FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / J Vet Intern Med / Efficacy of Tulathromycin for the Treatment of Foals with Mi...
Journal of veterinary internal medicine2017; 31(3); 901-906; doi: 10.1111/jvim.14717

Efficacy of Tulathromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia.

Abstract: There is conflicting data regarding the efficacy of tulathromycin for the treatment of foals with bronchopneumonia. Tulathromycin is effective for the treatment of bronchopneumonia in foals and noninferior to the combination of azithromycin and rifampin. A total of 240 foals on a farm endemic for infections caused by Rhodococcus equi. In a controlled, randomized, and double-blinded clinical trial, foals with ultrasonographic pulmonary lesions (abscess score 10-15 cm) were allocated to 3 groups: 1-tulathromycin IM q 7 days (n = 80); 2-azithromycin-rifampin, orally q24h (n = 80); or 3-untreated controls (n = 80). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were considered treatment failures and removed from the study. The proportion of foals that recovered was significantly higher for foals treated with tulathromycin (70 of 79) or azithromycin-rifampin (76 of 80) compared to that of control foals (22 of 80). The difference in the percentage of efficacy of azithromycin-rifampin versus tulathromycin was 6.4% (90% CI = -0.72-13.5%). Given that the confidence interval crossed the predetermined noninferiority limit of 10%, the null hypothesis that the response rate in the azithromycin-rifampin group is superior to that of the tulathromycin group could not be rejected. Resolution of ultrasonographic lesions occurred faster in foals treated with azithromycin-rifampin than in foals treated with tulathromycin. Tulathromycin was effective for the treatment of bronchopneumonia in foals at this farm but not as effective as the combination of azithromycin-rifampin.
Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2017-04-19 PubMed ID: 28421633PubMed Central: PMC5435035DOI: 10.1111/jvim.14717Google 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.
LinkedInCopy
  • Journal Article
  • Randomized Controlled Trial
  • Comment

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 study examines the effectiveness of the drug tulathromycin in treating foals with mild to moderate bronchopneumonia, comparing it to a combination of azithromycin and rifampin, and finds it less effective than the combination treatment.

Research Context and Methodology

  • The study was conducted via a randomized, controlled, and double-blind clinical trial to compare the efficacies of tulathromycin and a combination of azithromycin and rifampin in treating bronchopneumonia in foals. An ultrasonography method was used to choose foals with an abscess score between 10 to 15 cm.
  • 240 foals were chosen from an endemic farm affected with Rhodococcus equi infections. The foals were distributed into three groups randomly: 80 foals were treated with tulathromycin; another 80 foals were given a mixture of azithromycin and rifampin; and the remaining 80 foals were left untreated to serve as controls.
  • The individuals conducting physical examinations and thoracic ultrasonography were unaware of the treatment that each group received as the study was double-blinded.

Findings and Conclusion

  • The study found that the foals treated with either tulathromycin or combined azithromycin-rifampin showed significantly higher recovery rates compared to the untreated control group. Specifically, 70 out of 79 foals recovered in the tulathromycin treatment group, and 76 out of 80 in the azithromycin-rifampin treatment group, compared to just 22 out of 80 in the untreated control group.
  • However, the study could not reject the null hypothesis that the response rate in the azithromycin-rifampin group was superior to the tulathromycin group because the 90% Confidence Interval (CI) crossed the predetermined non-inferiority limit of 10%. Also, the ultrasonographic lesions resolved faster in foals treated with azithromycin-rifampin.
  • In conclusion, although tulathromycin was found to be effective in treating bronchopneumonia in foals, it was not as effective as the combined azithromycin-rifampin treatment.

Cite This Article

APA
Rutenberg D, Venner M, Giguère S. (2017). Efficacy of Tulathromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia. J Vet Intern Med, 31(3), 901-906. https://doi.org/10.1111/jvim.14717

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 31
Issue: 3
Pages: 901-906

Researcher Affiliations

Rutenberg, D
  • Equine Clinic, School of Veterinary Medicine, Hanover, Germany.
Venner, M
  • Veterinary Clinic, Destedt, Germany.
Giguère, S
  • Veterinary Medical Center, University of Georgia, Athens, GA.

