Analyze Diet
Journal of veterinary internal medicine2012; 27(1); 171-176; doi: 10.1111/jvim.12030

Efficacy of mass antimicrobial treatment of foals with subclinical pulmonary abscesses associated with Rhodococcus equi.

Abstract: Mass antimicrobial treatment of foals with small subclinical ultrasonographic pulmonary lesions is empirical practice on many farms with endemic disease caused by Rhodococcus equi. Objective: Mass antimicrobial treatment of foals with subclinical ultrasonographic pulmonary lesions is unnecessary. Methods: One hundred and eight foals on a farm endemic for infections caused by R. equi. Methods: Controlled, randomized, and double-blinded prospective study. Foals with ultrasonographic evidence of pulmonary abscesses 5.0-10 cm in diameter (n = 108) were randomly allocated in 5 treatment groups: (1) tulathromycin IM; (2) doxycycline monotherapy PO; (3) doxycycline with rifampin PO; (4) azithromycin with rifampin PO, and (5) saline IM as a placebo. Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals with evidence of disease progression were removed from the study and treated with azithromycin-rifampin. Results: Overall, 22/25 (88%) foals in the placebo group recovered without the need for treatment. The proportion of foals that had evidence of disease progression did not differ significantly between the treatment groups (P > .05). Although the median duration of treatment was significantly (P < .05) shorter in foals treated with azithromycin-rifampin (46 days) compared with foals treated with the placebo (73 days), the time frame of ultrasonographic lesion resolution did not differ significantly between the treatment groups. Conclusions: The majority of foals with subclinical pulmonary abscesses <10 cm in diameter recover without antimicrobial treatment and treatment of affected foals does not provide a clear benefit over administration of a placebo.
Publication Date: 2012-12-28 PubMed ID: 23278131DOI: 10.1111/jvim.12030Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article
  • Randomized Controlled Trial

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 investigates the effectiveness of mass antimicrobial treatment on foals with subclinical pulmonary abscesses caused by Rhodococcus equi. The results indicate that most foals affected recover without needing such treatment and there seems to be no clear advantage over administration of a placebo.

Study Methodology

  • The study was a controlled, randomized, and double-blind trial conducted on a farm with an endemic presence of infections caused by Rhodococcus equi.
  • A total of 108 foals possessing ultrasonographic evidence of pulmonary abscesses ranging from 5.0-10 cm in diameter were included.
  • These foals were randomly divided into five groups which were administered different treatments: (1) Tulathromycin IM, (2) Doxycycline monotherapy PO, (3) Doxycycline with Rifampin PO, (4) Azithromycin with Rifampin PO, and (5) Saline IM as a placebo.
  • Physical examinations and thoracic ultrasonography were performed by individuals who were kept unaware of the treatment group assignments.
  • Foals that showed disease progression were removed from the study and treated with Azithromycin-Rifampin.

Study Findings

  • From the findings, it was observed that 88% of the foals in the placebo group recovered without needing treatment.
  • The rate of disease progression did not significantly differ between the various treatment groups.
  • While the median duration of treatment was significantly shorter in foals treated with Azithromycin-Rifampin (46 days) compared to those treated with the placebo (73 days), the time taken for the ultrasonographic lesions to resolve did not vary significantly between the groups.

Conclusion

  • The findings suggest that the majority of foals with subclinical pulmonary abscesses less than 10 cm in diameter are likely to recover without antimicrobial treatment.
  • The study also found that providing treatment to affected foals does not confer any clear advantage compared to using a placebo.

This study’s findings could influence the treatment protocols in farms with a high prevalence of Rhodococcus equi, potentially reducing unnecessary use of antimicrobials.

Cite This Article

APA
Venner M, Astheimer K, Lämmer M, Giguère S. (2012). Efficacy of mass antimicrobial treatment of foals with subclinical pulmonary abscesses associated with Rhodococcus equi. J Vet Intern Med, 27(1), 171-176. https://doi.org/10.1111/jvim.12030

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 27
Issue: 1
Pages: 171-176

Researcher Affiliations

Venner, M
  • Veterinary Clinic, Destedt, Germany.
Astheimer, K
    Lämmer, M
      Giguère, S

        MeSH Terms

        • Actinomycetales Infections / drug therapy
        • Actinomycetales Infections / veterinary
        • Animals
        • Anti-Bacterial Agents / therapeutic use
        • Double-Blind Method
        • Female
        • Horse Diseases / drug therapy
        • Horse Diseases / microbiology
        • Horses
        • Lung Abscess / drug therapy
        • Lung Abscess / veterinary
        • Male
        • Rhodococcus equi
        • Treatment Outcome

