Erythromycin is a macrolide antibiotic commonly used in veterinary medicine, including equine care, to treat bacterial infections. It functions by inhibiting protein synthesis in bacteria, thereby preventing their growth and proliferation. In horses, erythromycin is often utilized in the treatment of infections caused by Rhodococcus equi, particularly in foals. The administration of erythromycin requires careful consideration due to potential side effects such as gastrointestinal disturbances, including diarrhea and colitis. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacokinetics, efficacy, and safety of erythromycin in horses, as well as its role in managing equine bacterial infections.
Patterson Rosa L, Mallicote MF, MacKay RJ, Brooks SA.Macrolide drugs are the treatment of choice for infections, despite severe side-effects temporary anhidrosis as a. To better understand the molecular biology leading to macrolide induced anhidrosis, we performed skin biopsies and Quantitative Intradermal Terbutaline Sweat Tests (QITSTs) in six healthy pony-cross foals for three different timepoints during erythromycin administration-pre-treatment (baseline), during anhidrosis and post-recovery. RNA sequencing of biopsies followed by differential gene expression analysis compared both pre and post normal sweating timepoints to the erythromycin...
Erol E, Locke S, Saied A, Cruz Penn MJ, Smith J, Fortner J, Carter C.Mainstay therapy for rhodococcosis in foals is the combination of rifampicin and a macrolide. While emergence of resistance to rifampicin and macrolides has been reported, studies demonstrating the development of resistance to such drugs is limited in necropsied foals with rhodococcosis. In this study, the foal necropsy records between 01/01/2011 and 08/30/2019 were reviewed for culture-positive R. equi with MICs and, whether or not the affected foals received any mainstay dual therapy before their deaths. Resistance to antimicrobials in the R. equi isolates from necropsied foals were then com...
Giguère S, Berghaus LJ, Willingham-Lane JM.Pneumonia caused by remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin has been the recommended treatment for foals with clinical signs of infection caused by since the early 1980s with, until recently, only rare reports of resistance. Resistance to macrolides and rifampin in isolates of cultured from horses is increasing, with isolates resistant to all macrolides and rifampin now being cultured from up to 40% of infected foals at some farms. This text reviews the available data regarding ant...
Giguère S.Pneumonia caused by Rhodococcus equi remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin remains the recommended therapy for foals with clinical signs of infection caused by R equi. Most foals with small, subclinical ultrasonographic pulmonary lesions associated with R equi recover without therapy, and administration of antimicrobial agents to these subclinically affected foals does not hasten lesion resolution relative to administration of a placebo. Resistance to macrolides and rifampin in isol...
Fenton CS, Buckley TC.Rhodococcus equi is a gram positive, intracellular pathogen of foals worldwide. The aim of this study was to determine whether there was an increasing resistance occurring in Rhodococcus equi towards the antibiotics rifampin and erythromycin over a seven year period. The investigation was carried out with the use of E test strips (epsilometers) for rifampin and erythromycin in order to determine the Minimum Inhibitory Concentrations (MIC) values of Rhodococcus equi to these antibiotics. Results: The main results of this study found that the mean MICs were higher for erythromycin than for rifam...
Stieler AL, Sanchez LC, Mallicote MF, Martabano BB, Burrow JA, MacKay RJ.The mechanism of hyperthermia, a potentially fatal adverse effect of erythromycin treatment of foals, is unknown. Objective: To determine the cause of erythromycin-associated hyperthermia. It was hypothesised that the normal sweat response of foals is impaired by treatment with erythromycin. Methods: Blinded, crossover study in 10 healthy pony foals. Methods: Foals kept in stalls were given either erythromycin (25 mg/kg bwt orally, 3 times daily) or control for 10 days then turned out for a further 10 days. Quantitative intradermal terbutaline sweat tests were performed on Days 1 (baseline)...
Giguère S, Berghaus LJ, Lee EA.Studies with facultative intracellular bacterial pathogens have shown that evaluation of the bactericidal activity of antimicrobial agents against intracellular bacteria is more closely associated with in vivo efficacy than traditional in vitro susceptibility testing. The objective of this study was to determine the relative activity of 10 antimicrobial agents against intracellular Rhodococcus equi. Equine monocyte-derived macrophages were infected with virulent R. equi and exposed to erythromycin, clarithromycin, azithromycin, rifampin, ceftiofur, gentamicin, enrofloxacin, vancomycin, imipene...