MeSH Terms

  • Actinomycetales Infections / drug therapy
  • Actinomycetales Infections / veterinary
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / administration & dosage
  • Azithromycin / therapeutic use
  • Bronchopneumonia / drug therapy
  • Bronchopneumonia / microbiology
  • Bronchopneumonia / veterinary
  • Disaccharides / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination / veterinary
  • Female
  • Heterocyclic Compounds / therapeutic use
  • Horse Diseases / drug therapy
  • Horses
  • Male
  • Rhodococcus equi / drug effects
  • Rifampin / administration & dosage
  • Rifampin / therapeutic use
  • Treatment Outcome

References

This article includes 40 references
  1. Cohen ND. Causes of and farm management factors associated with disease and death in foals.. J Am Vet Med Assoc 1994 May 15;204(10):1644-51.
    pubmed: 8050947
  2. Hoffman AM, Viel L, Prescott JF, Rosendal S, Thorsen J. Association of microbiologic flora with clinical, endoscopic, and pulmonary cytologic findings in foals with distal respiratory tract infection.. Am J Vet Res 1993 Oct;54(10):1615-22.
    pubmed: 8250386
  3. Giguère S, Gaskin JM, Miller C, Bowman JL. Evaluation of a commercially available hyperimmune plasma product for prevention of naturally acquired pneumonia caused by Rhodococcus equi in foals.. J Am Vet Med Assoc 2002 Jan 1;220(1):59-63.
    pubmed: 12680449doi: 10.2460/javma.2002.220.59google scholar: lookup
  4. Slovis NM, McCracken JL, Mundy G. How to use thoracic ultrasound to screen foals for Rhodococcus equi at affected farms. Proc Am Assoc Equine Pract 2005;51:274–278.
  5. McCracken JL, Slovis NM. Use of thoracic ultrasound for the prevention of Rhodococcus equi pneumonia on endemic farms. Proc Am Assoc Equine Pract 2009;55:38–44.
  6. Venner M, Kerth R, Klug E. Evaluation of tulathromycin in the treatment of pulmonary abscesses in foals.. Vet J 2007 Sep;174(2):418-21.
    pubmed: 17045497doi: 10.1016/j.tvjl.2006.08.016google scholar: lookup
  7. Giguère S, Cohen ND, Chaffin MK, Slovis NM, Hondalus MK, Hines SA, Prescott JF. Diagnosis, treatment, control, and prevention of infections caused by Rhodococcus equi in foals.. J Vet Intern Med 2011 Nov-Dec;25(6):1209-20.
    pubmed: 22092608doi: 10.1111/j.1939-1676.2011.00835.xgoogle scholar: lookup
  8. Giguère S, Jacks S, Roberts GD, Hernandez J, Long MT, Ellis C. Retrospective comparison of azithromycin, clarithromycin, and erythromycin for the treatment of foals with Rhodococcus equi pneumonia.. J Vet Intern Med 2004 Jul-Aug;18(4):568-73.
    pubmed: 15320600doi: 10.1892/0891-6640(2004)18<568:rcoaca>2.0.co;2google scholar: lookup
  9. Stratton-Phelps M, Wilson WD, Gardner IA. Risk of adverse effects in pneumonic foals treated with erythromycin versus other antibiotics: 143 cases (1986-1996).. J Am Vet Med Assoc 2000 Jul 1;217(1):68-73.
    pubmed: 10909450doi: 10.2460/javma.2000.217.68google scholar: lookup
  10. Scheuch E, Spieker J, Venner M, Siegmund W. Quantitative determination of the macrolide antibiotic tulathromycin in plasma and broncho-alveolar cells of foals using tandem mass spectrometry.. J Chromatogr B Analyt Technol Biomed Life Sci 2007 May 1;850(1-2):464-70.
    pubmed: 17267304doi: 10.1016/j.jchromb.2006.12.034google scholar: lookup
  11. Venner M, Peters J, Höhensteiger N, Schock B, Bornhorst A, Grube M, Adam U, Scheuch E, Weitschies W, Rosskopf D, Kroemer HK, Siegmund W. Concentration of the macrolide antibiotic tulathromycin in broncho-alveolar cells is influenced by comedication of rifampicin in foals.. Naunyn Schmiedebergs Arch Pharmacol 2010 Feb;381(2):161-9.
    pubmed: 20012942doi: 10.1007/s00210-009-0481-1google scholar: lookup
  12. Venner M, Rödiger A, Laemmer M, Giguère S. Failure of antimicrobial therapy to accelerate spontaneous healing of subclinical pulmonary abscesses on a farm with endemic infections caused by Rhodococcus equi.. Vet J 2012 Jun;192(3):293-8.
    pubmed: 21924651doi: 10.1016/j.tvjl.2011.07.004google scholar: lookup
