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Home / Equine Research Bank / Vet Clin North Am Equine Pract / Treatment of Infections Caused by Rhodococcus equi.
The Veterinary clinics of North America. Equine practice2017; 33(1); 67-85; doi: 10.1016/j.cveq.2016.11.002

Treatment of Infections Caused by Rhodococcus equi.

Abstract: Pneumonia caused by Rhodococcus equi remains an important cause of disease and death in foals. The combination of a macrolide (erythromycin, azithromycin, or clarithromycin) with rifampin remains the recommended therapy for foals with clinical signs of infection caused by R equi. Most foals with small, subclinical ultrasonographic pulmonary lesions associated with R equi recover without therapy, and administration of antimicrobial agents to these subclinically affected foals does not hasten lesion resolution relative to administration of a placebo. Resistance to macrolides and rifampin in isolates of R equi is increasing.
Copyright © 2016 Elsevier Inc. All rights reserved.
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Publication Date: 2017-02-01 PubMed ID: 28161038DOI: 10.1016/j.cveq.2016.11.002Google 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 focuses on the treatment of pneumonia in foals caused by Rhodococcus equi, stating that using a macrolide and rifampin combination is the typical recommended therapy. The study also highlights increasing resistance to these treatments in R. equi isolates.

About Rhodococcus equi

  • Rhodococcus equi is a bacterium that causes pneumonia, a serious lung infection, predominantly in foals.
  • If left untreated, this infection can often lead to disease and death.

Treatment Strategy

  • The research emphasises that the best-named treatment for infections caused by R. equi is a combined therapy of a macrolide (erythromycin, azithromycin, or clarithromycin) and rifampin.
  • This is specifically for foals exhibiting clinical signs of the infection.

Subclinical Ultrasonographic Pulmonary Lesions

  • The study points out that most foals with small, subclinical ultrasonographic pulmonary lesions associated with R. equi are often to recover without therapy.
  • Provision of antimicrobial agents to these foals does not hasten lesion resolution compared to the administration of a placebo. In other words, antibiotics do not necessarily speed up recovery in these mild cases.

Increasing Resistance

  • One of the most concerning findings of the study is the increase in resistance to the macrolide-rifampin combination therapy within isolates of R. equi.
  • This suggests that these treatments may become less effective over time, posing a significant challenge for preventing and treating infections caused by R. equi in the future.

Cite This Article

APA
Giguère S. (2017). Treatment of Infections Caused by Rhodococcus equi. Vet Clin North Am Equine Pract, 33(1), 67-85. https://doi.org/10.1016/j.cveq.2016.11.002

Publication

The Veterinary clinics of North America. Equine practice
ISSN: 1558-4224
NlmUniqueID: 8511904
Country: United States
Language: English
Volume: 33
Issue: 1
Pages: 67-85
PII: S0749-0739(16)30077-3

Researcher Affiliations

Giguère, Steeve
  • Department of Large Animal Medicine, Veterinary Medical Center, University of Georgia, Athens GA 30605. Electronic address: gigueres@uga.edu.

MeSH Terms

  • Actinomycetales Infections / drug therapy
  • Actinomycetales Infections / veterinary
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Clarithromycin / pharmacology
  • Drug Resistance, Multiple, Bacterial
  • Erythromycin / therapeutic use
  • Horse Diseases / drug therapy
  • Horse Diseases / microbiology
  • Horses
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / veterinary
  • Rhodococcus equi / isolation & purification
  • Rifampin / pharmacology