Berghaus LJ, Giguère S, Guldbech K.The objectives of this study were to determine the mutant prevention concentration (MPC), time above the MPC and mutant selection window for 10 antimicrobial agents against Rhodococcus equi and to determine if the combination of a macrolide with rifampin would decrease emergence of resistant mutants. Antimicrobial agents investigated (erythromycin, clarithromycin, azithromycin, rifampin, amikacin, gentamicin, enrofloxacin, vancomycin, imipenem, and doxycycline) were selected based on in vitro activity and frequency of use in foals or people infected with R. equi. Each antimicrobial agent or co...
Villarino N, Martín-Jiménez T.Macrolides are used for treatment of pneumonia and extrapulmonary conditions caused by Rhodococcus equi. In foals, macrolides have an extraordinary capacity to accumulate in different lung tissue compartments. These drugs show unique pharmacokinetic features such as rapid and extensive distribution and long persistence in pulmonary epithelial lining fluid (PELF) and bronchoalveolar lavage (BAL) cells from foals. This article reviews the pharmacokinetic characteristics of erythromycin, azithromycin, clarithromycin, tulathromycin, telithromycin, gamithromycin, and tilmicosin in foals, with empha...
Giguère S, Lee EA, Guldbech KM, Berghaus LJ.There are no studies investigating interactions between clarithromycin or azithromycin and rifampin or other commonly used antimicrobial agents against virulent isolates of Rhodococcus equi. In addition, there is no published data on the postantibiotic effects (PAEs) and pharmacodynamics properties of antimicrobial agents against R. equi. The objectives were to assess in vitro interactions, pharmacodynamics, and PAEs of 11 antimicrobial agents belonging to various antimicrobial classes against R. equi. Antimicrobial agents investigated (erythromycin, clarithromycin, azithromycin, rifampin, ami...
Johns IC, Desrochers A, Wotman KL, Sweeney RW.To describe the clinical presentation, case management, and outcome in 2 foals with Rhodococcus equi infection associated with presumptive severe immune-mediated hemolytic anemia. Methods: Two foals diagnosed with R. equi pneumonia on the basis of tracheal wash cultures, thoracic radiographs, and thoracic ultrasonography were concurrently diagnosed with hemolytic anemia. Both foals required whole blood transfusions, and were treated with the antimicrobial combination of rifampin and a macrolide (eg, clarithromycin, erythromycin, or azithromycin). Dexamethasone was used to prevent further hemol...
Javsicas LH, Giguère S, Womble AY.The objectives of this study were to determine the serum and pulmonary disposition of telithromycin in foals and to determine the minimum inhibitory concentration (MIC) of telithromycin against macrolide-susceptible and macrolide-resistant Rhodococcus equi isolates. A single dose of telithromycin (15 mg/kg of body weight) was administered to six healthy 6-10-week-old foals by the intragastric route. Activity of telithromycin was measured in serum, pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells using a microbiological assay. The broth macrodilution method was u...
Giguère S, Lee E, Williams E, Cohen ND, Chaffin MK, Halbert N, Martens RJ, Franklin RP, Clark CC, Slovis NM.To determine the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and to describe treatment outcome in foals infected with antimicrobial-resistant isolates of R equi. Methods: Cross-sectional study. Methods: 38 isolates classified as resistant to macrolide antimicrobials or rifampin received from 9 veterinary diagnostic laboratories between January 1997 and December 2008. Methods: For each isolate, the minimum inhibitory concentration of macrolide antimicrobials (ie, azithromycin, erythromycin, and clarithromycin) and rifampin was dete...
Buckley T, McManamon E, Stanbridge S.This study sought to determine whether an increase in resistance of Rhodococcus equi to the antibiotics rifampin and erythromycin occurred over a 10-year period. This was carried out by the use of E test strips for rifampin and erythromycin to determine the MIC (minimum inhibitory concentration) values of Rhodococcus equi to this combination of antibiotics.The findings of this study indicated that there was an increase in resistance of Rhodococcus equi to rifampin and erythromycin over the 10-year period. The MIC for rifampin increased from 0.081 μg/ml in 1996 to 0.187 μg/ml in 2006 and from...
