A systematic review and network meta-analysis of injectable antibiotic treatment options for naturally occurring swine respiratory disease

Abstract

Based on an a priori protocol, a review of injectable antibiotic regimens to treat swine respiratory disease (SRD) in weaned swine was conducted to assess the first-treatment failure at 5 to 14 days post-treatment. Information sources included Cambridge Agricultural and Biological Index, MEDLINE, Food and Drug Administration New Animal Drug Approval summaries, Swine Information Library abstracts, and bibliographies of relevant studies and reviews. Two reviewers screened the records, extracted data, and assessed bias risk. From 1266 records screened, 25 relevant records described 41 relevant studies. Thirty-four relevant studies were included in a meta-analysis. The top 3 model-estimated SRD treatments based on mean rank were enrofloxacin (7.5 mg/kg once or 2.5-5 mg/kg once daily for 3-5 days; n = 5; rank = 2; 95% CI, 1-4), gamithromycin (6 mg/kg once, n = 2; rank = 5; 95% CI, 1-14), and marbofloxacin (8 mg/kg once, n = 1; rank = 6; 95% CI, 1-16). When treating SRD, this information should be combined with antibiotic treatment selection criteria including sensitivity testing results, the farm’s pathogen susceptibility monitoring data, local antibiotic prescribing policies, product label recommendations for use and warnings, cost, convenience, importance of the antibiotic to human health, and prudent antibiotic use guidelines.