Tulathromycin (Draxxin®), a long-acting macrolide antibiotic, achieved significant commercial success in veterinary medicine, particularly within the cattle and pig industries. This success contrasts sharply with the poor performance of similar molecules. The study aims to understand the factors contributing to this success, particularly considering the context of increasing regulations aimed at limiting antimicrobial resistance in livestock farming, such as the French *Ecoantibio* plans. The study applies the ‘social life’ approach of Whyte et al. (2003) to investigate the drug's trajectory from production and marketing to its use by veterinarians and livestock farmers, considering its pharmacological properties, its marketing, and its practical application within the context of intensive farming practices. The study emphasizes that the success of tulathromycin depends not only on its biological effects but also on how its properties are perceived and utilized within specific social and economic contexts of livestock production.

The research draws upon existing literature examining the role of pharmaceutical companies in shaping prescribing practices and market demand for various drugs, including psychotropic drugs, diuretics, and painkillers. It notes the influence of packaging, presentation, and promotional strategies in shaping drug use. The study contrasts the commonly observed “pyramid model” of industry-practitioner-patient interaction with a model that accounts for the context and social demand for a given product. The example of chlorpromazine’s success in France, attributed to clinician support within a specific context, is cited as an example where success stemmed from fulfilling a specific need within a sector. The study highlights that the veterinary market, unlike the human medicine market, lacks reimbursement schemes, making price and economic factors particularly important in shaping drug selection.

The research employed a mixed-methods approach, combining qualitative and quantitative data collection. Qualitative data was gathered through semi-structured interviews (n=16) with individuals working in pharmaceutical companies (veterinarians, product managers, and regional representatives) from Zoetis and its competitors. These interviews were supplemented by observations of training sessions (attended by over a dozen veterinarians in each session) organized by pharmaceutical companies. The interviews were transcribed, coded thematically (eight themes identified, including those directly related to tulathromycin), and analyzed for patterns. Quantitative data consisted of analysis of professional literature (from *Semaine/Point Vétérinaire*, *Dépêche Vétérinaire*, and *Le Nouveau Praticien Vétérinaire Elevage et santé*) published between the early 2000s and the present, including articles and advertisements related to tulathromycin. The analysis examined the way tulathromycin was presented in the trade press, focusing on the themes emerging from the interview data. The methodological choices sought to account for the differences between two distinct contexts (beef and pork farming) and potential biases arising from the power dynamics and potential conflicts of interests within the industry.

The study's key findings are organized around three main themes: 1) The perceived pharmaceutical innovation of tulathromycin: Tulathromycin's long duration of action was presented as a key innovation, although this property is shared by competitors like gamithromycin and tildipirosin. However, differences in market penetration and sector targeting among competing companies highlight the importance of marketing strategies. 2) Tulathromycin's role in addressing sector-specific organizational challenges: The research shows that the unique characteristics of tulathromycin’s usage made it particularly suitable for intensive livestock farming. In the cattle industry, its effectiveness as both a treatment and a preventative measure addressed the lack of coordination between breeders and fatteners, creating a scenario analogous to a prisoner's dilemma, in which vaccination is unlikely to be adopted due to the lack of incentive for the breeders to bear the cost without reaping the benefits. In the pig industry, tulathromycin was effectively used to prevent diseases during the ‘immunity gap’ after weaning. 3) The marketing strategy and the conflation of antibiotic and vaccine: The research highlights the pivotal role played by Zoetis’ marketing strategy, particularly the name 'Draxxin', which bears phonetic resemblance to ‘vaccine’ and contributed to the misperception of tulathromycin. This, along with its easy administration (single subcutaneous injection), further reinforced this conflation among practitioners, especially those less directly involved in the clinical treatment. The study argues that this successful marketing strategy effectively circumvented the growing emphasis on limiting antimicrobial use by presenting tulathromycin as a vaccine-like solution.

The study's findings demonstrate that the success of tulathromycin is not solely attributable to its pharmacological properties but to a complex interplay of factors including its suitability to the organizational constraints of intensive livestock farming, its effective marketing and branding, and the resulting conflation with vaccines. The research underscores the importance of considering the social and economic contexts when analyzing pharmaceutical innovations. The ‘quick fix’ nature of the antibiotic addresses sector challenges, particularly in scenarios where vaccination is impractical or costly. The study highlights the significant impact of marketing in shaping perceptions and practices.

The success of tulathromycin underscores the significance of considering both pharmacological properties and socio-economic contexts in understanding the adoption of veterinary pharmaceuticals. The study's findings suggest that future research should focus on how evolving regulations, such as those limiting metaphylactic use of antibiotics, will impact industry practices and the adoption of alternative disease prevention strategies. The marketing strategies surrounding antibiotics and their interplay with emerging regulatory landscapes warrant further investigation.

The study primarily focuses on the French veterinary market, limiting the generalizability of its findings to other contexts. The sample size of interviews, while sufficient for qualitative analysis, might not fully represent the diversity of views within the industry. The reliance on self-reported data from industry actors requires consideration of potential bias.