Initial antimicrobial treatment of foals with sepsis: Do our choices make a difference?

This is an investigation into the impacts of initial antimicrobial treatments, particularly using amikacin and ampicillin, on the survival chances of foals below 30 days old diagnosed with sepsis.

Study Overview

• The research aims to gather cumulative antimicrobial susceptibility data at the individual patient level, and also determine the correlation between initial antimicrobial treatment and survival probability in foals diagnosed with sepsis.
• The candidate foals for the study were required to be under the age of 30 days, and the diagnosis of sepsis had to be confirmed through bacteria isolation from normally sterile sites upon admission to the hospital.
• The method of susceptibility testing employed in the study was the broth microdilution procedure.

Data & Results

• In all, 213 foals and 306 bacterial isolates were included in the study.
• The researchers found that the likelihood of survival for foals in which all bacteria were susceptible to the initial antimicrobial treatment was 65.4%
• The survival rate decreased to 41.7% if it was found that one or more isolates were resistant to the initial treatment. This suggests that initial treatment is less effective with resistant bacteria.
• The relative risk calculation resulted in a value of 1.57, further supporting the observation that resistance to initial treatment can negatively impact survival rates.

Conclusion

• This study concludes that the combination of amikacin and ampicillin, as an initial drug therapy, remains a suitable choice for the treatment of sepsis in foals.
• It underscores the importance of drug susceptibility testing in ensuring the effectiveness of treatments and improving survival outcomes for foals with sepsis.
• However, further investigation may be necessary to ascertain the effects of different antibiotic combinations, the consequences of resistance, and the development of more effective initial treatments.