Suarez-Mier G, Giguère S, Lee EA.The objectives of the present study were to determine and compare the pulmonary disposition of azithromycin, clarithromycin, and erythromycin in foals. A single dose (10 mg/kg) of azithromycin, clarithromycin, or erythromycin was administered intragastrically to six healthy 1- to 3-month-old foals using an orthogonal design. Activity of the drugs was measured in serum, pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells by use of a microbiologic assay. Peak drug activity in PELF was significantly higher in foals treated with clarithromycin (48.96+/-13.26 microg/mL)...
Boswinkel M, Sloet van Oldruitenborgh-Oosterbaan MM.Infection with Rhodococcus equi is an important cause of pneumonia in foals, but other organ systems may also be affected. The intracellular presence of R. equi and the formation of granulomatous and suppurative inflammatory tissue mean that prolonged treatment is needed. The pharmacological properties of the combination of erythromycin and rifampicin have improved the survival of foals infected with R. equi; however, erythromycin can cause adverse reactions in foals and mares, which has prompted the search for alternative therapies. The combination of azithromycin or clarithromycin with rifam...
McClintock SA, Collins AM.A 6-month-old Quarter Horse weanling filly was presented with lethargy, weight loss, inappetance, mild diarrhoea, marked ventral oedema and severe panhypoproteinaemia. Serum antibody titres for Lawsonia intracellularis were very high but PCR to detect faecal shedding of the organism was negative. Proliferative enteropathy due to L. intracellularis infection was diagnosed. After treatment for 4 weeks with oral erythromycin and rifampicin the filly made a complete recovery.
Giguère S, Jacks S, Roberts GD, Hernandez J, Long MT, Ellis C.The objective of this retrospective study was to compare the efficacy of azithromycin-rifampin, clarithromycin-rifampin, and erythromycin-rifampin for the treatment of pneumonia caused by Rhodococcus equi in foals. Eighty-one foals with naturally acquired pneumonia caused by R. equi were included in the study. Information on age, sex, breed, physical examination findings, laboratory testing, and thoracic radiography was abstracted from each medical record. Foals were divided in 3 groups based on the antimicrobial agent selected for therapy. Short-term (discharge from the hospital) and long-ter...
Pardo Mateu L, Faubel Serra M, Llavero Segovia MT, Cano Cuenca B, Pérez Climent F, Giménez Vaillo F, Grau Alario E, Lazaro Santander R.The Rhodococcus equi is an aerobic gram positive pleomorphic bacillus, that was isolated for the first time like a producer of bronchopneumonia in young horses. Every time more often, it is being recognized as a pathogen in humans, mainly in the immunodepressed population. We described a case, until now exceptional, of laryngeal infection by Rhodococcus equi in a patient with positive serology for the virus of the human immunodeficiency (HIV), and we reviewed some clinical and epidemiological characteristics of the infections by this germ. The treatment is riphampicine and/or erythromycin, bei...
Bihr TP.A 5-month-old Morgan filly was presented to the Atlantic Veterinary College with a history of lethargy, fever, depression, anorexia, and dependent ventral edema. Diagnostic tests revealed severe inflammation, hypoproteinemia, and thickened small intestinal loops. Protein-losing enteropathy caused by Lawsonia intracellularis was diagnosed and treated successfully with erythromycin-rifampin.
Lakritz J, Wilson WD, Marsh AE, Mihalyi JE.Plasma concentrations and pharmacokinetics of erythromycin and related compounds were determined after administration of erythromycin ethylsuccinate to six healthy male foals 3 to 5 months of age. Hay was withheld from the foals overnight and erythromycin ethylsuccinate (25 mg/kg of body weight) was administered intragastrically. Plasma erythromycin concentrations were determined at specific times after drug administration by high-performance liquid chromatography assay. Maximum peak plasma concentrations, time to maximum concentrations, area under plasma concentration versus time curves, elim...
Nieto JE, Van Hoogmoed LM, Spier SJ, Vatistas NJ, Snyder JR, Timmerman BL.To use an extracorporeal circuit to evaluate effects of intraluminal distention on the jejunum of healthy horses. Methods: 2 jejunal segments from each of 5 horses. Methods: Jejunal segments were harvested and maintained in an extracorporeal circuit. One segment was subjected to distention (intraluminal pressure, 25 cm H2O) followed by decompression, and 1 segment was maintained without distention. The influence of distention-decompression on vascular resistance was calculated. Mucosal permeability was evaluated by measuring the clearance of albumin from blood to lumen. After distention and de...