        Citations

        This article has been cited 21 times.
        1. Erol E, Scortti M, Fortner J, Patel M, Vázquez-Boland JA. Antimicrobial Resistance Spectrum Conferred by pRErm46 of Emerging Macrolide (Multidrug)-Resistant Rhodococcus equi. J Clin Microbiol 2021 Sep 20;59(10):e0114921.
          doi: 10.1128/JCM.01149-21pubmed: 34319806google scholar: lookup
        2. Álvarez-Narváez S, Huber L, Giguère S, Hart KA, Berghaus RD, Sanchez S, Cohen ND. Epidemiology and Molecular Basis of Multidrug Resistance in Rhodococcus equi. Microbiol Mol Biol Rev 2021 May 19;85(2).
          doi: 10.1128/MMBR.00011-21pubmed: 33853933google scholar: lookup
        3. Rosa B. Equine Drug Transporters: A Mini-Review and Veterinary Perspective. Pharmaceutics 2020 Nov 8;12(11).
          doi: 10.3390/pharmaceutics12111064pubmed: 33171593google scholar: lookup
        4. Rakowska A, Cywinska A, Witkowski L. Current Trends in Understanding and Managing Equine Rhodococcosis. Animals (Basel) 2020 Oct 18;10(10).
          doi: 10.3390/ani10101910pubmed: 33081047google scholar: lookup
        5. Álvarez-Narváez S, Giguère S, Berghaus LJ, Dailey C, Vázquez-Boland JA. Horizontal Spread of Rhodococcus equi Macrolide Resistance Plasmid pRErm46 across Environmental Actinobacteria. Appl Environ Microbiol 2020 Apr 17;86(9).
          doi: 10.1128/AEM.00108-20pubmed: 32169935google scholar: lookup
        6. Álvarez-Narváez S, Berghaus LJ, Morris ERA, Willingham-Lane JM, Slovis NM, Giguere S, Cohen ND. A Common Practice of Widespread Antimicrobial Use in Horse Production Promotes Multi-Drug Resistance. Sci Rep 2020 Jan 22;10(1):911.
          doi: 10.1038/s41598-020-57479-9pubmed: 31969575google scholar: lookup
        7. Álvarez-Narváez S, Giguère S, Anastasi E, Hearn J, Scortti M, Vázquez-Boland JA. Clonal Confinement of a Highly Mobile Resistance Element Driven by Combination Therapy in Rhodococcus equi. mBio 2019 Oct 15;10(5).
          doi: 10.1128/mBio.02260-19pubmed: 31615959google scholar: lookup
        8. Cywes-Bentley C, Rocha JN, Bordin AI, Vinacur M, Rehman S, Zaidi TS, Meyer M, Anthony S, Lambert M, Vlock DR, Giguère S, Cohen ND, Pier GB. Antibody to Poly-N-acetyl glucosamine provides protection against intracellular pathogens: Mechanism of action and validation in horse foals challenged with Rhodococcus equi. PLoS Pathog 2018 Jul;14(7):e1007160.
          doi: 10.1371/journal.ppat.1007160pubmed: 30024986google scholar: lookup
        9. 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.
          doi: 10.1111/jvim.14717pubmed: 28421633google scholar: lookup
        10. Willingham-Lane JM, Berghaus LJ, Giguère S, Hondalus MK. Influence of Plasmid Type on the Replication of Rhodococcus equi in Host Macrophages. mSphere 2016 Sep-Oct;1(5).
          doi: 10.1128/mSphere.00186-16pubmed: 27747295google scholar: lookup
        11. Giguère S, Berghaus LJ, Miller CD. Clinical Assessment of a Point-of-Care Serum Amyloid A Assay in Foals with Bronchopneumonia. J Vet Intern Med 2016 Jul;30(4):1338-43.
          doi: 10.1111/jvim.13978pubmed: 27296082google scholar: lookup
        12. 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.
          doi: 10.1371/journal.pone.0136586pubmed: 26305682google scholar: lookup
        13. 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.
          doi: 10.1111/jvim.12595pubmed: 25868480google scholar: lookup
        14. Prohl A, Lohr M, Ostermann C, Liebler-Tenorio E, Berndt A, Schroedl W, Rothe M, Schubert E, Sachse K, Reinhold P. Enrofloxacin and macrolides alone or in combination with rifampicin as antimicrobial treatment in a bovine model of acute Chlamydia psittaci infection. PLoS One 2015;10(3):e0119736.
          doi: 10.1371/journal.pone.0119736pubmed: 25768665google scholar: lookup
        15. 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.
          doi: 10.1111/jvim.12504pubmed: 25619521google scholar: lookup
        16. Berghaus LJ, Giguère S, Guldbech K, Warner E, Ugorji U, Berghaus RD. Comparison of Etest, disk diffusion, and broth macrodilution for in vitro susceptibility testing of Rhodococcus equi. J Clin Microbiol 2015 Jan;53(1):314-8.
          doi: 10.1128/JCM.02673-14pubmed: 25378571google scholar: lookup
        17. Si W, Zhang J, Zhang Y, Ji Y, Khan MZ, Chen Y, Cheng Z, Zhuang J, Zhao X, Liu W. Characterization of Bacterial Communities in Air and Bedding Materials of Intensive Donkey Farms During Summer. Microorganisms 2025 Dec 26;14(1).
        18. Berghaus LJ, Venner M, Helbig H, Hildebrandt D, Hart K. The potential value of cytokine, cortisol and vitamin D profiles in foals from birth to weaning for respiratory disease prediction on a farm endemic for Rhodococcus equi pneumonia. Equine Vet J 2026 Mar;58(2):359-371.
          doi: 10.1111/evj.70093pubmed: 40923138google scholar: lookup
        19. Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
          doi: 10.1111/avj.70003pubmed: 40903020google scholar: lookup
        20. Baptiste KE, Kyvsgaard NC, Ahmed MO, Damborg P, Dowling PM. Is Rifampin (Rifampicin) Essential for the Treatment of Rhodococcus equi Infections in Foals? A Critical Review of the Role of Rifampin. J Vet Pharmacol Ther 2025 Sep;48(5):345-358.
          doi: 10.1111/jvp.70007pubmed: 40552784google scholar: lookup
        21. Huguet AS, Gourbeyre O, Bernand A, Philibert C, Bousquet-Melou A, Lallemand EA, Ferran AA. Comparative bactericidal activity of four macrolides alone and combined with rifampicin or doxycycline against Rhodococcus equi at concentrations achievable in foals. Front Pharmacol 2024;15:1458496.
          doi: 10.3389/fphar.2024.1458496pubmed: 39624843google scholar: lookup