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Retrospective comparison of azithromycin, clarithromycin, and erythromycin for the treatment of foals with Rhodococcus equi pneumonia.
Abstract: The objective of this retrospective study was to compare the efficacy of azithromycin-rifampin, clarithromycin-rifampin, and erythromycin-rifampin for the treatment of pneumonia caused by Rhodococcus equi in foals. Eighty-one foals with naturally acquired pneumonia caused by R. equi were included in the study. Information on age, sex, breed, physical examination findings, laboratory testing, and thoracic radiography was abstracted from each medical record. Foals were divided in 3 groups based on the antimicrobial agent selected for therapy. Short-term (discharge from the hospital) and long-term (apparently healthy as a yearling) success rates, days of hospitalization, days with fever, days with tachypnea, and percentage of radiographic improvement were compared among groups. Foals treated with clarithromycin-rifampin had significantly (P = .02) higher odds of overall short-term (odds ratio [OR] = 12.2) and long-term (OR = 20.6) treatment success and significantly fewer days with fever than foals treated with erythromycin-rifampin. Foals treated with clarithromycin-rifampin had a significantly (P = .03) higher percentage of radiographic improvement and a tendency (P = .06) toward higher odds of overall short-term (OR = 8.1) and long-term (OR = 11.8) treatment success compared to foals treated with azithromycin-rifampin. Among foals with severe radiographic lesions, the success rates of foals treated with clarithromycin-rifampin both short-term (88%) and long-term (83%) were significantly (P = .02) higher than that of foals treated with azithromycin-rifampin (0%). For each treatment group, the only reported adverse effect was diarrhea that was mild and self-limiting in most cases. The combination clarithromycin-rifampin is superior to azithromycin-rifampin or erythromycin-rifampin for the treatment of pneumonia caused by R. equi in foals in a referral population.
Publication Date: 2004-08-24 PubMed ID: 15320600DOI: 10.1892/0891-6640(2004)18<568:rcoaca>2.0.co;2Google 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.
- Comparative Study
- Evaluation Study
- Journal Article
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.
The research aims to compare the effectiveness of three types of antibiotics in treating a particular type of pneumonia in foals. The study concluded that the use of clarithromycin-rifampin proves to be the most effective amongst the three in treating pneumonia caused by Rhodococcus equi.
Objective of the Study
- The research was designed as a retrospective study to compare and contrast the efficiency of azithromycin-rifampin, clarithromycin-rifampin, and erythromycin-rifampin. These were used for treating pneumonia induced by the bacterium Rhodococcus equi in foals.
Methodology and Parameters
- The study enlisted 81 foals that had naturally contracted pneumonia caused by R. equi.
- Data was collected through multiple sources such as medical records, including particulars like age, sex, breed, physical examination results, laboratory testing, and thoracic radiography.
- The foals were divided into three groups, each treated with one of the three antibiotic combinations.
- Various outcomes were compared across these groups, including short-term (discharge from the hospital) and long-term (good health as a yearling) success rates, days of hospitalization, days with fever, days with tachypnea, and percentage of radiographic improvement.
Findings of the Study
- The study found that foals treated with clarithromycin-rifampin had significantly higher odds of both short-term and long-term treatment success, and fewer days with fever, than those treated with erythromycin-rifampin.
- Moreover, the foals treated with clarithromycin-rifampin also had a significantly higher percentage of radiographic improvement and a tendency towards better overall short-term and long-term treatment success compared to foals treated with azithromycin-rifampin.
- In severe cases with complicated radiographic lesions, treatment success rates were significantly higher for foals treated with clarithromycin-rifampin, both in the short-term and in the long-term, compared to those treated with azithromycin-rifampin.
- Across all treatment groups, the only reported side effect was mild, self-limiting diarrhea.
Conclusion
- The findings suggest that the combination of clarithromycin and rifampin is superior to either azithromycin-rifampin or erythromycin-rifampin when it comes to treating pneumonia caused by R. equi in foals.
Cite This Article
APA
Giguère S, Jacks S, Roberts GD, Hernandez J, Long MT, Ellis C.
(2004).
Retrospective comparison of azithromycin, clarithromycin, and erythromycin for the treatment of foals with Rhodococcus equi pneumonia.
J Vet Intern Med, 18(4), 568-573.
https://doi.org/10.1892/0891-6640(2004)18<568:rcoaca>2.0.co;2 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA. gigueres@mail.vetmed.ufl.edu
MeSH Terms
- Actinomycetales Infections / drug therapy
- Actinomycetales Infections / veterinary
- Animals
- Animals, Newborn
- Anti-Bacterial Agents / administration & dosage
- Azithromycin / administration & dosage
- Clarithromycin / administration & dosage
- Erythromycin / administration & dosage
- Female
- Florida / epidemiology
- Horse Diseases / diagnostic imaging
- Horse Diseases / drug therapy
- Horse Diseases / epidemiology
- Horse Diseases / pathology
- Horses
- Male
- Pneumonia, Bacterial / drug therapy
- Pneumonia, Bacterial / veterinary
- Radiography
- Records / veterinary
- Retrospective Studies
- Rhodococcus equi
- Severity of Illness Index
- Treatment Outcome
Citations
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- 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.
- 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.
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- Tsuzuki N, Maruko T, Takeyama A, Ikeda H, Mizuguchi Y. Evaluation of oxidative stress in foals with Rhodococcus equi infection-induced pneumonia for the judgment of therapeutic effect. J Vet Med Sci 2023 Dec 6;85(12):1277-1280.
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