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Veterinary surgery : VS2020; 49(3); 427-435; doi: 10.1111/vsu.13382

Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses.

Abstract: To describe perioperative antimicrobial use in horses undergoing elective arthroscopy. Methods: Retrospective study. Methods: Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions. Methods: Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis of variance, χ test was used for categorical comparisons, and least squares fit was used to evaluate factors associated with duration of postoperative antimicrobials. Results: Among 150 horses, 149 (99.3%) received systemic preoperative antimicrobials. Only 53 (40.2%) horses were administered doses within 60 minutes of surgical incision. First incision was performed more than two half-lives after administration of sodium penicillin in 46 of 131 (35.1%) horses but in only 1 of 106 (0.8%) horses that received trimethoprim-sulfadoxine. Body weight was associated with underdosing for penicillin (P = .0075) and trimethoprim-sulfadoxine (P = .002) but not gentamicin (P = .92). Twenty-six (17%) horses received one postoperative antimicrobial dose, while antimicrobials were continued in hospital for a mean of 22.3 ± 4.4 hours after surgery in the other 123 horses. Among the 149 discharged horses, 115 (77.2%) were prescribed antimicrobials after discharge (range, 3-10 days; median, 3 days, interquartile range, 0 days). Conclusions: Deviations from common recommendations were apparent and provide evidence for the requirement to develop interventions to optimize perioperative prophylaxis. Conclusions: Perioperative antimicrobial use practices should be regularly assessed to provide a benchmark and identify areas for intervention.
© 2020 The American College of Veterinary Surgeons.
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Publication Date: 2020-01-17 PubMed ID: 31950522DOI: 10.1111/vsu.13382Google Scholar: Lookup
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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 article investigates how antibiotics are used before, during, and after elective arthroscopy surgery in horses. The study looked at horses’ medical records to assess antibiotic use and found that practices often deviated from standard recommendations, suggesting the need for improved interventions.

Study Design and Methods

  • The study was conducted retrospectively, using medical records from surgeries performed at a single institution between July 2016 and May 2018.
  • Horses with infectious orthopedic disease or a comorbidity affecting antibiotic use decisions were excluded.
  • Usage of antibiotics was assessed at three stages – preoperative, intraoperative, and postoperative. The selection of the drug, its dose, and timing of administration were evaluated.
  • The research employed analysis of variance, chi-square test, and least squares fit statistical methods to understand factors influencing antibiotic use, specifically duration of postoperative antibiotics and association of body weight with underdosing.

Findings

  • Almost all horses (99.3%) received antibiotics before surgery, but only 40.2% within the recommended 60-minute window prior to surgical incision.
  • In 35.1% of horses given sodium penicillin, the first incision was made after more than two half-lives of the drug had passed since its administration. This poorly timed administration was less common in horses that received trimethoprim-sulfadoxine (0.8%).
  • Body weight influenced the likelihood of underdosing for penicillin and trimethoprim-sulfadoxine, but not for gentamicin.
  • About 17% of horses received only one postoperative dose of antibiotics. For the rest, antibiotics were given in the hospital for an average of 22.3 hours after surgery.
  • Of the horses sent home, 77.2% were prescribed antibiotics to take (for anywhere from 3-10 days).

Conclusions and Implications

  • The study found there were deviations from commonly recommended practices for the use of antibiotics. This underlines the need for developing interventions to optimize perioperative prophylaxis (i.e., to prevent post-surgery infections).
  • The findings suggest perioperative antimicrobial usage practices should be regularly assessed as a benchmark for identifying areas that need intervention and improvement.

Cite This Article

APA
Muntwyler N, Dubois MS, Weese JS. (2020). Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses. Vet Surg, 49(3), 427-435. https://doi.org/10.1111/vsu.13382

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 49
Issue: 3
Pages: 427-435

Researcher Affiliations

Muntwyler, Noah
  • Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Dubois, Marie-Soleil
  • Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Weese, J Scott
  • Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Arthroscopy / veterinary
  • Elective Surgical Procedures / veterinary
  • Female
  • Horse Diseases / surgery
  • Horses
  • Male
  • Perioperative Period / veterinary
  • Retrospective Studies
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / prevention & control

References

This article includes 26 references
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Citations

This article has been cited 6 times.
  1. Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. Current Antimicrobial Use in Horses Undergoing Exploratory Celiotomy: A Survey of Board-Certified Equine Specialists. Animals (Basel) 2023 Apr 22;13(9).
    doi: 10.3390/ani13091433pubmed: 37174470google scholar: lookup
  2. Gandini M, Cerullo A, Franci P, Giusto G. Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report. Vet Sci 2022 Oct 4;9(10).
    doi: 10.3390/vetsci9100546pubmed: 36288159google scholar: lookup
  3. Merchán A, Koenig J, Côté N, Cribb N, Monteith G. Fragment size is associated with post-operative complications following elective arthroscopy of the tibiotarsal joint of horses. Can Vet J 2022 Jan;63(1):74-80.
    pubmed: 34975171
  4. Ceriotti S, Westerfeld R, Bonilla AG, Pang DSJ. Use of Clinical Audits to Evaluate Timing of Preoperative Antimicrobials in Equine Surgery at a Veterinary Teaching Hospital. Front Vet Sci 2021;8:630111.
    doi: 10.3389/fvets.2021.630111pubmed: 33842572google scholar: lookup
  5. Pezzanite LM, Griffenhagen GM, Krause DM, Hendrickson DA. Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy. Vet Med Sci 2021 May;7(3):609-620.
    doi: 10.1002/vms3.447pubmed: 33595201google scholar: lookup
  6. Recchi L, Cribb N, Côté N, Dubois MS, Koenig J, Valverde A, Monteith G. Retrospective study of perioperative antimicrobial use in horses undergoing elective laparoscopy at a single institution. Can J Vet Res 2024 Jan;88(1):24-29.
    pubmed: 38222072
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