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1.
L. Y. Hardefeldt 《Equine Veterinary Education》2020,32(6):284-285
Underdosing of equine antimicrobials is a global issue and may be contributing to antimicrobial resistance in horses. Recent research in Australia has identified that most antimicrobial use in peer-reviewed literature is at a higher dose than that currently on the label for many common equine antimicrobials in the United States, the UK and Australia. These dosing regimens used are now considered the most appropriate doses to be using in horses and veterinarians treating equine patients should be aware of the contemporary dosing regimens. 相似文献
2.
B. Dunkel 《Equine Veterinary Education》2021,33(12):653-658
Due 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. 相似文献
3.
LY Hardefeldt JR Gilkerson H Billman‐Jacobe MA Stevenson K Thursky KE Bailey 《Australian veterinary journal》2018,96(5):151-154
Antimicrobial resistance is a public health emergency, placing veterinary antimicrobial use under growing scrutiny. Antimicrobial stewardship, through appropriate use of antimicrobials, is a response to this threat. The need for antimicrobial stewardship in Australian veterinary practices has had limited investigation. A 2016 survey undertaken to investigate antimicrobial usage patterns by Australian veterinarians found that antimicrobial dose rates were varied and often inappropriate. Doses of procaine penicillin in horses and cattle were often low, with 68% and 90% of respondents, respectively, reporting doses that were unlikely to result in plasma concentrations above minimum inhibitory concentrations for common equine and bovine pathogens. Frequency of penicillin administration was also often inappropriate. Gentamicin doses in horses were largely appropriate (89% of dose rates appropriate), but 9% of respondents reported twice daily dosing. Amoxycillin and amoxycillin‐clavulanate were administered at the appropriate doses, or above, to dogs and cats by 54% and 70% of respondents, respectively. Here, we explore the potential reasons for inappropriate antimicrobial dose regimens and report that antimicrobial labels often recommend incorrect dose rates and thus may be contributing to poor prescribing practices. Changes to legislation are needed to ensure that antimicrobial drug labels are regularly updated to reflect the dose needed to effectively and safely treat common veterinary pathogens. This will be especially true if changes in legislation restrict antimicrobial use by veterinarians to the uses and doses specified on the label, thus hampering the current momentum towards improved antimicrobial stewardship. 相似文献
4.
B. S. BARR B. M. WALDRIDGE P. R. MORRESEY S. M. REED C. CLARK R. BELGRAVE J. M. DONECKER D. J. WEIGEL 《Equine veterinary journal》2013,45(2):154-158
Reasons for performing study: Although antimicrobial‐associated diarrhoea (AAD) is the most frequently observed adverse effect of antimicrobial therapy in horses, few multicentred studies on the prevalence of AAD have been performed. Objectives: To determine the prevalence of AAD in horses that developed diarrhoea after antimicrobial treatment for nondiarrhoeic conditions and identify the antimicrobials used. Methods: The 2009 database of 3 referral hospitals was searched to identify nonhospitalised horses (weanling age or older) treated with antimicrobials for nongastrointestinal conditions. Horses with these criteria that presented with diarrhoea during 2009 were included in the study. Additional information, including antimicrobial administered and results of faecal pathogen testing, was gathered on each hospitalised case. Results: Of the 5251 horses treated with antimicrobials for nongastrointestinal signs, 32 were diagnosed with probable AAD, a prevalence of 0.6% (95% confidence interval: 0.43–0.86%). The AAD‐diagnosed horses had an 18.8% (6/32) mortality rate. Horses with AAD had been treated for an average of 4.2 days. The most frequently used antimicrobials in horses with AAD were gentamicin in combination with penicillin (n = 7), enrofloxacin (n = 7) and doxycycline (n = 4). Clostridium difficile was identified in faecal samples from 4 horses, 2 of which died and Salmonella from 3 horses. Conclusions: Results indicated that the prevalence of AAD is low. Any antimicrobial class commonly used in equine practice is a potential cause of equine AAD. Other risk factors, such as opportunistic enteropathogens, may play a part in the development of diarrhoea secondary to antimicrobial usage. Potential relevance: Although the risk of equine AAD is low, this sequela of antimicrobial treatment is possible especially when opportunistic enteropathogens or other risk factors are present. Because drugs from any antimicrobial class can be potentially involved in AAD, clinicians have additional incentive to ensure the judicious use of antimicrobial agents. 相似文献
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Ka Y. Yuen Justine S. Gibson Sophia Hinrichsen Carlos E. Medina-Torres Francois-Rene Bertin Allison J. Stewart 《Journal of veterinary diagnostic investigation》2021,33(1):149
Prudent use of antimicrobials is paramount to slow the development of resistance and for successful treatment. The use of cumulative antibiograms will allow evidence-based antimicrobial selection with consideration of local resistance patterns. We generated a “first-isolate-per-patient” cumulative antibiogram for a regional equine referral hospital. Bacterial organisms cultured from horses between 2011 and 2018, sample origin, antimicrobial susceptibilities, and multidrug-resistant (MDR) status were tabulated. Of 1,176 samples, 50% were culture positive. Overall, 93 of 374 (25%) were MDR. Of the MDR isolates, 11 (12%) were susceptible to high-importance antimicrobials only (as defined by the Australian Strategic and Technical Advisory Group on antimicrobial resistance). β-hemolytic streptococci were uniformly susceptible to penicillin (76 of 76); 17 of 20 (85%) non–β-hemolytic Streptococcus spp. were susceptible to penicillin. Despite veterinary-specific challenges in constructing an antibiogram, our study provides an exemplar of the clinical utility of regional-, farm-, or hospital-specific cumulative antibiograms for evidence-based empirical antimicrobial selection by veterinarians prior to susceptibility result availability. 相似文献
7.
