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Veterinary medicine and science2021; 7(3); 609-620; doi: 10.1002/vms3.447

Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy.

Abstract: Prophylactic perioperative antimicrobial protocols in equine synovial endoscopy have been described but not compared with respect to post-operative outcomes and complications. Increasing antimicrobial resistance in equine practice and interest in promoting judicious use of antimicrobials has prompted reevaluation of drug selection and dosing strategies. To determine the frequency of and compare post-operative complications following elective synovial endoscopy between horses receiving different perioperative antimicrobial protocols. Records from the Colorado State University Veterinary Teaching Hospital were evaluated (2014-2018) and equine patients undergoing elective synovial endoscopy were identified. Patients undergoing endoscopy for sepsis or internal fixation were excluded. Patient signalment, clinician, joint and limb involved, perioperative antimicrobial regimen, number endoscopic portals and closure technique, and post-operative complications including incidence of joint infection were recorded. Generalized linear models were used to estimate the odds of post-operative complications. Elective synovial endoscopies of 516 horses in 537 procedures evaluating 761 synovial structures were performed. No horses developed post-operative septic synovitis. Administration of post-operative antimicrobials, type used and patient sex were all significantly associated with increased risk of complications, which were predominantly gastrointestinal-related. Complication rates in horses receiving a single preoperative dose of cefazolin were lower than in horses receiving potassium penicillin, gentamicin or multiple doses. Complication rates were lower in females compared to castrated or intact males. Other factors evaluated (breed, age, surgeon, anaesthesia duration or hospitalization, joint/limb operated, number endoscopic portals) were not associated with increased risk of complications post-operatively in this case population. Prophylactic perioperative antimicrobial protocols in equine practice deserve periodic reconsideration due to increased antimicrobial resistance. Prolonged antimicrobial usage beyond the time of surgery was unnecessary to prevent septic synovitis following synovial endoscopy in this case population and was furthermore associated with an increased risk of gastrointestinal complications.
© 2021 The Authors Veterinary Medicine and Science Published by John Wiley & Sons Ltd.
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Publication Date: 2021-02-17 PubMed ID: 33595201PubMed Central: PMC8136966DOI: 10.1002/vms3.447Google 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.

The research investigated the connection between different perioperative antimicrobial protocols and post-operative complications in horses that underwent elective synovial endoscopy. It found that prolonged use of antimicrobials beyond surgery time was not required to prevent septic synovitis and was, in fact, associated with higher risks of gastrointestinal complications.

Research Context

  • The study was motivated by rising antimicrobial resistance and the need to be more judicious with the use of antimicrobials in equine practice. This led to the reevaluation of drug selection and dosing strategies for horses undergoing synovial endoscopy — a surgical procedure used to diagnose and treat conditions within a joint.

Methodology

  • The researchers evaluated records from 2014-2018 from the Colorado State University Veterinary Teaching Hospital, tallying horses that went through elective synovial endoscopy. Horses that had sepsis or internal fixation were kept out of the research.
  • Various factors were recorded, including patient sex, clinician, involved limb and joint, perioperative antimicrobial regimen, number of endoscopic portals, closure technique, and post-operative complications.
  • The authors used generalized linear models to assess the chances of post-operative complications.

Findings

  • The study involved 516 horses in 537 procedures assessing 761 synovial structures. No post-operative septic synovitis was noted in the horses.
  • A significantly higher risk of complications, mostly gastrointestinal-related, was linked to the administration of post-operative antimicrobials, the type of antimicrobials used, and patient sex.
  • Horses that received a single preoperative dose of the antibiotic cefazolin experienced lower complication rates than those given potassium penicillin, gentamicin, or multiple doses.
  • Females had lower complication rates compared to castrated or intact males. Factors such as breed, age, surgeon, duration of anaesthesia or hospitalization, and the number of endoscopic portals, were not linked to increased risk of complications post-operatively.

Conclusions

  • The researchers concluded that due to increasing antimicrobial resistance, the routines around prophylactic perioperative antimicrobial protocols in equine practice need to be reconsidered periodically.
  • The findings suggest that sustained antimicrobial use beyond the time of surgery was unnecessary to prevent septic synovitis after synovial endoscopy, and that such practice could instead result in a higher risk of gastrointestinal complications.

Cite This Article

APA
Pezzanite LM, Griffenhagen GM, Krause DM, Hendrickson DA. (2021). Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy. Vet Med Sci, 7(3), 609-620. https://doi.org/10.1002/vms3.447

Publication

Veterinary medicine and science
ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 7
Issue: 3
Pages: 609-620

Researcher Affiliations

Pezzanite, Lynn M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, CO, USA.
Griffenhagen, Gregg M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, CO, USA.
Krause, Danielle M
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, CO, USA.
Hendrickson, Dean A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, CO, USA.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Elective Surgical Procedures / statistics & numerical data
  • Elective Surgical Procedures / veterinary
  • Endoscopy / adverse effects
  • Endoscopy / veterinary
  • Female
  • Horses / surgery
  • Male
  • Perioperative Period / statistics & numerical data
  • Perioperative Period / veterinary
  • Postoperative Complications / etiology
  • Postoperative Complications / veterinary
  • Retrospective Studies
  • Sex Factors

Grant Funding

  • TL1 TR002533 / NCATS NIH HHS
  • T32 OD010437 / NIH HHS

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

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Citations

This article has been cited 1 times.
  1. 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
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