  13. Venner M, Astheimer K, Lämmer M, Giguère S. Efficacy of mass antimicrobial treatment of foals with subclinical pulmonary abscesses associated with Rhodococcus equi.. J Vet Intern Med 2013 Jan-Feb;27(1):171-6.
    pubmed: 23278131doi: 10.1111/jvim.12030google scholar: lookup
  14. Carlson KL, Kuskie KR, Chaffin KM, Libal MC, Giguère S, Lawhon SD, Cohen ND. Antimicrobial activity of tulathromycin and 14 other antimicrobials against virulent Rhodococcus equi in vitro.. Vet Ther 2010 Summer;11(2):E1-9.
    pubmed: 20957614
  15. Riesenberg A, Feßler AT, Erol E, Prenger-Berninghoff E, Stamm I, Böse R, Heusinger A, Klarmann D, Werckenthin C, Schwarz S. MICs of 32 antimicrobial agents for Rhodococcus equi isolates of animal origin.. J Antimicrob Chemother 2014 Apr;69(4):1045-9.
    pubmed: 24275117doi: 10.1093/jac/dkt460google scholar: lookup
  16. Kilian K. Comparative studies of the detection of Rhodococcus equi in the breath, in tracheobronchial fluids and in faeces of foals. Thesis, Veterinary School of Hanover, 2008. 128 pages.
  17. Lammer M. Detection of Rhodococcus equi in faeces and tracheobronchial secretions of foals on a farm with endemic rhodococcus: comparison of healthy foals and foals with pulmonary abscesses. Thesis, Veterinary School of Hanover, 2010. 116 pages.
  18. Venner M, Heyers P, Strutzberg-Minder K, Lorenz N, Verspohl J, Klug E. [Detection of rhodococcus equi by microbiological culture and by polymerase chain reaction in samples of tracheobronchial secretions of foals].. Berl Munch Tierarztl Wochenschr 2007 Mar-Apr;120(3-4):126-33.
    pubmed: 17416135
  19. Venner M, Meyer-Hamme B, Verspohl J, Hatori F, Shimizu N, Sasaki Y, Kakuda T, Tsubaki S, Takai S. Genotypic characterization of VapA positive Rhodococcus equi in foals with pulmonary affection and their soil environment on a warmblood horse breeding farm in Germany.. Res Vet Sci 2007 Dec;83(3):311-7.
    pubmed: 17360011doi: 10.1016/j.rvsc.2007.01.009google scholar: lookup
  20. Hagist C. Genotypisierung von Rhodococcus equi stämmen aus Deutschland, isoliert bei fohlen und anderen tierarten. Thesis, Veterinary School of Hanover, 2016. 134 pages.
  21. Weimar BM. Lung abscesses in foals: Evaluation of clinical, ultrasonic, endoscopical, pathomorphological and microbiological findings. Thesis, Veterinary School of Hanover, 2006. 157 pages.
  22. Giguère S, Hernandez J, Gaskin J, Miller C, Bowman JL. Evaluation of white blood cell concentration, plasma fibrinogen concentration, and an agar gel immunodiffusion test for early identification of foals with Rhodococcus equi pneumonia.. J Am Vet Med Assoc 2003 Mar 15;222(6):775-81.
    pubmed: 12675301doi: 10.2460/javma.2003.222.775google scholar: lookup
  23. Venner M, Reinhold B, Beyerbach M, Feige K. Efficacy of azithromycin in preventing pulmonary abscesses in foals.. Vet J 2009 Feb;179(2):301-3.
    pubmed: 18023599doi: 10.1016/j.tvjl.2007.10.002google scholar: lookup
  24. El Garch F, de Jong A, Simjee S, Moyaert H, Klein U, Ludwig C, Marion H, Haag-Diergarten S, Richard-Mazet A, Thomas V, Siegwart E. Monitoring of antimicrobial susceptibility of respiratory tract pathogens isolated from diseased cattle and pigs across Europe, 2009-2012: VetPath results.. Vet Microbiol 2016 Oct 15;194:11-22.
    pubmed: 27102206doi: 10.1016/j.vetmic.2016.04.009google scholar: lookup
  25. Gajda A, Bladek T, Jablonski A, Posyniak A. The influence of Actinobacillus pleuropneumoniae infection on tulathromycin pharmacokinetics and lung tissue disposition in pigs.. J Vet Pharmacol Ther 2016 Apr;39(2):176-82.
    pubmed: 26270490doi: 10.1111/jvp.12259google scholar: lookup
  26. Schunicht OC, Booker CW, Guichon PT, Jim GK, Wildman BK, Pittman TJ, Perrett T. An evaluation of the relative efficacy of tulathromycin for the treatment of undifferentiated fever in feedlot calves in Nebraska.. Can Vet J 2007 Jun;48(6):600-6.
    pmc: PMC1876186pubmed: 17616056
  27. Wellman NG, O'Connor AM. Meta-analysis of treatment of cattle with bovine respiratory disease with tulathromycin.. J Vet Pharmacol Ther 2007 Jun;30(3):234-41.