David A Dargatz Josie L Traub-Dargatz 《Veterinary Clinics of North America: Equine Practice》2004,20(3):587-600
Nosocomial infections are a serious threat to optimum patient care. In addition, nosocomial infections can have far-reaching consequences for the hospital personnel and the financial aspects of the hospital. Nosocomial infections with Salmonella spp have been described among hospitalized equine populations more frequently than any other agent. Salmonella spp associated with hospitalized equids often possess more antimicrobial resistance determinants than do Salmonella spp isolated from healthy horses in the general population. There is little evidence to suggest that resistant salmonellae are more virulent than nonresistant forms. MDR forms of Salmonella complicate the selection of appropriate antimicrobials when they are indicated, however. Furthermore, the use of some antimicrobials may apply selection pressure toward enhanced ability of MDR Salmonella to colonize equine patients. Further research should help to elucidate the risky uses of antimicrobials in the hospital setting and define the role of disinfectants and treatments such as NSAIDs in the ecology of MDR forms of nosocomial infections, including Salmonella. In the meantime, thoughtful selection of when and how to use antimicrobials in equine patients, together with deliberate selection of which antimicrobials to use based on monitoring data and other factors, such as safety and spectrum, is advised. 相似文献
8.
The objective of this study was to examine the impact of hospitalisation and antimicrobial drug administration on the prevalence of resistance in commensal faecal E. coli of horses. Faecal samples were collected from ten hospitalised horses treated with antimicrobials, ten hospitalised horses not treated with antimicrobials and nine non-hospitalised horses over a consecutive five day period and susceptibility testing was performed on isolated E. coli. Results revealed that hospitalisation alone was associated with increased prevalence of antimicrobial resistance and multidrug resistance in commensal E. coli of horses. Due to the risk of transfer of resistance between commensal and pathogenic bacteria, veterinarians need to be aware of possible resistance in commensal bacteria when treating hospitalised horses. 相似文献
9.
Controversies exist regarding the use, misuse and potential overuse of antimicrobial treatments in foals and adults. When antimicrobials are required for treatment of infectious diseases, veterinarians should follow a logical approach and not simply reach for the newest drug. Targeted, single drug therapy is probably best, and culture and sensitivity testing should be undertaken. The most likely infectious agent, potential drug toxicities, and age‐appropriate dose and route should be considered. The development of an increasing number of different multiple drug resistant pathogens requires that veterinarians use antimicrobial drugs responsibly to protect veterinary patients and the public at large. 相似文献
10.
C. M. Isgren 《Equine Veterinary Education》2022,34(9):482-492
The growing problem of antimicrobial resistance affects veterinarians on a daily basis. Antimicrobial stewardship and responsible prescribing are essential for a future with effective antimicrobials, as it is unlikely that new antimicrobials will become available for use in horses in the near future. Extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, methicillin-resistant Staphylococcus aureus (MRSA) and Salmonella spp. are pathogens of significant concern but there are also other opportunistic pathogens such as Pseudomonas spp., α-haemolytic Streptococcus spp., Enterococcus spp. and Acinetobacter spp. which, due to their high intrinsic resistance, have limited treatment options in adult horses. It is essential that highest priority critically important antimicrobials such as ceftiofur, enrofloxacin, rifampicin and polymyxin B are used prudently in horses and ideally based on culture and antimicrobial susceptibility testing (AST). For example, the use of polymyxin B at a low anti-endotoxic dose rather than at a higher antimicrobial dose in horses for the treatment of systemic inflammatory response syndrome is a potential driver for resistance to colistin (polymyxin E), an antimicrobial used as a last resort in the treatment of multidrug resistant (MDR) Enterobacteriaceae infections in humans. Serum procalcitonin levels are used in humans to distinguish noninfectious inflammatory conditions from inflammation caused by bacteria and other infectious agents and are also used to guide cessation of antimicrobial treatment. Although no such studies have been performed in horses, this or other markers may prove to be helpful in guiding antimicrobial treatment decisions in the future. Optimising sampling techniques and good communication with the microbiology laboratory are essential for generating the accurate culture and AST results that underpin appropriate antimicrobial use. Additionally, there is clearly a need for national and international harmonisation of laboratory methods in order to improve the reliability and consistency of results reported by different laboratories. 相似文献
11.
