Antibiotic treatment of metritis in dairy cows—A meta-analysis

Abstract

The objective of this meta-analysis was to assess the efficacy of the treatment of bovine metritis with common antibiotic and nonantibiotic treatment options. Acute puerperal metritis, a systemic and potentially painful illness with rectal temperature >39.5°C and signs of toxemia due to an infection of the uterus, occurs within 21 d after parturition. Because of the infectious nature, antibiotics are considered beneficial for the treatment of acute puerperal metritis. Each use of an antimicrobial drug, however, is associated with selective pressure for eventual emergence of resistant bacteria. The 23 trials evaluated in the course of a previously conducted systematic review were the basis for meta-analytic investigations. Selected trials were screened regarding their eligibility for the following investigations: (1) comparison of different antibiotic treatments with respect to metritis prevalence at time of re-examination, (2) efficacy of ceftiofur treatment with respect to metritis prevalence at time of re-examination, (3) comparison of efficacy of antibiotic versus nonantibiotic drugs with respect to metritis prevalence at time of re-examination, and (4) equivalence assessment of treatment effects on reproductive performance measures. Where at least 3 trials had investigated the same outcome variable and met the inclusion criteria (inclusion of a control or reference group diagnosed with metritis; reporting means and standard deviation in case of continuous data), meta-analytic investigations were carried out. Due to a shortage of comparable studies, we could not conduct investigations (1) and (3). Ceftiofur treatment of 828 metritic cows was associated with a decrease in the prevalence of metritis following treatment in comparison to 804 untreated cows. In conclusion, meta-analytic investigations uncovered a need for more high-quality studies. Furthermore, a positive effect of the most commonly used antibiotic drug, ceftiofur, for the treatment of bovine metritis could be shown. A comparison with other antibiotic or nonantibiotic treatment options could not be made.

Analysis of puerperal metritis treatment records in a grazing dairy farm in Argentina

“…Most of the randomized clinical trials that assessed the efficacy of ATB usage for the treatment of PM reported in the liter ature during the last 2 decades have the advantage of comparing an untreated group or positive control group but have the limita tion of including a limited number of animals [25]. For example, in a recent metaanalysis of ATB treatment of metritis in dairy cows, from a total of 26 trials that were evaluated, only 7 trials reported cure rates, and 5 from these 7 trials used ceftiofur for treatment of PM [16]. These researchers were able to include in the meta-anal ysis 828 ceftiofur treated cows and 804 untreated cows and con cluded that they were not able to compare different ATB treatments or the efficacy of ATB versus non-ATB drugs to metritis occurrence at the time of reexamination [16].…”

“…For example, in a recent metaanalysis of ATB treatment of metritis in dairy cows, from a total of 26 trials that were evaluated, only 7 trials reported cure rates, and 5 from these 7 trials used ceftiofur for treatment of PM [16]. These researchers were able to include in the meta-anal ysis 828 ceftiofur treated cows and 804 untreated cows and con cluded that they were not able to compare different ATB treatments or the efficacy of ATB versus non-ATB drugs to metritis occurrence at the time of reexamination [16]. Conversely, in our study, over 2400 cow records of ATB treatments, clinical cure, milk production, and reproductive efficiency, were retrieved and analyzed to obtain valuable information of efficacy of PM score 3 treatment under field conditions.…”

“…The most important finding was that the cef tiofur treatment of metritic cows was associated with a decrease in the prevalence of metritis following therapy in comparison to un treated cows. However, this study also concluded that the compar ison of different ATB treatments and the efficacy of ATB versus non-ATB drugs concerning metritis prevalence at the time of reexamina tion was not analyzed because of the lack of comparable trials [16].…”

“…Prudent use of ATB in dairy production medicine in general and in the treatment of PM, in particular, is becoming an important issue to minimize the risk of antimicrobialresistant organisms and to minimize the risk of antimicrobial residues in dairy products [12] [16]. Dairy practitioners must use the proper combination of diag nostic methods and ATB selection to maximize the cure rate and minimize antimicrobial resistance (AMR) and antimicrobial resi dues in milk.…”

“…Sometimes this information is scarce and not readi ly available to the practitioner. Most recently, a metaanalysis has been used to systematically analyze and summarize an extensive collection of randomized clinical trials on ATB treatment of metri tis in dairy cows [16]. The most important finding was that the cef tiofur treatment of metritic cows was associated with a decrease in the prevalence of metritis following therapy in comparison to un treated cows.…”