Systemic antimicrobial therapy in foals

Floyd, Emily; Easton-Jones, C. A.; Theelen, M. J. P.

doi:10.1111/eve.13467

Cited by 4 publications

(5 citation statements)

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“…Empirical first line broad-spectrum treatment at our hospital regularly includes sodium-ampicillin—provided market unavailability of IV salts of penicillin G—mostly combined with amikacin, which is usually preferred to gentamicin for its lower reported nephrotoxicity and greater efficacy [ 2 ]. Albeit amikacin and gentamicin are not completely overlapping in their spectrum of action [ 1 ], they were considered together as a class to the aim of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Sepsis is the most common cause of death during the first week of life and failure of passive transfer of immunity (FPT) is a leading risk factor [ 1 ]. Ischemic-hypoxic intestinal damage also puts foals affected from perinatal asphyxia syndrome (PAS) at higher risk of developing sepsis [ 2 ]. In the treatment or prevention of sepsis, the empirical selection of broad-spectrum antimicrobials, preferentially administered by intravenous (IV) route, is paramount in most cases.…”

Section: Introductionmentioning

confidence: 99%

“…A combination of beta lactams and an aminoglycoside is the most commonly used as ampicillin 22–30 mg/kg IV or orally (PO) every 6–8 h and amikacin 25 mg/kg IV every 24 h [ 3 ]. This combination has been recently shown to be effective in 91.5% of bacterial isolates in neonatal foals [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…To the authors’ knowledge, no studies to date have reported changes in gut bacterial microbiota in relation to broad-spectrum antimicrobial use in neonatal foals. Alterations of gut microbiota after antimicrobial administration have been reported in adult horses [ 19 ], and early exposure to antimicrobials has been associated with long term implications in human babies [ 2 ]. This information prompts the need for deep insights on the antimicrobials’ effects on foals’ intestinal microbiota in view of a more informed drug selection.…”

Section: Introductionmentioning

confidence: 99%

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Changes in the Fecal Microbiota Associated with a Broad-Spectrum Antimicrobial Administration in Hospitalized Neonatal Foals with Probiotics Supplementation

Freccero

Lanci

Mariella

et al. 2021

Animals

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There is a wide array of evidence across species that exposure to antibiotics is associated with dysbiosis, and due to their widespread use, this also raises concerns also in medicine. The study aimed to determine the changes on the fecal microbiota in hospitalized neonatal foals administered with broad-spectrum antimicrobials and supplemented probiotics. Fecal samples were collected at hospital admission (Ta), at the end of the antimicrobial treatment (Te) and at discharge (Td). Feces were analysed by next-generation sequencing of the 16S rRNA gene on Illumina MiSeq. Seven foals treated with IV ampicillin and amikacin/gentamicin were included. The mean age at Ta was 19 h, the mean treatment length was 7 days and the mean time between Te and Td was 4.3 days. Seven phyla were identified: Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, Proteobacteria, TM7 and Verrucomicrobia. At Ta, Firmicutes (48.19%) and Proteobacteria (31.56%) were dominant. The alpha diversity decreased from Ta to Te, but it was the highest at Td. The beta diversity was higher at Ta than at Te and higher at Td than at Te. An increase in Akkermansia over time was detected. The results suggest that the intestinal microbiota of neonatal foals rapidly returns to a high diversity after treatment. It is possible that in foals, the effect of antimicrobials is strongly influenced or overshadowed by the time-dependent changes in the developing gut microbiota.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Changes in the Fecal Microbiota Associated with a Broad-Spectrum Antimicrobial Administration in Hospitalized Neonatal Foals with Probiotics Supplementation

Freccero

Lanci

Mariella

et al. 2021

Animals

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“…Developing and incorporating an antimicrobial stewardship strategy are therefore important for all equine practices in order to reduce the use of antimicrobial drugs. Several papers have published guidelines for antimicrobial stewardship in equine medicine 67,73,74 , however, papers evaluating the effectiveness of implementation of these programmes in equine practice are currently lacking. In Chapter 8, practical guidelines for antimicrobial stewardship in equine (neonatal) medicine are presented that can be applied by equine veterinarians.…”

Section: Antimicrobial Stewardship In Equine (Neonatal) Medicinementioning

confidence: 99%

Fighting antimicrobial resistance in foal sepsis

Theelen¹

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General introductionChapter 1 may lead to excessive inflammation and bacterial translocation into the bloodstream, resulting in sepsis. It has been suggested this is the most common route for development of sepsis in foals. While many foals admitted to equine hospitals show clinical signs consistent with 'suspected sepsis', definite diagnosis of sepsis is complicated. Blood cultures are considered the gold standard. However, up to 40% of blood cultures collected from foals with sepsis were found to be false negative in a study comparing blood culture results to samples collected at necropsy 18 . False negatives can result from samples collected after antimicrobial treatment has started or if low blood volumes are used 19 . Blood cultures can also be false positive, in case of sample contamination or potential transient bacteremia without clinical implications 20 . Therefore, it is important that blood culture results are interpreted in the light of presence of clinical signs suggestive of sepsis. A weighted sepsis scoring system is therefore often used as a diagnostic tool for sepsis in neonatal foals, but this has a relatively low sensitivity and specificity 21, 22 . Progression of sepsis is often rapid and sepsis can lead to multiple organ dysfunction syndrome (MODS), multiple organ failure syndrome (MOFS), septic shock and ultimately the death of the foal within hours 15 . Culture and antimicrobial susceptibility testing results are usually not available until at least 48 hours after submission of the sample. The rapid clinical deterioration in foals with sepsis is a challenge to the treating veterinarian and warrants immediate initiation of (antimicrobial) treatment, while awaiting culture and susceptibility testing results. TREATMENT OF SEPSIS IN FOALS: THE IMPORTANCE OF ANTIMICROBIALSThe most common form of sepsis in foals is bacterial sepsis 23 . Therefore, in attempt to control the infection, antimicrobials are the cornerstone of treatment in foals with sepsis. Other important aspects of treatment of sepsis in foals are anti-inflammatory treatment, cardiovascular support, respiratory support and nutritional support 15 . Because of the immature immune system and the large variation in bacteria that can cause sepsis in foals, initial antimicrobial treatment should be bactericidal and broad-spectrum. Drug selection is often based on historic data of causative organisms and their susceptibility patterns. Most studies until now have identified Escherichia coli as the most common causative organism isolated from foals with sepsis. Prevalence of other bacteria such as Enterococcus spp., Streptococcus spp., Actinobacillus spp., Enterobacter spp., Staphylococcus spp. and Klebsiella spp. vary widely between studies conducted in different geographic locations and in different time periods. 8, 13,[23][24][25][26][27] . Temporal trends in prevalence of bacteria causing sepsis in foals have been identified 23 . A decrease in enteric gram-negative organisms, Salmonella spp. and Actinobacillus spp. isolated from blood...

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Veterinary Medicines

2023

Veterinary Treatment for Working Equines

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Systemic antimicrobial therapy in foals

Cited by 4 publications

References 43 publications

Changes in the Fecal Microbiota Associated with a Broad-Spectrum Antimicrobial Administration in Hospitalized Neonatal Foals with Probiotics Supplementation

Changes in the Fecal Microbiota Associated with a Broad-Spectrum Antimicrobial Administration in Hospitalized Neonatal Foals with Probiotics Supplementation

Fighting antimicrobial resistance in foal sepsis

Veterinary Medicines

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