In mares with placentitis does the duration of antibiotic treatment affect foal outcome?

Elizabeth Barter

doi:10.18849/ve.v5i3.309

Abstract

PICO question In mares with placentitis does treatment with long-term antibiotics result in improved foal viability when compared to repeated short courses of 7 to 10 days?  Clinical bottom line Category of research question Treatment The number and type of study designs reviewed The literature search identified six publications that included length of antibiotic treatment and foetal outcome. The publications consisted of four non-randomised non-blinded controlled trials and two randomised non-blinded controlled trials Strength of evidence Collectively there was weak evidence to support either an intermittent or continuous antibiotic protocol in the treatment of placentitis in mares Outcomes reported The literature involved experimental induction of ascending placentitis with foal survival or viability as the outcome Conclusion Further research is required into the diagnosis of placentitis, length of treatment and choice of antibiotic/s to penetrate the uterus in a diseased state  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

Group 1 (n = 3): Administered CCFA 6.6 mg/kg IM q96h Group 2 (n = 6): Administered CCFA 6.6 mg/kg IM q96h, altrenogest and pentoxifylline Group 3 (n = 3): No treatment was given Treatment was continued until abortion or parturition
Unknown number of CFU installed into the cervix Unknown if strain of S. zooepidemicus was sensitive in vitro to CCFA Small sample size Unable to extrapolate to other forms of CCFA such as short acting intravenous administration
Mares were infected intra-cervically with approximately 2 x 106 CFU of S. zooepidemicus tested sensitive to TMS in vitro

Summary

KNOWLEDGE SUMMARY

PICO question In mares with placentitis does treatment with long-term antibiotics result in improved foal viability when compared to repeated short courses of 7 to 10 days?. The publications consisted of four non-randomised non-blinded controlled trials and two randomised non-blinded controlled trials Strength of evidence Collectively there was weak evidence to support either an intermittent or continuous antibiotic protocol in the treatment of placentitis in mares Outcomes reported The literature involved experimental induction of ascending placentitis with foal survival or viability as the outcome Conclusion Further research is required into the diagnosis of placentitis, length of treatment and choice of antibiotic/s to penetrate the uterus in a diseased state. These findings support the need for ongoing research into identifying mares at risk of placentitis and once diagnosed monitoring clinical progression

Summary of the evidence

Limitations

Limited number of horses makes statistical power poor between groups

Search Strategy

Findings

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