Lakritz J, Wilson WD, Marsh AE, Mihalyi JE.To determine pharmacokinetics and plasma concentrations of erythromycin and related compounds after intragastric administration of erythromycin phosphate and erythromycin estolate to healthy foals. Methods: 11 healthy 2- to 6-month-old foals. Methods: Food was withheld from foals overnight before intragastric administration of erythromycin estolate (25 mg/kg of body weight; n = 8) and erythromycin phosphate (25 mg/kg; 7). Four foals received both drugs with 2 weeks between treatments. Plasma erythromycin concentrations were determined at various times after drug administration by use of high-p...
Stratton-Phelps M, Wilson WD, Gardner IA.To determine whether foals with pneumonia that were treated with erythromycin, alone or in combination with rifampin or gentamicin, had a higher risk of developing adverse effects, compared with foals treated with trimethoprim-sulfamethoxazole (TMS), penicillin G procaine (PGP), or a combination of TMS and PGP (control foals). Methods: Retrospective study. Methods: 143 foals < 240 days old. Methods: Information on age, sex, breed, primary drug treatment, total days of treatment with the primary drug, and whether the foal developed diarrhea, hyperthermia, or respiratory distress was obtained...
Nieto JE, Rakestraw PC, Snyder JR, Vatistas NJ.To evaluate effects of erythromycin, lidocaine, and metoclopramide on smooth muscle of the pyloric antrum (PA), proximal portion of the duodenum (PD), and middle portion of the jejunum (MJ) of horses. Sample Population-Strips of smooth muscle from 7 horses. Methods: Isolated muscle strips were suspended in a bath and attached to isometric force transducers. Once stable spontaneous contractions were observed, agents were added. Isometric stress responses were compared with the amplitude of spontaneous contractions. Results: A single dose of erythromycin to the PA increased contractile amplitude...
Båverud V, Franklin A, Gunnarsson A, Gustafsson A, Hellander-Edman A.In Sweden, mares sometimes develop acute, often fatal, colitis when their foals are treated orally with erythromycin and rifampicin for Rhodococcus (R.) equi infection. Clostridium (C.) difficile, or its cytotoxin, was demonstrated in faecal samples from 5 of 11 (45%) mares with diarrhoea. By contrast C. difficile was not found in the faecal flora of 12 healthy mares with foals treated for R. equi infection or in 56 healthy mares with healthy untreated foals. No other enteric pathogen was isolated from any diarrhoeic mare. Of 7 investigated treated foals, 4 had a high (1651.0, 1468.3, 273.0 an...
Doherty TJ, Andrews FM, Provenza MK, Frazier DL.Gastric emptying was evaluated in ponies using the acetaminophen (AP) method. Fifteen minutes after i.v. administration of metoclopramide, erythromycin, yohimbine, atropine or saline, the ponies were given AP by stomach tube. Blood samples for AP analysis were collected at baseline and 15, 30, 45, 60, 75, 90, 105 and 120 min after AP administration. Time to reach peak serum concentration (Tmax), maximum serum concentration (Cmax) and area under the AP serum concentration vs. time curve (AUC) were determined for each treatment group. In the control group, Tmax was 31 min and this decreased sign...
Fuhrmann C, Lämmler C.In the present investigation 19 and 22 R. equi-cultures isolated from diseased horses and humans, respectively, could be correctly identified by their morphological, biochemical and serological properties. The rod-coccus life cycle appeared to be a common feature of almost all cultures investigated. The cultures were typeable with the typing system described by Prescott (1981). The predominant serotypes among the R. equi-isolates belonged to serotypes 1 and 2. Among the R. equi-isolates from horses haemagglutination-positive cultures were mainly found among isolates of serotype 1, those of ser...
Lakritz J, Wilson WD, Watson JL, Hyde DM, Mihalyi J, Plopper CG.To determine whether oral administration of erythromycin alters the inflammatory response to bronchoalveolar lavage (BAL) in young horses. Methods: 12 healthy, unweaned, mixed-breed foals of either sex, between 2 and 4 months old. Methods: BAL was performed; 250 ml of phosphate-buffered saline solution (300 mOsm, pH 7.4) was administered in 50-ml aliquots. Foals were carefully monitored for 4 days, then erythromycin base (25 mg/kg of body weight, PO, q 12 h) was given to foals of the treated group. After 4 days, foals were reanesthetized, and the same lung was relavaged. Cytologic examination ...
