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Does antimicrobial therapy improve outcomes in horses with severe equine asthma and a positive tracheal wash bacterial culture?

Abstract: The objective of this study was to observe the outcomes of adding an antimicrobial treatment to a conventional treatment regime in horses with severe equine asthma in a clinical setting. Eleven client-owned horses with a history consistent with severe equine asthma, increased respiratory effort and nostril flaring, ≥ 20% neutrophils on bronchoalveolar lavage (BAL), and a positive tracheal wash (TW) bacterial culture were treated with environmental management, corticosteroids, and bronchodilators. Six horses were also treated with an antimicrobial (principal group), while the other 5 were administered saline as a placebo (control group). Treatment with antimicrobials significantly improved the post-treatment clinical score of the principal group compared with the pre-treatment score, whereas no significant difference occurred in the control group. The principal group also had significantly less neutrophil myeloperoxidase (MPO) activity post-treatment than pre-treatment, with a median difference of -0.39 units/[protein] in the principal group and a median difference of -0.21 units/[protein] in the controls. There was no difference in MPO activity pre- post-treatment in the control group. No differences were noted in the intra-group comparisons of pre- post-treatment BAL neutrophil counts, mucus scores, and concentrations of interleukin-8 (IL-8) or tumor necrosis factor-alpha (TNF-α) in bronchoalveolar lavage fluid (BALF) in either group. There were no differences found in the inter-group comparisons of the principal controls for each of the pre- and post-treatment time periods for BAL neutrophil count, mucus score, clinical scores, MPO activity, and IL-8 or TNF-α concentrations. The role of airway bacteria in horses with severe equine asthma requires further investigation as antimicrobial therapy improved post-treatment clinical scores and decreased MPO activity in the group of horses studied, but did not affect other measures of airway inflammation. L’objectif de la présente étude était d’observer dans un contexte clinique les résultats de l’ajout d’un traitement antimicrobien au traitement conventionnel de chevaux souffrant d’asthme sévère. Onze chevaux appartenant à des propriétaires et ayant une histoire correspondant avec de l’asthme sévère, un effort inspiratoire augmenté et un élargissement des narines, ≥ 20 % de neutrophiles dans le lavage bronchoalvéolaire (LBA), et une culture bactérienne positive à partir du lavage trachéal (LT) ont été traités par gestion de leur environnement, des corticostéroïdes, et des broncho-dilatateurs. Six chevaux ont également été traités avec un antimicrobien (groupe principal) alors que les cinq autres chevaux ont reçu de la saline à titre de placebo (groupe témoin). Le traitement avec les antimicrobiens améliora de manière significative le score clinique post-traitement du groupe principal comparativement au score pré-traitement, alors qu’aucune différence significative ne fut notée dans le groupe témoin. Dans le groupe principal on nota également qu’il y avait significativement moins d’activité myéloperoxydase (MPO) des neutrophiles post-traitement comparativement à pré-traitement, avec une différence médiane de −0,39 unités/[protéine] dans le groupe principal et une différence médiane de −0,21 unités/[protéine] dans le groupe témoin. Il n’y avait pas de différence de l’activité MPO pré- post-traitement dans le groupe témoin. Aucune différence ne fut notée dans les comparaisons intra-groupe pré- posttraitement du dénombrement de neutrophiles dans les LAB, du score de mucus, et des concentrations d’interleukine-8 (IL-8) ou du facteuralpha nécrosant des tumeurs (TNF-α) dans les liquides de lavage broncho-alvéolaire (LLBA) d’un groupe ou l’autre. Aucune différence ne fut trouvée dans les comparaisons inter-groupes du principal les témoins pour chacune des périodes de temps pré- et post-traitement pour le dénombrement des neutrophiles des LAB, le score de mucus, les scores cliniques, l’activité MPO, et les concentrations d’IL-8 ou de TNF-. Le rôle des bactéries dans les voies respiratoires des chevaux souffrant d’asthme sévère nécessite des études supplémentaires étant donné que les thérapies antimicrobiennes ont améliorés les scores cliniques post-traitement et ont diminué l’activité MPO dans le groupe de chevaux étudiés, mais n’affecta pas d’autres mesures de l’inflammation des voies respiratoires.(Traduit par Docteur Serge Messier).
Publication Date: 2018-07-22 PubMed ID: 30026642PubMed Central: PMC6040016
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  • Clinical Trial
  • Journal Article

Summary

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This research article studies the impact of using antimicrobial treatment on horses suffering from severe equine asthma by comparing a group treated with antimicrobials to a control group. The results indicate the former showed significant improvement in clinical scores and reduced myeloperoxidase (MPO) activity, although other measurements related to airway inflammation were not affected.

