Rifampicin is an antibiotic commonly used in veterinary medicine to treat bacterial infections in horses. It is particularly effective against Rhodococcus equi, a pathogen that can cause severe respiratory disease in foals. Rifampicin functions by inhibiting bacterial RNA synthesis, thereby limiting the proliferation of the bacteria. In equine medicine, it is often used in combination with other antibiotics, such as erythromycin or clarithromycin, to enhance its efficacy and prevent the development of resistance. The pharmacokinetics, dosage, potential side effects, and interactions with other medications are important considerations in its use. This page compiles peer-reviewed research studies and scholarly articles that explore the application, effectiveness, and safety of rifampicin in equine health management.
Bacci S, Meucci V, Sgorbini M, De Marchi L, Pirone A, Pretti C, Tognetti R, Intorre L.Antimicrobial prescriptions of the University of Pisa and their compliance with prudent use recommendations were investigated over 11 years (2011-2021). At least one antimicrobial was always prescribed in surgical prophylaxis for the suture of wounds and in 33% of horses with signs of disease of a body system. Antimicrobials were administered in monotherapy (48%) in fixed dose combinations (21%) and empirical combinations (31%). Antimicrobials were mostly (63%) administered by parenteral route, while oral and topical antimicrobials accounted for 14% and 23% of prescriptions, respectively. Gen...
Fernández-Hernández P, Valero-González M, Fuentes-Romero B, Iglesias-García M, Ezquerra-Calvo LJ, Martín-Cuervo M, Macías-García B.Currently, for in vitro embryo production in live mares, immature oocytes are retrieved by transvaginal follicular aspiration or ovum pick up (OPU). Occasionally, ovarian abscesses have been described after OPU, but no current consensus exists on how to treat this condition. Objective: To describe diagnosis and successful treatment of ovarian abscesses in two mares subjected to OPU. Methods: Case report. Methods: Case records were reviewed and summarised. Results: In the first case, a pony mare showed tachypnoea, tachycardia, high temperature, leukocytosis, left hindlimb lameness and slight in...
Zúñiga MP, Badillo E, Abalos P, Valencia ED, Marín P, Escudero E, Galecio JS.Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line a...
Huber L, Giguère S, Hart KA, Slovis NM, Greiter ME, Dailey CA, Cohen ND.To compare soil concentrations of macrolide- and rifampicin-resistant strains (MRRE) on horse-breeding farms that used thoracic ultrasonographic screening (TUS) to identify foals with subclinical pneumonia combined with subsequent administration of macrolides and rifampin to affected foals (TUS farms) versus soil concentrations on farms that did not (non-TUS farms), determine whether the combined use of TUS and antimicrobial treatment of subclinically affected foals was associated with soil concentration of MRRE, and assess whether there were temporal effects on soil concentrations of MRRE du...
Petry S, Sévin C, Kozak S, Foucher N, Laugier C, Linster M, Breuil MF, Dupuis MC, Hans A, Duquesne F, Tapprest J.Study of the rifampicin resistance of Rhodococcus equi strains isolated from French horses over a 20-year period. Rifampicin susceptibility was tested by disk diffusion (DD) and broth macrodilution methods, and rpoB gene sequencing and MLST were performed on 40 R. equi strains, 50.0% of which were non-susceptible to rifampicin. Consistency of results was observed between rifampicin susceptibility testing and rpoB sequencing. Strains non-susceptible to rifampicin by DD had a substitution at one of the sites (Asp516, His526 and Ser531) frequently encountered and conferring rifampicin resistance....
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...
Huber L, Giguère S, Cohen ND, Slovis NM, Hanafi A, Schuckert A, Berghaus L, Greiter M, Hart KA.The combination of a macrolide and rifampicin has been the mainstay of therapy in foals with Rhodococcus equi pneumonia for decades. Recent studies suggest that mass antimicrobial treatment of subclinically affected foals over time has selected for antimicrobial resistance. Our objective was to estimate the prevalence of R. equi strains resistant to macrolides and rifampicin at horse breeding farms in Kentucky. A hundred breeding farms in Kentucky were surveyed and R. equi were cultured from soil samples. Data were analyzed with logistic regression and generalized linear modeling (P < 0...
