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.
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/...
Chaffin MK, Honnas CM, Crabill MR, Schneiter HL, Brumbaugh GW, Briner RP.A 4-month-old male Quarter Horse was referred for evaluation of urinary incontinence. Physical examination revealed clinical signs consistent with cauda equina syndrome. Radiography revealed diskospondylitis of S2 through S4. Infected bone was surgically curretted, and drainage was established for an associated paravertebral abscess. Rhodococcus equi was isolated from specimens of bone and from fluid samples obtained from the paravertebral abscess. Bethanechol was administered to stimulate urination. Erythromycin and rifampin were administered for 120 days. The foal's neurologic dysfunction re...
Knottenbelt DC.Twenty-four foals were confirmed to be infected with Rhodococcus equi on a private stud in Zimbabwe over a two-year period. Six mares had foals which were affected in each of the two years. All the foals were febrile and early cases were detected by this pyrexia. Bronchopneumonia was only clinically detectable in advanced cases. In spite of energetic hygiene measures relating to pasture and housing management, the incidence was higher in the second year (23 per cent of foals born) than in the first (15 per cent of foals born). The mean age of the foals was significantly greater in the second y...
Palmer JE, Benson CE.Sixteen healthy ponies were inoculated IV with Ehrlichia risticii-infected P388D1 mouse monocytes. Of the 16 ponies, 15 developed clinical signs of equine ehrlichial colitis. Twenty-four hours after onset of fever (rectal temperature > 38.8 C), 7 ponies were treated with 25 mg of erythromycin stearate/kg of body weight and 10 mg of rifampin/kg, given orally every 12 hours for 5 days. The remaining 8 ill ponies served as nontreated controls. All ponies were observed for progression of clinical signs typical of equine ehrlichial colitis. Within 12 hours of initiation of treatment, 4 of the 7 ...
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...
Sweeney CR, Sweeney RW, Divers TJ.Case records of 48 foals with pneumonia due to Rhodococcus equi were reviewed. Twenty of the 48 foals survived and 28 died or were euthanized. There was no significant difference between the survivors and non-survivors in the age of onset of illness, duration of illness prior to admission, the mean white blood cell (WBC) count, or the mean plasma fibrinogen content. All foals had R. equi isolated from a tracheobronchial aspirate or lung specimens obtained at necropsy. All organisms were susceptible in vitro (Kirby-Bauer) to erythromycin and gentamicin. Susceptibilities to other drugs were: tri...
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...
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...
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...
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...
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...
Lewis J, Poland J.The ability of erythromycin in liquid medium to suppress the growth of eight species of acholeplasma and of 13 species of mycoplasma was tested. The Acholeplasma spp and two glycolytic Mycoplasma spp from horses--a slow glucose-metabolising (SGM) mycoplasma and a strain N3, related to M mycoides--were sensitive to erythromycin. Thus the growth of acholeplasmas can be suppressed when attempts are made to isolate pathogens from the porcine respiratory tract, but, in the case of horses, erythromycin would suppress not only Acholeplasma spp but also two Mycoplasma spp of unknown pathogenicity in t...
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, 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 ...
Chaffin MK, Honnas CM, Crabill MR, Schneiter HL, Brumbaugh GW, Briner RP.A 4-month-old male Quarter Horse was referred for evaluation of urinary incontinence. Physical examination revealed clinical signs consistent with cauda equina syndrome. Radiography revealed diskospondylitis of S2 through S4. Infected bone was surgically curretted, and drainage was established for an associated paravertebral abscess. Rhodococcus equi was isolated from specimens of bone and from fluid samples obtained from the paravertebral abscess. Bethanechol was administered to stimulate urination. Erythromycin and rifampin were administered for 120 days. The foal's neurologic dysfunction re...
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...
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...
Knottenbelt DC.Twenty-four foals were confirmed to be infected with Rhodococcus equi on a private stud in Zimbabwe over a two-year period. Six mares had foals which were affected in each of the two years. All the foals were febrile and early cases were detected by this pyrexia. Bronchopneumonia was only clinically detectable in advanced cases. In spite of energetic hygiene measures relating to pasture and housing management, the incidence was higher in the second year (23 per cent of foals born) than in the first (15 per cent of foals born). The mean age of the foals was significantly greater in the second y...
Lewis J, Poland J.The ability of erythromycin in liquid medium to suppress the growth of eight species of acholeplasma and of 13 species of mycoplasma was tested. The Acholeplasma spp and two glycolytic Mycoplasma spp from horses--a slow glucose-metabolising (SGM) mycoplasma and a strain N3, related to M mycoides--were sensitive to erythromycin. Thus the growth of acholeplasmas can be suppressed when attempts are made to isolate pathogens from the porcine respiratory tract, but, in the case of horses, erythromycin would suppress not only Acholeplasma spp but also two Mycoplasma spp of unknown pathogenicity in t...
Palmer JE, Benson CE.Sixteen healthy ponies were inoculated IV with Ehrlichia risticii-infected P388D1 mouse monocytes. Of the 16 ponies, 15 developed clinical signs of equine ehrlichial colitis. Twenty-four hours after onset of fever (rectal temperature > 38.8 C), 7 ponies were treated with 25 mg of erythromycin stearate/kg of body weight and 10 mg of rifampin/kg, given orally every 12 hours for 5 days. The remaining 8 ill ponies served as nontreated controls. All ponies were observed for progression of clinical signs typical of equine ehrlichial colitis. Within 12 hours of initiation of treatment, 4 of the 7 ...
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...
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...
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...
