Intestinal and hepatic contributions to the pharmacokinetic interaction between gamithromycin and rifampicin after single‐dose and multiple‐dose administration in healthy foals

Berlin, Sarah; Wallstabe, Sandra; Scheuch, Eberhard; Oswald, Stefan; Hasan, Mahmoud; Wegner, Danilo; Grube, Markus; Venner, Monica; Ullrich, Anett; Siegmund, Werner

doi:10.1111/evj.12796

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…Drug interactions between other macrolides and rifampin are variable and when gamithromycin and rifampin are combined, plasma concentrations of gamithromycin are actually increased (Berlin et al. 2018). Rifampin should not be used as a sole agent due to rapid acquisition of resistance (Haggett 2008) and can be combined with other oral medications such as doxycycline or trimethoprim sulfadiazine for treatment of osteomyelitis or umbilical infections.…”

Section: Part 2: Specific Antimicrobial Drugs – Indications and Considerationsmentioning

confidence: 99%

“…However, as co-therapy is thought to reduce the chance of bacteria acquiring rifampin resistance and because plasma levels above the MIC for most common pathogens can still be reached, combination therapy should be used. Drug interactions between other macrolides and rifampin are variable and when gamithromycin and rifampin are combined, plasma concentrations of gamithromycin are actually increased (Berlin et al 2018). Rifampin should not be used as a sole agent due to rapid acquisition of resistance (Haggett 2008) and can be combined with other oral medications such as doxycycline or trimethoprim sulfadiazine for treatment of osteomyelitis or umbilical infections.…”

Section: Rifampinmentioning

confidence: 99%

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Systemic antimicrobial therapy in foals

Floyd

Easton-Jones

Theelen

2021

Equine Veterinary Education

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Summary Antimicrobial agents are commonly used in neonatal foals for the treatment or prevention of sepsis. However, due to concerns about the development of antimicrobial resistance and increasing pressure on veterinarians to rationalise antimicrobial use, we should be trying to reduce the unnecessary use of antimicrobials. This article reviews many of the important considerations when selecting an antimicrobial for use in neonatal foals. Firstly, we consider general differences in neonatal pharmacology and physiology. Secondly, we review common antimicrobial drugs and their indications. Finally, we review antimicrobial stewardship.

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Section: Part 2: Specific Antimicrobial Drugs – Indications and Considerationsmentioning

confidence: 99%

Section: Rifampinmentioning

confidence: 99%

Systemic antimicrobial therapy in foals

Floyd

Easton-Jones

Theelen

2021

Equine Veterinary Education

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“…A similar drug-drug interaction was not found when a combination of intravenous gamithromycin (6 mg/kg once weekly) and oral rifampicin (10 mg/kg once daily) was studied. Co-administration of these antimicrobials resulted in significantly increased plasma exposure of gamithromycin due to likely inhibition of hepatic elimination mechanisms leading to prolonged mean residence time and reduced clearance [19]. Further work needs to be done to determine if rifampicin co-administration is necessary for successful treatment of R. equi pneumonia in foals.…”

Section: Judicious Use Of Macrolide Antibioticsmentioning

confidence: 99%

Clinical insights: Antimicrobials in an age of resistance

Mercer

Davis

2019

Equine Veterinary Journal

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Antimicrobial-resistant bacteria cause at least 700,000 human deaths per year according to the World Health Organization [1]. The veterinary field remains a relatively minor contributor to the development of antimicrobial resistance, and significant morbidity and mortality associated with antimicrobial resistance remains relatively limited in companion and food animals. However, the risk of antimicrobial-resistant determinants travelling among bacteria, animals and humans through the food chain, direct contact and environmental contamination has made the issue of judicious antimicrobial use in the veterinary field a trending topic both among lawmakers and human healthcare professionals. Reliable estimates for equine morbidity and mortality relating to infection with antimicrobial-resistant bacteria are not yet available. However, cases doubtless occur and the most significant threat to both human and equine populations is multidrug-resistant (MDR) pathogens, including methicillin resistant Staphylococcus aureus (MRSA), extended spectrum betalactamase (ESBL) producing Escherichia coli, MDR Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium, and rising MDR strains of Salmonella spp. and Clostridium difficile. Veterinarians and their staff carry a higher risk of MRSA colonisation compared to the general population, and nosocomial MRSA infections have been reported in equine hospitals resulting in patient morbidity and significant financial losses [2]. In an analysis of 12,695 antibiograms in France between 2012 and 2016, the highest proportion (22.5%) of MDR-resistant isolates was S. aureus [3]. Carriage and isolation of ESBL E. coli strains that are resistant to all available antimicrobial classes has increased markedly in horses, and are being seen as a rising cause of nosocomial disease in equine hospitals [2]. In a sampling of healthy adult horses at 41 premises in France in 2015, 44% of horses sampled shed MDR-resistant E. coli, with 29% of premises shedding ESBL isolates [4]. Resistance to even 'reserved' classes of antimicrobials has been reported in equine and canine Salmonella isolates, such as the fluoroquinolone-resistant serovar ST198 as well as ESBL and ceftiofur-resistant strains [2]. Macrolide and rifampicin-resistant strains of R. equi have been demonstrated in farms in the United States, and an increasing prevalence has been noted in Kentucky over the period of 2007-2017 compared with the period 1995-2006 [5]. Antimicrobial use is critical to the practice of veterinary medicine and safeguarding animal welfare; however, inappropriate antimicrobial use in equine and companion animal practice may lead the industry to face legislative regulations on par with food animal practices. The World Health Organization has identified five classes of antimicrobials, later generation cephalosporins, glycopeptides, macrolides, polymyxins and quinolones, as being critically important, and therefore reserved, antimicrobials in human medicine [1]. In a recent review of prescribing behaviour of three '...

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“…A number of other clinically valuable articles on equine neonatology have been published in Equine Veterinary Journal but cannot be covered here. However, other relevant topics include different methods of assessment of transfer of passive immunity in newborn foals , examination of the perinatal gut microbial ecosystem , evaluation of different medications potentially used in the foal (rifampicin, clarithromycin, azithromycin, gamithromycin) , genetic risk factors for osteochondrosis , risk factors for post‐operative complications following umbilical resection in foals along with a host of other topics. The wealth of research in neonatal diseases of the horse will surely benefit the veterinarians understanding and treatment of disease processes for the years to come.…”

mentioning

confidence: 99%