Giguère S, Lee E, Williams E, Cohen ND, Chaffin MK, Halbert N, Martens RJ, Franklin RP, Clark CC, Slovis NM.To determine the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and to describe treatment outcome in foals infected with antimicrobial-resistant isolates of R equi. Methods: Cross-sectional study. Methods: 38 isolates classified as resistant to macrolide antimicrobials or rifampin received from 9 veterinary diagnostic laboratories between January 1997 and December 2008. Methods: For each isolate, the minimum inhibitory concentration of macrolide antimicrobials (ie, azithromycin, erythromycin, and clarithromycin) and rifampin was dete...
Hillidge CJ.The selection of lipid-soluble antibiotics capable of intracellular penetration is considered critical for the successful treatment of Rhodococcus equi pneumonia and lung abscesses in foals. Two such antibiotics: erythromycin (25 mg kg-1, three times daily) and rifampin (5 mg kg-1 twice daily) have been used in combination for this purpose at the University of Florida since 1981. Positive evidence of R. equi was present on culture of tracheal aspirates in 57 foals, most of which exhibited radiographic evidence of extensive lung abscessation. The duration of therapy ranged from 4 to 9 weeks. Mi...
Giguère S, Berghaus LJ, Willingham-Lane JM.Pneumonia caused by remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin has been the recommended treatment for foals with clinical signs of infection caused by since the early 1980s with, until recently, only rare reports of resistance. Resistance to macrolides and rifampin in isolates of cultured from horses is increasing, with isolates resistant to all macrolides and rifampin now being cultured from up to 40% of infected foals at some farms. This text reviews the available data regarding ant...
Giguère S.Pneumonia caused by Rhodococcus equi remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin remains the recommended therapy for foals with clinical signs of infection caused by R equi. Most foals with small, subclinical ultrasonographic pulmonary lesions associated with R equi recover without therapy, and administration of antimicrobial agents to these subclinically affected foals does not hasten lesion resolution relative to administration of a placebo. Resistance to macrolides and rifampin in isol...
Giguère S, Jacks S, Roberts GD, Hernandez J, Long MT, Ellis C.The objective of this retrospective study was to compare the efficacy of azithromycin-rifampin, clarithromycin-rifampin, and erythromycin-rifampin for the treatment of pneumonia caused by Rhodococcus equi in foals. Eighty-one foals with naturally acquired pneumonia caused by R. equi were included in the study. Information on age, sex, breed, physical examination findings, laboratory testing, and thoracic radiography was abstracted from each medical record. Foals were divided in 3 groups based on the antimicrobial agent selected for therapy. Short-term (discharge from the hospital) and long-ter...
Giguère S, Lee EA, Guldbech KM, Berghaus LJ.There are no studies investigating interactions between clarithromycin or azithromycin and rifampin or other commonly used antimicrobial agents against virulent isolates of Rhodococcus equi. In addition, there is no published data on the postantibiotic effects (PAEs) and pharmacodynamics properties of antimicrobial agents against R. equi. The objectives were to assess in vitro interactions, pharmacodynamics, and PAEs of 11 antimicrobial agents belonging to various antimicrobial classes against R. equi. Antimicrobial agents investigated (erythromycin, clarithromycin, azithromycin, rifampin, ami...
Prescott JF, Nicholson VM.The minimal inhibitory concentrations of penicillin G, ampicillin, gentamicin, erythromycin and rifampicin were determined for nine strains of Corynebacterium equi. The effect of combinations of any two of these antibiotics on the killing of these strains was determined at antibiotic concentrations achievable in horses using recommended drug dosages (ampicillin 4.0 microgram/ml, gentamicin 1.0 microgram/ml using recommended drug dosages (ampicillin 4.0 microgram/ml, gentamicin 1.0 microgram/ml and erythromycin 0.25 microgram/ml). Penicillin G was used at 4.0 microgram/ml and rifampicin at 0.06...
Berghaus LJ, Giguère S, Guldbech K.The objectives of this study were to determine the mutant prevention concentration (MPC), time above the MPC and mutant selection window for 10 antimicrobial agents against Rhodococcus equi and to determine if the combination of a macrolide with rifampin would decrease emergence of resistant mutants. Antimicrobial agents investigated (erythromycin, clarithromycin, azithromycin, rifampin, amikacin, gentamicin, enrofloxacin, vancomycin, imipenem, and doxycycline) were selected based on in vitro activity and frequency of use in foals or people infected with R. equi. Each antimicrobial agent or co...