    pubmed: 17472655doi: 10.1111/j.1365-2885.2007.00846.xgoogle scholar: lookup
  28. Foster DM, Martin LG, Papich MG. Comparison of Active Drug Concentrations in the Pulmonary Epithelial Lining Fluid and Interstitial Fluid of Calves Injected with Enrofloxacin, Florfenicol, Ceftiofur, or Tulathromycin.. PLoS One 2016;11(2):e0149100.
    pmc: PMC4752255pubmed: 26872361doi: 10.1371/journal.pone.0149100google scholar: lookup
  29. McClary DG, Loneragan GH, Shryock TR, Carter BL, Guthrie CA, Corbin MJ, Mechor GD. Relationship of in vitro minimum inhibitory concentrations of tilmicosin against Mannheimia haemolytica and Pasteurella multocida and in vivo tilmicosin treatment outcome among calves with signs of bovine respiratory disease.. J Am Vet Med Assoc 2011 Jul 1;239(1):129-35.
    pubmed: 21718206doi: 10.2460/javma.239.1.129google scholar: lookup
  30. Giamarellos-Bourboulis EJ. Macrolides beyond the conventional antimicrobials: a class of potent immunomodulators.. Int J Antimicrob Agents 2008 Jan;31(1):12-20.
    pubmed: 17935949doi: 10.1016/j.ijantimicag.2007.08.001google scholar: lookup
  31. Fischer CD, Beatty JK, Zvaigzne CG, Morck DW, Lucas MJ, Buret AG. Anti-Inflammatory benefits of antibiotic-induced neutrophil apoptosis: tulathromycin induces caspase-3-dependent neutrophil programmed cell death and inhibits NF-kappaB signaling and CXCL8 transcription.. Antimicrob Agents Chemother 2011 Jan;55(1):338-48.
    pmc: PMC3019645pubmed: 20956586doi: 10.1128/aac.01052-10google scholar: lookup
  32. Fischer CD, Duquette SC, Renaux BS, Feener TD, Morck DW, Hollenberg MD, Lucas MJ, Buret AG. Tulathromycin exerts proresolving effects in bovine neutrophils by inhibiting phospholipases and altering leukotriene B4, prostaglandin E2, and lipoxin A4 production.. Antimicrob Agents Chemother 2014 Aug;58(8):4298-307.
    pmc: PMC4136062pubmed: 24820086doi: 10.1128/aac.02813-14google scholar: lookup
  33. Fischer CD, Beatty JK, Duquette SC, Morck DW, Lucas MJ, Buret AG. Direct and indirect anti-inflammatory effects of tulathromycin in bovine macrophages: inhibition of CXCL-8 secretion, induction of apoptosis, and promotion of efferocytosis.. Antimicrob Agents Chemother 2013 Mar;57(3):1385-93.
    pmc: PMC3591872pubmed: 23295921doi: 10.1128/aac.01598-12google scholar: lookup
  34. Venner M, Credner N, Lämmer M, Giguère S. Comparison of tulathromycin, azithromycin and azithromycin-rifampin for the treatment of mild pneumonia associated with Rhodococcus equi.. Vet Rec 2013 Oct 26;173(16):397.
    pubmed: 24106244doi: 10.1136/vr.101867google scholar: lookup
  35. 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.
    pmc: PMC4858060pubmed: 25619521doi: 10.1111/jvim.12504google scholar: lookup
  36. Nordmann P, Ronco E. In-vitro antimicrobial susceptibility of Rhodococcus equi.. J Antimicrob Chemother 1992 Apr;29(4):383-93.
    pubmed: 1607327doi: 10.1093/jac/29.4.383google scholar: lookup
  37. Prescott JF, Nicholson VM. The effects of combinations of selected antibiotics on the growth of Corynebacterium equi.. J Vet Pharmacol Ther 1984 Mar;7(1):61-4.
    pubmed: 6561258doi: 10.1111/j.1365-2885.1984.tb00880.xgoogle scholar: lookup
  38. Giguère S, Lee EA, Guldbech KM, Berghaus LJ. In vitro synergy, pharmacodynamics, and postantibiotic effect of 11 antimicrobial agents against Rhodococcus equi.. Vet Microbiol 2012 Nov 9;160(1-2):207-13.
    pubmed: 22704561doi: 10.1016/j.vetmic.2012.05.031google scholar: lookup
  39. Berghaus LJ, Giguère S, Guldbech K. Mutant prevention concentration and mutant selection window for 10 antimicrobial agents against Rhodococcus equi.. Vet Microbiol 2013 Oct 25;166(3-4):670-5.
    pubmed: 23915992doi: 10.1016/j.vetmic.2013.07.006google scholar: lookup
  40. Kees F, Wellenhofer M, Bröhl K, Grobecker H. Bioavailability of cefpodoxime proxetil with co-administered acetylcysteine.. Arzneimittelforschung 1996 Apr;46(4):435-8.
    pubmed: 8740095

