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
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- Comparative Study
- Evaluation Study
- Journal Article
Summary
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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
This article has been cited 18 times.- Liu L, Yu W, Cai K, Ma S, Wang Y, Ma Y, Zhao H. Identification of vaccine candidates against rhodococcus equi by combining pangenome analysis with a reverse vaccinology approach.. Heliyon 2023 Aug;9(8):e18623.
- Zúñiga MP, Badillo E, Abalos P, Valencia ED, Marín P, Escudero E, Galecio JS. Antimicrobial susceptibility of Rhodococcus equi strains isolated from foals in Chile.. World J Microbiol Biotechnol 2023 Jun 22;39(9):231.
- 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).
- Patterson Rosa L, Mallicote MF, MacKay RJ, Brooks SA. Ion Channel and Ubiquitin Differential Expression during Erythromycin-Induced Anhidrosis in Foals.. Animals (Basel) 2021 Nov 25;11(12).
- Rakowska A, Cywinska A, Witkowski L. Current Trends in Understanding and Managing Equine Rhodococcosis.. Animals (Basel) 2020 Oct 18;10(10).
- Ejuh GW, Fonkem C, Tadjouteu Assatse Y, Yossa Kamsi RA, Nya T, Ndukum LP, Ndjaka JMB. Study of the structural, chemical descriptors and optoelectronic properties of the drugs Hydroxychloroquine and Azithromycin.. Heliyon 2020 Aug;6(8):e04647.
- Ruocco NA 3rd, Luedke LK, Fortier LA, Ducharme NG, Reesink HL. Rhodococcus equi Joint Sepsis and Osteomyelitis Is Associated With a Grave Prognosis in Foals.. Front Vet Sci 2019;6:503.
- Trevisani MM, Hanna ES, Oliveira AF, Cardoso SA, Roque-Barreira MC, Soares SG. Vaccination of Mice with Virulence-Associated Protein G (VapG) Antigen Confers Partial Protection against Rhodococcus equi Infection through Induced Humoral Immunity.. Front Microbiol 2017;8:857.
- 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.
- 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.
- Burton AJ, Giguère S, Berghaus LJ, Hondalus MK. Activity of clarithromycin or rifampin alone or in combination against experimental Rhodococcus equi infection in mice.. Antimicrob Agents Chemother 2015;59(6):3633-6.
- 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.
- 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.
- Rivulgo V, Sparo M, Ceci M, Fumuso E, Confalonieri A, Delpech G, Bruni SF. Comparative plasma exposure and lung distribution of two human use commercial azithromycin formulations assessed in murine model: a preclinical study.. Biomed Res Int 2013;2013:392010.
- Schlusselhuber M, Jung S, Bruhn O, Goux D, Leippe M, Leclercq R, Laugier C, Grötzinger J, Cauchard J. In vitro potential of equine DEFA1 and eCATH1 as alternative antimicrobial drugs in rhodococcosis treatment.. Antimicrob Agents Chemother 2012 Apr;56(4):1749-55.
- Coulson GB, Agarwal S, Hondalus MK. Characterization of the role of the pathogenicity island and vapG in the virulence of the intracellular actinomycete pathogen Rhodococcus equi.. Infect Immun 2010 Aug;78(8):3323-34.
- Schnellmann C, Gerber V, Rossano A, Jaquier V, Panchaud Y, Doherr MG, Thomann A, Straub R, Perreten V. Presence of new mecA and mph(C) variants conferring antibiotic resistance in Staphylococcus spp. isolated from the skin of horses before and after clinic admission.. J Clin Microbiol 2006 Dec;44(12):4444-54.
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