Buckley T, McManamon E, Stanbridge S.This study sought to determine whether an increase in resistance of Rhodococcus equi to the antibiotics rifampin and erythromycin occurred over a 10-year period. This was carried out by the use of E test strips for rifampin and erythromycin to determine the MIC (minimum inhibitory concentration) values of Rhodococcus equi to this combination of antibiotics.The findings of this study indicated that there was an increase in resistance of Rhodococcus equi to rifampin and erythromycin over the 10-year period. The MIC for rifampin increased from 0.081 μg/ml in 1996 to 0.187 μg/ml in 2006 and from...
Stratton-Phelps M, Wilson WD, Gardner IA.To determine whether foals with pneumonia that were treated with erythromycin, alone or in combination with rifampin or gentamicin, had a higher risk of developing adverse effects, compared with foals treated with trimethoprim-sulfamethoxazole (TMS), penicillin G procaine (PGP), or a combination of TMS and PGP (control foals). Methods: Retrospective study. Methods: 143 foals < 240 days old. Methods: Information on age, sex, breed, primary drug treatment, total days of treatment with the primary drug, and whether the foal developed diarrhea, hyperthermia, or respiratory distress was obtained...
Erol E, Locke S, Saied A, Cruz Penn MJ, Smith J, Fortner J, Carter C.Mainstay therapy for rhodococcosis in foals is the combination of rifampicin and a macrolide. While emergence of resistance to rifampicin and macrolides has been reported, studies demonstrating the development of resistance to such drugs is limited in necropsied foals with rhodococcosis. In this study, the foal necropsy records between 01/01/2011 and 08/30/2019 were reviewed for culture-positive R. equi with MICs and, whether or not the affected foals received any mainstay dual therapy before their deaths. Resistance to antimicrobials in the R. equi isolates from necropsied foals were then com...
Ringger NC, Lester GD, Neuwirth L, Merritt AM, Vetro T, Harrison J.To investigate the prokinetic effect of bethanechol and erythromycin in the upper gastrointestinal tract of healthy horses by measuring the gastric emptying (GE) rate of a radioactive meal. Methods: 4 healthy adult horses. Methods: After food was withheld for 12 hours, horses were given 370 MBq of 99mTc-labeled sulfur colloid incorporated into egg albumen and 37 MBq of 111In-labeled diethyltriaminepentaacetic acid in 120 ml of water via nasogastric intubation. Intravenously administered treatments were 0.9% NaCl solution, erythromycin (0.1 or 1.0 mg/kg of body weight), or bethanechol (0.25 mg/...
Giguère S, Berghaus LJ, Lee EA.Studies with facultative intracellular bacterial pathogens have shown that evaluation of the bactericidal activity of antimicrobial agents against intracellular bacteria is more closely associated with in vivo efficacy than traditional in vitro susceptibility testing. The objective of this study was to determine the relative activity of 10 antimicrobial agents against intracellular Rhodococcus equi. Equine monocyte-derived macrophages were infected with virulent R. equi and exposed to erythromycin, clarithromycin, azithromycin, rifampin, ceftiofur, gentamicin, enrofloxacin, vancomycin, imipene...
Prescott JF, Sweeney CR.Combined antimicrobial drug treatment was recommended for foals with Corynebacterium equi pneumonia. The preferred combination is orally administered erythromycin estolate (25 mg/kg of body weight, QID) plus rifampin (10 mg/kg, BID). Erythromycin estolate also can be combined for synergistic effect with sodium benzyl penicillin given IV (100,000 IU/kg, QID) or with ampicillin given IV (11 to 15 mg/kg, QID). A third choice is sodium benzyl penicillin IV with gentamicin IM (2.2 mg/kg, TID) or with kanamycin IM (10 mg/kg, QID). Gentamicin should be combined with penicillin G or ampicillin and not...
Doherty TJ, Andrews FM, Provenza MK, Frazier DL.Gastric emptying was evaluated in ponies using the acetaminophen (AP) method. Fifteen minutes after i.v. administration of metoclopramide, erythromycin, yohimbine, atropine or saline, the ponies were given AP by stomach tube. Blood samples for AP analysis were collected at baseline and 15, 30, 45, 60, 75, 90, 105 and 120 min after AP administration. Time to reach peak serum concentration (Tmax), maximum serum concentration (Cmax) and area under the AP serum concentration vs. time curve (AUC) were determined for each treatment group. In the control group, Tmax was 31 min and this decreased sign...
