Abstract
SummaryDue to increasing antimicrobial resistance, pressure on veterinarians is mounting to adhere to responsible use of antimicrobial drugs. Antimicrobials are frequently included in the treatment of systemically ill horses due to the strong likelihood of an infection and the innate difficulties in differentiating systemic inflammation secondary to noninfectious from infectious causes. In light of increasing antimicrobial drug resistance and the potential negative impact of antimicrobials on equine patients, every attempt should be made to identify noninfectious disease, choose first‐line antimicrobials and discontinue treatment as soon as possible. In most cases, a short duration of antimicrobial therapy ranging from a single dose (e.g. preoperatively) to 24–72 h might be sufficient with long‐term treatment being rarely required. This article aims to provide practical guidelines for antimicrobial drug usage in critically ill adult horses by describing ancillary diagnostic aids that can help establishing whether or not an infection is present, discussing commonly encountered pathogens and their typical antimicrobial drug sensitivity patterns, and providing some guidance how to safely shorten the duration of antimicrobial therapy.
Highlights
Critical or intensive care in people extends beyond internal medicine dealing with a subset of patients with immediate life-threatening conditions (Marshall, Bosco et al 2017)
Many critical illnesses in horses are associated with infection or with significant absorption of bacterial products and toxins causing activation of the inflammatory and coagulation system
Not effective against purely inflammatory conditions, antimicrobials are frequently included in the treatment of these animals due to the strong likelihood of an infection and the innate difficulties in differentiating systemic inflammation secondary to non-infectious causes from infections
Summary
Due to increasing microbial resistance, pressure on veterinarians is mounting to adhere to responsible use of antimicrobial drugs. Antimicrobials are frequently included in the treatment of systemically ill horses due to the strong likelihood of an infection and the innate difficulties in differentiating systemic inflammation secondary to non-infectious from infectious causes. In light of increasing antimicrobial drug resistance and the potential negative impact of antimicrobials on equine patients, every attempt should be made to identify non-infectious disease, choose first line antimicrobials and discontinue treatment as soon as possible. The article aims to provide practical guidelines for antimicrobial drug usage in critically ill adult horses by describing ancillary diagnostic aids that can help establishing whether or not an infection is present, discussing commonly encountered pathogens and their typical antimicrobial drug sensitivity patterns and providing some guidance how to safely shorten the duration of antimicrobial therapy
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