Berlin S, Wallstabe S, Scheuch E, Oswald S, Hasan M, Wegner D, Grube M, Venner M, Ullrich A, Siegmund W.Standard treatment of foals with severe abscessing lung infection caused by Rhodococcus equi using rifampicin and a macrolide antibiotic can be compromised by extensive inhibition and/or induction of drug metabolising enzymes (e.g. CYP3A4) and transport proteins (e.g. P-glycoprotein), as has been shown for rifampicin and clarithromycin. The combination of rifampicin with the new, poorly metabolised gamithromycin, a long-acting analogue of azithromycin and tulathromycin with lower pharmacokinetic interaction potential, might be a suitable alternative. Objective: To evaluate the pharmacokinetic ...
Stefanski A, Mevissen M, Möller AM, Kuehni-Boghenbor K, Schmitz A.In this study, we established cell culture conditions for primary equine hepatocytes allowing cytochrome P450 enzyme (CYP) induction experiments. Hepatocytes were isolated after a modified method of Bakala et al. (2003) and cultivated on collagen I coated plates. Three different media were compared for their influence on morphology, viability and CYP activity of the hepatocytes. CYP activity was evaluated with the fluorescent substrate 7-benzyloxy-4-trifluoromethylcoumarin. Induction experiments were carried out with rifampicin, dexamethasone or phenobarbital. Concentration-response curves for...
Venner M, Peters J, Höhensteiger N, Schock B, Bornhorst A, Grube M, Adam U, Scheuch E, Weitschies W, Rosskopf D, Kroemer HK, Siegmund W.Macrolide antibiotics penetrate in the lung against steep concentration gradients into the epithelial lining fluid (ELF) and broncho-alveolar cells (BAC). Since they interact with ABCB1, ABCC2, and organic anion transporting proteins (OATPs), which are localized to lung tissue, pulmonary concentration may be influenced by rifampicin (RIF), an inducer and modulator of efflux and uptake transporters. We measured concentrations of tulathromycin (TM) in plasma, ELF and BAC in 21 warm-blooded foals 24 and 192 h after first and last intramuscular injection of 2.5 mg/kg TM once weekly for 6 weeks. In...
Winther L, Andersen RM, Baptiste KE, Aalbæk B, Guardabassi L.Stenotrophomonas maltophilia is being reported with increasing frequency as a human nosocomial pathogen, especially among immuno-compromised patients. To the authors' knowledge, this pathogen has not previously been associated with lower airway disease in the horse. In this paper the clinical findings, laboratory diagnosis and response to treatment of seven cases of respiratory infection with S. maltophilia in horses, presented at three equine referral hospitals in Denmark in 2007, are described. In all cases there was a clinical history of chronic coughing and abundant mucopurulent exudate wa...
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.
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...
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...
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...
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, 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...
Huber L, Giguère S, Cohen ND, Slovis NM, Hanafi A, Schuckert A, Berghaus L, Greiter M, Hart KA.The combination of a macrolide and rifampicin has been the mainstay of therapy in foals with Rhodococcus equi pneumonia for decades. Recent studies suggest that mass antimicrobial treatment of subclinically affected foals over time has selected for antimicrobial resistance. Our objective was to estimate the prevalence of R. equi strains resistant to macrolides and rifampicin at horse breeding farms in Kentucky. A hundred breeding farms in Kentucky were surveyed and R. equi were cultured from soil samples. Data were analyzed with logistic regression and generalized linear modeling (P < 0...
Winther L, Andersen RM, Baptiste KE, Aalbæk B, Guardabassi L.Stenotrophomonas maltophilia is being reported with increasing frequency as a human nosocomial pathogen, especially among immuno-compromised patients. To the authors' knowledge, this pathogen has not previously been associated with lower airway disease in the horse. In this paper the clinical findings, laboratory diagnosis and response to treatment of seven cases of respiratory infection with S. maltophilia in horses, presented at three equine referral hospitals in Denmark in 2007, are described. In all cases there was a clinical history of chronic coughing and abundant mucopurulent exudate wa...
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...
Huber L, Giguère S, Hart KA, Slovis NM, Greiter ME, Dailey CA, Cohen ND.To compare soil concentrations of macrolide- and rifampicin-resistant strains (MRRE) on horse-breeding farms that used thoracic ultrasonographic screening (TUS) to identify foals with subclinical pneumonia combined with subsequent administration of macrolides and rifampin to affected foals (TUS farms) versus soil concentrations on farms that did not (non-TUS farms), determine whether the combined use of TUS and antimicrobial treatment of subclinically affected foals was associated with soil concentration of MRRE, and assess whether there were temporal effects on soil concentrations of MRRE du...