Higgins R, Biberstein EL, Jang SS.Of 24 isolates of nutritionally variant streptococci recovered from equine corneal ulcers, 22 were tested for growth requirements, physiological and biochemical reactions, and susceptibility to different antimicrobial agents. Satisfactory growth was obtained by supplementing blood agar and Todd-Hewitt broth with pyridoxal hydrochloride, and all of the media for the culture and the biochemical testing were supplemented with 0.002% of this substance. Biochemical patterns of 12 of the isolates resembled those of two viridans streptococcal species, Streptococcus intermedius and Streptococcus const...
Suarez-Mier G, Giguère S, Lee EA.The objectives of the present study were to determine and compare the pulmonary disposition of azithromycin, clarithromycin, and erythromycin in foals. A single dose (10 mg/kg) of azithromycin, clarithromycin, or erythromycin was administered intragastrically to six healthy 1- to 3-month-old foals using an orthogonal design. Activity of the drugs was measured in serum, pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells by use of a microbiologic assay. Peak drug activity in PELF was significantly higher in foals treated with clarithromycin (48.96+/-13.26 microg/mL)...
Bihr TP.A 5-month-old Morgan filly was presented to the Atlantic Veterinary College with a history of lethargy, fever, depression, anorexia, and dependent ventral edema. Diagnostic tests revealed severe inflammation, hypoproteinemia, and thickened small intestinal loops. Protein-losing enteropathy caused by Lawsonia intracellularis was diagnosed and treated successfully with erythromycin-rifampin.
Villarino N, Martín-Jiménez T.Macrolides are used for treatment of pneumonia and extrapulmonary conditions caused by Rhodococcus equi. In foals, macrolides have an extraordinary capacity to accumulate in different lung tissue compartments. These drugs show unique pharmacokinetic features such as rapid and extensive distribution and long persistence in pulmonary epithelial lining fluid (PELF) and bronchoalveolar lavage (BAL) cells from foals. This article reviews the pharmacokinetic characteristics of erythromycin, azithromycin, clarithromycin, tulathromycin, telithromycin, gamithromycin, and tilmicosin in foals, with empha...
Fenton CS, Buckley TC.Rhodococcus equi is a gram positive, intracellular pathogen of foals worldwide. The aim of this study was to determine whether there was an increasing resistance occurring in Rhodococcus equi towards the antibiotics rifampin and erythromycin over a seven year period. The investigation was carried out with the use of E test strips (epsilometers) for rifampin and erythromycin in order to determine the Minimum Inhibitory Concentrations (MIC) values of Rhodococcus equi to these antibiotics. Results: The main results of this study found that the mean MICs were higher for erythromycin than for rifam...
Nieto JE, Rakestraw PC, Snyder JR, Vatistas NJ.To evaluate effects of erythromycin, lidocaine, and metoclopramide on smooth muscle of the pyloric antrum (PA), proximal portion of the duodenum (PD), and middle portion of the jejunum (MJ) of horses. Sample Population-Strips of smooth muscle from 7 horses. Methods: Isolated muscle strips were suspended in a bath and attached to isometric force transducers. Once stable spontaneous contractions were observed, agents were added. Isometric stress responses were compared with the amplitude of spontaneous contractions. Results: A single dose of erythromycin to the PA increased contractile amplitude...
Kirchhoff H, Heitmann J, Bisping W.Mycoplasmas were isolated from 11 (=#6,8%) of 161 cervix swabs from infertile mares. A total of 17 strains was isolated and characterized by indirect immunofluorescent test and metabolic inhibition test as Mycoplasma equigenitalium (11 strains), Mycoplasma subdolum (2 strains), Acholeplasma laidlawii (3 strains) and Acholeplasma equifetale (1 strain). In addition cervix swabs of the mares were investigated for bacteria. There was no specific correlation between presence of mycoplasmas and bacteria (table 1). In clinical investigations 5 of the 11 mares which harboured mycoplasmas showed a pneu...