Citations

This article has been cited 6 times.
  1. Onzere CK, Hulbert M, Sears KP, Williams LBA, Fry LM. Tulathromycin and Diclazuril Lack Efficacy against Theileria haneyi, but Tulathromycin Is Not Associated with Adverse Clinical Effects in Six Treated Adult Horses.. Pathogens 2023 Mar 14;12(3).
    doi: 10.3390/pathogens12030453pubmed: 36986375google scholar: lookup
  2. Rakowska A, Marciniak-Karcz A, Bereznowski A, Cywińska A, Żychska M, Witkowski L. Less Typical Courses of Rhodococcus equi Infections in Foals.. Vet Sci 2022 Oct 31;9(11).
    doi: 10.3390/vetsci9110605pubmed: 36356082google scholar: lookup
  3. Zhu X, Wei Z, Liu X. Efficacy of Ambroxol Hydrochloride Combined with Amoxicillin Potassium Clavulanate Combination on Children with Bronchopneumonia and Its Impact on the Level of Inflammatory Factors.. Evid Based Complement Alternat Med 2022;2022:2604114.
    doi: 10.1155/2022/2604114pubmed: 36034961google scholar: lookup
  4. Wu C, Zha D, Gao H. Prediction of Bronchopneumonia Inpatients' Total Hospitalization Expenses Based on BP Neural Network and Support Vector Machine Models.. Comput Math Methods Med 2022;2022:9275801.
    doi: 10.1155/2022/9275801pubmed: 35633928google scholar: lookup
  5. 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.
    doi: 10.2903/j.efsa.2022.7081pubmed: 35136423google scholar: lookup
  6. 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
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.