Petry S, Sévin C, Kozak S, Foucher N, Laugier C, Linster M, Breuil MF, Dupuis MC, Hans A, Duquesne F, Tapprest J.Study of the rifampicin resistance of Rhodococcus equi strains isolated from French horses over a 20-year period. Rifampicin susceptibility was tested by disk diffusion (DD) and broth macrodilution methods, and rpoB gene sequencing and MLST were performed on 40 R. equi strains, 50.0% of which were non-susceptible to rifampicin. Consistency of results was observed between rifampicin susceptibility testing and rpoB sequencing. Strains non-susceptible to rifampicin by DD had a substitution at one of the sites (Asp516, His526 and Ser531) frequently encountered and conferring rifampicin resistance....
Stefanski A, Mevissen M, Möller AM, Kuehni-Boghenbor K, Schmitz A.In this study, we established cell culture conditions for primary equine hepatocytes allowing cytochrome P450 enzyme (CYP) induction experiments. Hepatocytes were isolated after a modified method of Bakala et al. (2003) and cultivated on collagen I coated plates. Three different media were compared for their influence on morphology, viability and CYP activity of the hepatocytes. CYP activity was evaluated with the fluorescent substrate 7-benzyloxy-4-trifluoromethylcoumarin. Induction experiments were carried out with rifampicin, dexamethasone or phenobarbital. Concentration-response curves for...
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...
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...
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.
Venner M, Peters J, Höhensteiger N, Schock B, Bornhorst A, Grube M, Adam U, Scheuch E, Weitschies W, Rosskopf D, Kroemer HK, Siegmund W.Macrolide antibiotics penetrate in the lung against steep concentration gradients into the epithelial lining fluid (ELF) and broncho-alveolar cells (BAC). Since they interact with ABCB1, ABCC2, and organic anion transporting proteins (OATPs), which are localized to lung tissue, pulmonary concentration may be influenced by rifampicin (RIF), an inducer and modulator of efflux and uptake transporters. We measured concentrations of tulathromycin (TM) in plasma, ELF and BAC in 21 warm-blooded foals 24 and 192 h after first and last intramuscular injection of 2.5 mg/kg TM once weekly for 6 weeks. In...
Berlin S, Wallstabe S, Scheuch E, Oswald S, Hasan M, Wegner D, Grube M, Venner M, Ullrich A, Siegmund W.Standard treatment of foals with severe abscessing lung infection caused by Rhodococcus equi using rifampicin and a macrolide antibiotic can be compromised by extensive inhibition and/or induction of drug metabolising enzymes (e.g. CYP3A4) and transport proteins (e.g. P-glycoprotein), as has been shown for rifampicin and clarithromycin. The combination of rifampicin with the new, poorly metabolised gamithromycin, a long-acting analogue of azithromycin and tulathromycin with lower pharmacokinetic interaction potential, might be a suitable alternative. Objective: To evaluate the pharmacokinetic ...
Zúñiga MP, Badillo E, Abalos P, Valencia ED, Marín P, Escudero E, Galecio JS.Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line a...
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...
Fernández-Hernández P, Valero-González M, Fuentes-Romero B, Iglesias-García M, Ezquerra-Calvo LJ, Martín-Cuervo M, Macías-García B.Currently, for in vitro embryo production in live mares, immature oocytes are retrieved by transvaginal follicular aspiration or ovum pick up (OPU). Occasionally, ovarian abscesses have been described after OPU, but no current consensus exists on how to treat this condition. Objective: To describe diagnosis and successful treatment of ovarian abscesses in two mares subjected to OPU. Methods: Case report. Methods: Case records were reviewed and summarised. Results: In the first case, a pony mare showed tachypnoea, tachycardia, high temperature, leukocytosis, left hindlimb lameness and slight in...
Bacci S, Meucci V, Sgorbini M, De Marchi L, Pirone A, Pretti C, Tognetti R, Intorre L.Antimicrobial prescriptions of the University of Pisa and their compliance with prudent use recommendations were investigated over 11 years (2011-2021). At least one antimicrobial was always prescribed in surgical prophylaxis for the suture of wounds and in 33% of horses with signs of disease of a body system. Antimicrobials were administered in monotherapy (48%) in fixed dose combinations (21%) and empirical combinations (31%). Antimicrobials were mostly (63%) administered by parenteral route, while oral and topical antimicrobials accounted for 14% and 23% of prescriptions, respectively. Gen...