Objective and Methodology

  • The study observed the effects of adding an antimicrobial treatment to the traditional treatment plan for horses with severe equine asthma. This condition in horses includes symptoms like increased respiratory effort and nostril flaring, and a history of high levels of neutrophils in bronchoalveolar lavage (BAL) and a positive bacterial culture from a tracheal wash (TW).
  • A total of eleven horses, owned by clients, with a consistent history of asthma were observed. All of them were managed environmentally and were treated with corticosteroids and bronchodilators.
  • Six of these horses were treated with an additional antimicrobial (principal group), while the other five were given saline as a placebo (control group).

Key Findings

  • The group treated with antimicrobials showed a significant improvement in their post-treatment clinical scores compared to their pre-treatment scores. The control group, however, showed no significant difference.
  • There was also a substantial reduction in neutrophil myeloperoxidase (MPO) activity post-treatment as compared to pre-treatment in the principal group. In contrast, such a difference was not observed in the control group.
  • No differences were noted in either group in terms of intra-group comparisons of pre- and post-treatment BAL neutrophil counts, mucus scores, and concentrations of interleukin-8 (IL-8) or tumor necrosis factor-alpha (TNF-α) in bronchoalveolar lavage fluid (BALF).
  • Similarly, no differences were found between the principal and control groups for each of the pre- and post-treatment time periods for BAL neutrophil count, mucus score, clinical scores, MPO activity, and IL-8 or TNF-α concentrations.

Conclusion

  • The findings suggest that while antimicrobial therapy significantly improved post-treatment clinical scores and decreased MPO activity in horses with severe equine asthma, it did not affect other measurements of airway inflammation.
  • The study concludes that the role of airway bacteria in horses with severe equine asthma necessitates further research. As antimicrobial therapy could potentially be helpful as an additional treatment strategy, it is crucial to understand its specific impact and limitations.

Cite This Article

APA
Husulak ML, Manning ST, Meachem MD, Burgess HJ, Epp TY, Montgomery JB. (2018). Does antimicrobial therapy improve outcomes in horses with severe equine asthma and a positive tracheal wash bacterial culture? Can J Vet Res, 82(3), 184-191.

Publication

ISSN: 1928-9022
NlmUniqueID: 8607793
Country: Canada
Language: English
Volume: 82
Issue: 3
Pages: 184-191

Researcher Affiliations

Husulak, Michelle L
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Manning, Stephen T
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Meachem, Melissa D
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Burgess, Hilary J
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Epp, Tasha Y
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Montgomery, Julia B
  • Department of Large Animal Clinical Sciences (Husulak, Manning, Epp, Montgomery) and Department of Veterinary Pathology (Meachem, Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.

MeSH Terms

  • Animals
  • Asthma / drug therapy
  • Asthma / microbiology
  • Asthma / veterinary
  • Bronchoalveolar Lavage
  • Bronchoalveolar Lavage Fluid / cytology
  • Female
  • Horse Diseases / drug therapy
  • Horse Diseases / microbiology
  • Horses
  • Interleukin-8 / chemistry
  • Interleukin-8 / metabolism
  • Male
  • Neutrophils / enzymology
  • Peroxidase / metabolism
  • Trachea / microbiology
  • Tumor Necrosis Factor-alpha / chemistry
  • Tumor Necrosis Factor-alpha / metabolism

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Citations

This article has been cited 2 times.
  1. Mainguy-Seers S, Lavoie JP. Glucocorticoid treatment in horses with asthma: A narrative review.. J Vet Intern Med 2021 Jul;35(4):2045-2057.
    doi: 10.1111/jvim.16189pubmed: 34085342google scholar: lookup
  2. Manguin E, Pépin E, Boivin R, Leclere M. Tracheal microbial populations in horses with moderate asthma.. J Vet Intern Med 2020 Mar;34(2):986-995.
    doi: 10.1111/jvim.15707pubmed: 31985115google scholar: lookup