in pre-ruminant cattle, administered for seven consecutive days. Gabbrovet Multi (Ceva Santé Animale) carries a dual claim against both C. parvum cryptosporidiosis and E. coli colibacillosis in pre-ruminant cattle and pigs, with a five-day treatment course for cryptosporidiosis. Both are prescription-only aminoglycosides.

Concerns about paromomycin resistance are growing, with experts warning that routine use may increase selection pressure against a drug class considered critically important in human medicine. Dr Kat Baxter-Smith, veterinary adviser at MSD Animal Health, said the trends reinforce the need for prevention-led disease control.

Bovilis Cryptium (MSD Animal Health), VMD-approved in August 2024, is the first and only vaccine in Great Britain against Cryptosporidium parvum. Administered to pregnant heifers and cows, it raises antibodies in colostrum against C. parvum, providing passive protection to calves from birth. MSD’s Five-Point Plan for Cryptosporidiosis Control — covering diagnosis, colostrum management, hygiene, prevention and treatment — positions vaccination within a broader farm-level strategy.

A UK Ruminant Antibiotic Stewardship Roadmap, expected later this year, is anticipated to place the trajectory of paromomycin sales under increasing scrutiny.