Reasons for performing study: To determine the sedative, analgesic and anaesthetic drugs and techniques that are used by equine veterinarians. Hypothesis or objectives: To provide equine veterinarians with information concerning veterinary use of anaesthetic techniques, a reflection of the collective experiences of the profession. Methods: A survey was conducted of those members of the American Association of Equine Practitioners (AAEP) with an electronic mail address on file with the organisation using proprietary, web‐based software. The survey was comprised of 30 questions divided into 8 sections: nonsteroidal anti‐inflammatory drugs; local anaesthesia; alternative techniques; standing chemical restraint; epidural anaesthesia; short‐term anaesthesia; long‐term anaesthesia; and a place for the respondent to make comments. Results: The response rate was 13.8% (952/6911) AAEP member veterinarians primarily use phenylbutazone and flunixin as anti‐inflammatory drugs, and lidocaine and mepivacaine for local anaesthesia. Combinations of drugs are preferred for standing chemical restraint. While many veterinarians frequently utilise short‐term anaesthesia, longer anaesthesia is less frequently performed. Conclusions: Most AAEP member veterinarians use sedatives in combination to provide standing chemical restraint. Extra‐label use of drugs is a core component of current equine sedation and anaesthetic practice. Potential relevance: Equine veterinarians can compare their choices of anaesthetic drugs with others practising equine medicine and surgery and may be stimulated to investigate alternative methods of providing comfort to horses. 相似文献
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Inga Karasek Catherine Butler Ronald Baynes Arno Werners 《Journal of veterinary pharmacology and therapeutics》2020,43(5):421-428
Ectoparasites infestations are a growing concern to horse owners and equine veterinarians alike. Ectoparasites cause significant health and welfare issues and can potentially can serve as vectors for a variety of pathogens. The prevalence of ectoparasites increases around the world, and especially in horses information on the successful prevention and treatment of ectoparasite infestations in scarce and in many instances anecdotal. This poses a challenge to the equine veterinarian and off-label use of drugs can lead to detrimental effects in horses. In this review we describe the current available evidence for the prevention and treatment of ectoparasite infestations in horses. Only a very limited number of products is approved for the use in horses and fortunately many of the other products that are used in an off-label manner appear to be safe in horses. Future research in this area should aim at providing PK/PD modelling data to assure appropriate and safe dose regimen to prevent and treat ectoparasite infestations in horses. 相似文献
14.
SL Raidal 《Australian veterinary journal》2019,97(7):238-242
Antimicrobial stewardship involves the judicious use of antimicrobials balanced against the requirement to treat the presenting clinical condition. The same mandate and principles as discussed in human medicine and other veterinary disciplines are relevant to equine practice. This brief review will focus on available resources for equine practitioners, emerging perspectives on antimicrobial use and stewardship, and opportunities for more effective antimicrobial use in equine practice. There is a need for improved client education, availability of faster and more accurate techniques for identification and sensitivity testing of bacterial pathogens, and the development of novel agents. 相似文献
15.
Heath TJ 《Australian veterinary journal》2004,82(8):474-478
OBJECTIVE: To give an account of the views held by Australian veterinarians who work with horses on the future of their professional field. METHOD: Questionnaires were mailed to 866 veterinarians who had been identified as working with horses, and 87% were completed and returned. Data were entered onto an Excel spreadsheet, and analysed using the SAS System for Windows. RESULTS: Their future prospects were believed to be very good or excellent by >60% of equine veterinarians but by only 30% of mixed practitioners seeing < 10% horses. The main factors believed likely to affect these prospects were the strength of the equine industries and the economic climate affecting horse owners, followed by the encroachment of cities into areas used for horses, competition from other veterinarians including specialist centres and from non-veterinary operators, and their ability to recruit and retain veterinarians with interest, experience and skill with horses. Urban encroachment, competition and recruitment were especially important for those seeing few horses. Concerns were also expressed about the competence and ethical behaviour of other veterinarians, the physical demands and dangers of horse work, the costs of providing equine veterinary services and of being paid for them, the regulatory restrictions imposed by governments and statutory bodies, the potential effects of litigation, and insurance issues. For many veterinarians in mixed practice these factors have reduced and are likely to reduce further the number of horses seen, to the extent that they have scant optimism about the future of horse work in their practices. CONCLUSION: Economic and local factors will result in an increasing proportion of equine veterinary work being done in specialised equine centres, and the future of horse work in many mixed practices is, at best, precarious. A key factor influencing future prospects will be the availability of competent veterinarians committed to working with horses. 相似文献
16.
