Comparison of tulathromycin, azithromycin and azithromycin-rifampin for the treatment of mild pneumonia associated with Rhodococcus equi.
Abstract: The objectives of the present study were to determine the relative efficacy of tulathromycin, azithromycin, or azithromycin with rifampin for the treatment of pulmonary abscesses on a farm with endemic infections caused by Rhodococcus equi. Foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0-15 cm; n=120) were randomly allocated in four equal treatment groups: (1) tulathromycin intramuscularly; (2) azithromycin monotherapy, orally; (3) azithromycin with rifampin, orally; (4) saline intramuscularly as a placebo. Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study. The proportion of foals that recovered without the need for a change in therapy was significantly higher for foals treated with azithromycin (29 of 30) or azithromycin with rifampin (28 of 30) than for foals treated with a placebo (20 of 30). Additionally, azithromycin or azithromycin with rifampin resulted in a significantly faster decrease in the number of abscesses and abscess score compared with a placebo. The proportion of foals treated with tulathromycin that recovered (27 of 30) was not significantly different from that of foals treated with a placebo. Azithromycin alone or in combination with rifampin was beneficial in the study population.
Publication Date: 2013-10-07 PubMed ID: 24106244DOI: 10.1136/vr.101867Google Scholar: Lookup
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- Comparative Study
- Journal Article
- Randomized Controlled Trial
Summary
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The research studies the relative effectiveness of three antibiotics (tulathromycin, azithromycin, and azithromycin with rifampin) in treating mild pneumonia related with the bacterial infection Rhodococcus equi in young horses (foals). The finding showed that azithromycin and the combination of azithromycin with rifampin provided significant results while tulathromycin did not show any considerable improvement compared to the placebo.
Objective and Methodology
- The study aimed to analyze the relative efficacy of three different drugs, namely tulathromycin, azithromycin, and a combined dose of azithromycin with rifampin in curing pulmonary abscesses in a farm where Rhodococcus equi infections are common.
- The experiment was conducted on a sample of 120 foals that showed ultrasonographic evidence of pulmonary abscesses. They were divided randomly into four groups. Each group was treated with one of the three antibiotics or a placebo (saline)
- The health status of the foals was regularly monitored by examinations and thoracic ultrasonography performed by individuals who were unaware of the medication allocated to each foal.
Findings
- The foals that were treated with azithromycin (29 out of 30) or azithromycin combined with rifampin (28 out of 30) showed significantly higher recovery without requiring a change of therapy, compared to those treated with a placebo (20 out of 30).
- Additionally, the treatments with azithromycin, and azithromycin combined with rifampin, resulted in a substantial decrease in the number of abscesses at a faster rate than the placebo.
- In contrast, the recovery rate of the foals treated with tulathromycin (27 out of 30) was not significantly different from those treated with the placebo, indicating that tulathromycin did not have a significant effect on recovery.
Conclusion
- The research concludes that among the three drugs studied, azithromycin, alone or in combination with rifampin, were beneficial in treating the horses in the study population.
- Tulathromycin, on the other hand, did not make significant contributions to the recovery of the foals compared with the placebo. These findings will be helpful in choosing the appropriate antibiotic for treating pneumonia associated with Rhodococcus equi infections in horses.
Cite This Article
APA
Venner M, Credner N, Lämmer M, Giguère S.
(2013).
Comparison of tulathromycin, azithromycin and azithromycin-rifampin for the treatment of mild pneumonia associated with Rhodococcus equi.
Vet Rec, 173(16), 397.
https://doi.org/10.1136/vr.101867 Publication
Researcher Affiliations
- Veterinary Clinic, Trift 4, Destedt 38162, Germany.
MeSH Terms
- Actinomycetales Infections / drug therapy
- Actinomycetales Infections / epidemiology
- Actinomycetales Infections / veterinary
- Animals
- Anti-Bacterial Agents / therapeutic use
- Azithromycin / therapeutic use
- Disaccharides / therapeutic use
- Double-Blind Method
- Drug Therapy, Combination / veterinary
- Endemic Diseases / veterinary
- Germany / epidemiology
- Heterocyclic Compounds / therapeutic use
- Horse Diseases / drug therapy
- Horse Diseases / epidemiology
- Horses
- Lung Abscess / drug therapy
- Lung Abscess / veterinary
- Pneumonia, Bacterial / drug therapy
- Pneumonia, Bacterial / microbiology
- Pneumonia, Bacterial / veterinary
- Rhodococcus equi
- Rifampin / therapeutic use
- Severity of Illness Index
- Treatment Outcome
Citations
This article has been cited 9 times.- Nielsen SS, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin-Bastuji B, Gonzales Rojas JL, Gortázar C, Herskin M, Michel V, Miranda Chueca MÁ, Padalino B, Pasquali P, Roberts HC, Spoolder H, Ståhl K, Velarde A, Viltrop A, Winckler C, Baldinelli F, Broglia A, Kohnle L, Alvarez J. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): antimicrobial-resistant Rhodococcus equi in horses.. EFSA J 2022 Feb;20(2):e07081.
- Rosa B. Equine Drug Transporters: A Mini-Review and Veterinary Perspective.. Pharmaceutics 2020 Nov 8;12(11).
- Awosile BB, Heider LC, Saab ME, McClure JT. Antimicrobial resistance in bacteria isolated from horses from the Atlantic Provinces, Canada (1994 to 2013).. Can Vet J 2018 Sep;59(9):951-957.
- Chen QF, Zhang YW. [Clinical effect of Saccharomyces boulardii powder combined with azithromycin sequential therapy in treatment of children with diarrhea secondary to Mycoplasma pneumoniae pneumonia].. Zhongguo Dang Dai Er Ke Za Zhi 2018 Feb;20(2):116-120.
- Rutenberg D, Venner M, Giguère S. Efficacy of Tulathromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia.. J Vet Intern Med 2017 May;31(3):901-906.
- Whitfield-Cargile CM, Cohen ND, Suchodolski J, Chaffin MK, McQueen CM, Arnold CE, Dowd SE, Blodgett GP. Composition and Diversity of the Fecal Microbiome and Inferred Fecal Metagenome Does Not Predict Subsequent Pneumonia Caused by Rhodococcus equi in Foals.. PLoS One 2015;10(8):e0136586.
- Cohen ND, Slovis NM, Giguère S, Baker S, Chaffin MK, Bernstein LR. Gallium maltolate as an alternative to macrolides for treatment of presumed Rhodococcus equi pneumonia in foals.. J Vet Intern Med 2015 May-Jun;29(3):932-9.
- Burton AJ, Giguère S, Berghaus LJ, Hondalus MK. Activity of clarithromycin or rifampin alone or in combination against experimental Rhodococcus equi infection in mice.. Antimicrob Agents Chemother 2015;59(6):3633-6.
- Hildebrand F, Venner M, Giguère S. Efficacy of gamithromycin for the treatment of foals with mild to moderate bronchopneumonia.. J Vet Intern Med 2015 Jan;29(1):333-8.
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