Stieler AL, Sanchez LC, Mallicote MF, Martabano BB, Burrow JA, MacKay RJ.The mechanism of hyperthermia, a potentially fatal adverse effect of erythromycin treatment of foals, is unknown. Objective: To determine the cause of erythromycin-associated hyperthermia. It was hypothesised that the normal sweat response of foals is impaired by treatment with erythromycin. Methods: Blinded, crossover study in 10 healthy pony foals. Methods: Foals kept in stalls were given either erythromycin (25 mg/kg bwt orally, 3 times daily) or control for 10 days then turned out for a further 10 days. Quantitative intradermal terbutaline sweat tests were performed on Days 1 (baseline)...
Prescott JF, Hoover DJ, Dohoo IR.The pharmacokinetic parameters of erythromycin in foals were determined following intravenous administration of 5.0 mg/kg to animals aged 1, 3, 5 and 7 weeks. The distribution of the drug was described by a two-compartment open model, and no significant differences were observed between coefficients on which the parameters were based. Pharmacokinetic values were also determined for four mares given 5.0 mg/kg intravenously and for six 10-12-week-old foals given 20.0 mg/kg intravenously. The half-life of erythromycin for all groups of animals (foals less than 7 weeks, mares, foals 10-12 weeks) w...
Pardo Mateu L, Faubel Serra M, Llavero Segovia MT, Cano Cuenca B, Pérez Climent F, Giménez Vaillo F, Grau Alario E, Lazaro Santander R.The Rhodococcus equi is an aerobic gram positive pleomorphic bacillus, that was isolated for the first time like a producer of bronchopneumonia in young horses. Every time more often, it is being recognized as a pathogen in humans, mainly in the immunodepressed population. We described a case, until now exceptional, of laryngeal infection by Rhodococcus equi in a patient with positive serology for the virus of the human immunodeficiency (HIV), and we reviewed some clinical and epidemiological characteristics of the infections by this germ. The treatment is riphampicine and/or erythromycin, bei...
Nieto JE, Van Hoogmoed LM, Spier SJ, Vatistas NJ, Snyder JR, Timmerman BL.To use an extracorporeal circuit to evaluate effects of intraluminal distention on the jejunum of healthy horses. Methods: 2 jejunal segments from each of 5 horses. Methods: Jejunal segments were harvested and maintained in an extracorporeal circuit. One segment was subjected to distention (intraluminal pressure, 25 cm H2O) followed by decompression, and 1 segment was maintained without distention. The influence of distention-decompression on vascular resistance was calculated. Mucosal permeability was evaluated by measuring the clearance of albumin from blood to lumen. After distention and de...
Javsicas LH, Giguère S, Womble AY.The objectives of this study were to determine the serum and pulmonary disposition of telithromycin in foals and to determine the minimum inhibitory concentration (MIC) of telithromycin against macrolide-susceptible and macrolide-resistant Rhodococcus equi isolates. A single dose of telithromycin (15 mg/kg of body weight) was administered to six healthy 6-10-week-old foals by the intragastric route. Activity of telithromycin was measured in serum, pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells using a microbiological assay. The broth macrodilution method was u...
Lakritz J, Wilson WD, Marsh AE, Mihalyi JE.To determine pharmacokinetics and plasma concentrations of erythromycin and related compounds after intragastric administration of erythromycin phosphate and erythromycin estolate to healthy foals. Methods: 11 healthy 2- to 6-month-old foals. Methods: Food was withheld from foals overnight before intragastric administration of erythromycin estolate (25 mg/kg of body weight; n = 8) and erythromycin phosphate (25 mg/kg; 7). Four foals received both drugs with 2 weeks between treatments. Plasma erythromycin concentrations were determined at various times after drug administration by use of high-p...
Lakritz J, Wilson WD, Watson JL, Hyde DM, Mihalyi J, Plopper CG.To determine whether oral administration of erythromycin alters the inflammatory response to bronchoalveolar lavage (BAL) in young horses. Methods: 12 healthy, unweaned, mixed-breed foals of either sex, between 2 and 4 months old. Methods: BAL was performed; 250 ml of phosphate-buffered saline solution (300 mOsm, pH 7.4) was administered in 50-ml aliquots. Foals were carefully monitored for 4 days, then erythromycin base (25 mg/kg of body weight, PO, q 12 h) was given to foals of the treated group. After 4 days, foals were reanesthetized, and the same lung was relavaged. Cytologic examination ...