J. F. Prescott 《Equine Veterinary Education》2021,33(10):539-545
Antimicrobial stewardship (AMS) is the term increasingly used to describe the multiple approaches needed to sustain the efficacy of antimicrobial drugs in the face of the increasing development and spread of antimicrobial resistance in bacterial pathogens, and the global crisis in medicine that it is engendering. The concept and the practices associated with AMS continue to evolve but the general approach is a dynamic and multifaceted one of continuous improvement based on reducing, improving, monitoring and evaluating the use of antimicrobials so as to preserve their future efficacy and to protect human and animal health. Using many equine examples, this basic overview discusses the multiple and interacting elements of AMS: Practice guidelines, infection control and prevention, clinical microbiology, resistance and use surveillance, dosage, pharmacokinetics and pharmacodynamics, regulation, education and owner compliance, leadership, coordination and measurement. There have been impressive advances in recent years in reporting and analysis of AMR in horses, in the scrutiny and assessment of how antimicrobial drugs are used in horses and in identification of areas for improvement including dosing, surgical prophylaxis, infection control, development of practice standards and the use of clinical microbiology. Antimicrobial stewardship is taking shape as we start to see the emergence of evidence-based recommendations but far more is required. Containing and even rolling back AMR will need the continued engagement of practitioners, equine national and international practitioner organisations, researchers and educators in the academic community, horse owners, regulators and others. 相似文献
17.
Concerns exist that some uses of antimicrobials in cattle may lead to the emergence, proliferation, dissemination and persistence of resistant pathogenic bacteria in animal agriculture, which in turn can infect humans via the food supply. The degree of perceived risk varies with the clinical indication for which the antimicrobial in question is used. In this study, four uses of antimicrobials are considered, including in acutely sick, chronically sick, at-risk, and high-risk cattle, contrasting the degree of risk among these uses. Using a random sample of 103 feedlot cattle veterinarians and variables drawn from the theory of planned behavior, we predict differences in risk perception by clinical indication with differences in perceived efficacy of antimicrobials, social pressures to use antimicrobials, and moral obligations to use antimicrobials. In most models, veterinarians who perceived that others in the feedlot industry (i.e., other feedlot veterinarians, nutritionists, feedlot clients, and retained owners of cattle) were more likely to expect them to use antimicrobials in one situation versus another, the less likely those veterinarians perceived the risk of antimicrobial risk to be greater in the former versus the latter situation. Only two of these contrasts contained influences outside the immediate feedlot relationships. This exception involves the 'downstream' public: meat packers, retailers, and consumers. Veterinarians who believe that using antimicrobials for acutely sick cattle is more beneficial than using antimicrobials for chronically sick cattle were more likely to believe that antimicrobial resistance was a less probable outcome in acutely sick cattle than in chronically sick cattle. 相似文献
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C Kollias-Baker 《Veterinary Clinics of North America: Equine Practice》2001,17(3):433-444
Analytic chemistry laboratories responding to the concerns of the industry over drug use and abuse in performance horses should continue to develop more sensitive methods of drug detection. The unwanted result of this increase in sensitivity is the detection of therapeutic medications days to weeks after administration. The adoption of decision or threshold concentrations for residues of nonpermitted medications should allow laboratories to focus their efforts on drugs of abuse in the performance horse industries and permit veterinarians to provide appropriate medical care to these equine athletes. 相似文献
20.
Prevention and treatment of gastrointestinal adhesions. 总被引：3，自引：0，他引：3
Randall B Eggleston P O Eric Mueller 《Veterinary Clinics of North America: Equine Practice》2003,19(3):741-763
As with many aspects of clinical medicine, there is yet to be a single or definitive cure for postoperative adhesion formation. Current methods of prevention target risk factors predisposing horses to adhesion formation. Systemic pharmacologic therapies, such as antimicrobials, nonsteroidal anti-inflammatory drugs, Salmonella antiserum, and hyperimmune plasma, help to reduce abdominal inflammation and minimize the effects of endotoxemia. Intra-abdominal or systemic heparin aids in enhancing peritoneal fibrinolysis. Prokinetic therapy promotes early postoperative return of intestinal motility, minimizing the propensity for adhesion formation between apposing adynamic segments of intestine. Mechanical separation of potentially adhesiogenic serosal and peritoneal surfaces is commonly achieved with use of abdominal lavage, protective coating solutions, and barrier membranes. Ongoing and future research is directed toward a better understanding of the local effects of intestinal trauma and the corresponding response of the fibrinolytic system. Recognition of horses at high risk for adhesion formation helps to guide the equine surgeon to an appropriate perioperative and intraoperative plan for adhesion prevention, including good surgical technique and a combination of adjunct therapies. 相似文献