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Home / Equine Research Bank / BMC Vet Res / Administration of trimethoprim-sulphadimidine does not impro...
BMC veterinary research2014; 10; 180; doi: 10.1186/s12917-014-0180-0

Administration of trimethoprim-sulphadimidine does not improve healing of glandular gastric ulceration in horses receiving omeprazole: a randomised, blinded, clinical study.

Abstract: Interest in Equine Gastric Ulcer Syndrome (EGUS) has recently increased in part due to a growing awareness of the differences between squamous and glandular disease. The pathophysiology and epidemiology of squamous and glandular disease are different and recently it has been shown that the response of glandular gastric ulceration to monotherapy with omeprazole is poor. Given these differences it has been recommended that specific treatment guidelines be formulated for equine glandular disease and that adjunctive therapies be investigated. Along these lines it has been suggested that the addition of antimicrobials may enhance healing. The objective of this study was to investigate whether the addition of trimethoprim-sulphadimidine to omeprazole therapy would result in superior healing of naturally occurring equine glandular ulceration compared with omeprazole monotherapy. Results: Combination therapy of omeprazole plus trimethoprim-sulphadimidine could not be demonstrated to be superior to omeprazole monotherapy. Healing of the glandular mucosa was observed in 7/15 (47%; 95% CI 24 to 71%) and 3/13 (23%; 95% CI 7% to 50%) of horses in the TMPS and OMEP groups, respectively (OR = 1.8; 95% CI 0.32 to 10.0; p = 0.67). Improvement of the glandular mucosa was observed in 12/15 (80%; 95% CI 56 to 94%) and 9/13 (69%; 95% CI 42 to 89%) of horses in the TMPS and OMEP groups, respectively (OR = 2.9; 95% CI 0.6 to 15.0; p = 0.25). Conclusions: The results of the present study do not support the addition of trimethoprim-sulphadimidine to therapeutic protocols for equine glandular ulceration. Several limitations were present in the study and the use of antimicrobials as an adjunctive treatment warrants further investigation. However, given the potential deleterious consequences associated with the indiscriminate use of antimicrobials, the inclusion of antimicrobials in treatment regimes for EGUS is not justified until their efficacy is further validated.
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Publication Date: 2014-08-23 PubMed ID: 25927827PubMed Central: PMC4445647DOI: 10.1186/s12917-014-0180-0Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research paper investigates whether adding the antibiotic trimethoprim-sulphadimidine to omeprazole therapy would improve the healing of equine glandular gastric ulcers. The results do not support this combination therapy as being superior to omeprazole monotherapy.

Introduction to the Study

  • The research focuses on the treatment of Equine Gastric Ulcer Syndrome (EGUS), a prevalent condition among horses which manifests as squamous or glandular ulceration.
  • Recent studies show that the glandular form of the disease does not respond well to therapy with omeprazole alone, suggesting that combined or adjunctive treatment methods should be investigated.
  • The objective of this study was to investigate the efficacy of combining omeprazole with the antibiotic trimethoprim-sulphadimidine to improve the healing of naturally occurring glandular gastric ulcers in horses.

Results of the Study

  • The results showed no significant improvement in healing of glandular ulcers when omeprazole was combined with trimethoprim-sulphadimidine compared to omeprazole monotherapy.
  • In fact, healing was observed in 47% of horses treated with the combination therapy and just 23% in the omeprazole-only group.
  • While the combination therapy had a slightly higher rate of improved glandular conditions (80% compared to 69% in the omeprazole-only group), the difference was not statistically significant.

Conclusions and Recommendations

  • The researchers concluded that their results did not support the addition of trimethoprim-sulphadimidine to omeprazole treatments for EGUS.
  • They acknowledged some limitations in their study and suggested that further research is warranted before ruling out the use of antibiotics entirely for EGUS treatment.
  • However, given the potentially harmful effects of indiscriminate antibiotic use, such treatment methods should not be adopted until their efficacy has been thoroughly proven.

Cite This Article

APA
Sykes BW, Sykes KM, Hallowell GD. (2014). Administration of trimethoprim-sulphadimidine does not improve healing of glandular gastric ulceration in horses receiving omeprazole: a randomised, blinded, clinical study. BMC Vet Res, 10, 180. https://doi.org/10.1186/s12917-014-0180-0

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 10
Pages: 180

Researcher Affiliations

Sykes, Ben W
  • BW Sykes Consultancy, Upper Orara, NSW, Australia. bensykes21@hotmail.com.
Sykes, Katja M
  • BW Sykes Consultancy, Upper Orara, NSW, Australia. katjasykes@hotmail.com.
Hallowell, Gayle D
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK. gaylehallowell@yahoo.co.uk.

MeSH Terms

  • Animals
  • Anti-Ulcer Agents / administration & dosage
  • Anti-Ulcer Agents / therapeutic use
  • Female
  • Horse Diseases / drug therapy
  • Horses
  • Male
  • Omeprazole / administration & dosage
  • Omeprazole / therapeutic use
  • Single-Blind Method
  • Stomach Ulcer / drug therapy
  • Stomach Ulcer / veterinary
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

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Citations

This article has been cited 6 times.
  1. Shan R, Steel CM, Sykes B. The Impact of Two Recommended Withholding Periods for Omeprazole and the Use of a Nutraceutical Supplement on Recurrence of Equine Gastric Ulcer Syndrome in Thoroughbred Racehorses. Animals (Basel) 2023 May 31;13(11).
    doi: 10.3390/ani13111823pubmed: 37889700google scholar: lookup
  2. Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge. Animals (Basel) 2023 Apr 5;13(7).
    doi: 10.3390/ani13071261pubmed: 37048517google scholar: lookup
  3. Pratt SL, Bowen M, Hallowell GH, Shipman E, Bailey J, Redpath A. Does lesion type or severity predict outcome of therapy for horses with equine glandular gastric disease? - A retrospective study. Vet Med Sci 2023 Jan;9(1):150-157.
    doi: 10.1002/vms3.1034pubmed: 36495212google scholar: lookup
  4. Paul LJ, Ericsson AC, Andrews FM, Keowen ML, Morales Yniguez F, Garza F Jr, Banse HE. Gastric microbiome in horses with and without equine glandular gastric disease. J Vet Intern Med 2021 Sep;35(5):2458-2464.
    doi: 10.1111/jvim.16241pubmed: 34351018google scholar: lookup
  5. Banse HE, Andrews FM. Equine glandular gastric disease: prevalence, impact and management strategies. Vet Med (Auckl) 2019;10:69-76.
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  6. Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement--Equine Gastric Ulcer Syndrome in Adult Horses. J Vet Intern Med 2015 Sep-Oct;29(5):1288-99.
    doi: 10.1111/jvim.13578pubmed: 26340142google scholar: lookup
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