Citations

This article has been cited 13 times.
  1. 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.
    doi: 10.1016/j.heliyon.2023.e18623pubmed: 37576287google scholar: lookup
  2. Li L, Maboni G, Lack A, Gomez DE. Nontuberculous Mycobacteria in Horses: A Narrative Review.. Vet Sci 2023 Jul 6;10(7).
    doi: 10.3390/vetsci10070442pubmed: 37505847google scholar: lookup
  3. Val-Calvo J, Darcy J, Gibbons J, Creighton A, Egan C, Buckley T, Schmalenberger A, Fogarty U, Scortti M, Vázquez-Boland JA. International Spread of Multidrug-Resistant Rhodococcus equi.. Emerg Infect Dis 2022 Sep;28(9):1899-1903.
    doi: 10.3201/eid2809.220222pubmed: 35997496google scholar: lookup
  4. Narváez SÁ, Fernández I, Patel NV, Sánchez S. Novel Quantitative PCR for Rhodococcus equi and Macrolide Resistance Detection in Equine Respiratory Samples.. Animals (Basel) 2022 May 3;12(9).
    doi: 10.3390/ani12091172pubmed: 35565598google scholar: lookup
  5. Erol E, Scortti M, Fortner J, Patel M, Vázquez-Boland JA. Antimicrobial Resistance Spectrum Conferred by pRErm46 of Emerging Macrolide (Multidrug)-Resistant Rhodococcus equi.. J Clin Microbiol 2021 Sep 20;59(10):e0114921.
    doi: 10.1128/JCM.01149-21pubmed: 34319806google scholar: lookup
  6. Álvarez-Narváez S, Huber L, Giguère S, Hart KA, Berghaus RD, Sanchez S, Cohen ND. Epidemiology and Molecular Basis of Multidrug Resistance in Rhodococcus equi.. Microbiol Mol Biol Rev 2021 May 19;85(2).
    doi: 10.1128/MMBR.00011-21pubmed: 33853933google scholar: lookup
  7. Álvarez-Narváez S, Giguère S, Cohen N, Slovis N, Vázquez-Boland JA. Spread of Multidrug-Resistant Rhodococcus equi, United States.. Emerg Infect Dis 2021 Feb;27(2):529-537.
    doi: 10.3201/eid2702.203030pubmed: 33496218google scholar: lookup
  8. Álvarez-Narváez S, Giguère S, Berghaus LJ, Dailey C, Vázquez-Boland JA. Horizontal Spread of Rhodococcus equi Macrolide Resistance Plasmid pRErm46 across Environmental Actinobacteria.. Appl Environ Microbiol 2020 Apr 17;86(9).
    doi: 10.1128/AEM.00108-20pubmed: 32169935google scholar: lookup
  9. Álvarez-Narváez S, Berghaus LJ, Morris ERA, Willingham-Lane JM, Slovis NM, Giguere S, Cohen ND. A Common Practice of Widespread Antimicrobial Use in Horse Production Promotes Multi-Drug Resistance.. Sci Rep 2020 Jan 22;10(1):911.
    doi: 10.1038/s41598-020-57479-9pubmed: 31969575google scholar: lookup
  10. Rampacci E, Marenzoni ML, Giovagnoli S, Passamonti F, Coletti M, Pietrella D. Phenotypic Characterization of Rhodococcus equi Biofilm Grown In Vitro and Inhibiting and Dissolving Activity of Azithromycin/Rifampicin Treatment.. Pathogens 2019 Dec 4;8(4).
    doi: 10.3390/pathogens8040284pubmed: 31817114google scholar: lookup
  11. Álvarez-Narváez S, Giguère S, Anastasi E, Hearn J, Scortti M, Vázquez-Boland JA. Clonal Confinement of a Highly Mobile Resistance Element Driven by Combination Therapy in Rhodococcus equi.. mBio 2019 Oct 15;10(5).
    doi: 10.1128/mBio.02260-19pubmed: 31615959google scholar: lookup
  12. Rampacci E, Marenzoni ML, Chiaradia E, Passamonti F, Ricci M, Pepe M, Coletti M, Giovagnoli S. In vitro performances of novel co-spray-dried azithromycin/rifampicin microparticles for Rhodococcus equi disease treatment.. Sci Rep 2018 Aug 14;8(1):12149.
    doi: 10.1038/s41598-018-30715-zpubmed: 30108265google scholar: lookup
  13. Wright LM, Carpinone EM, Bennett TL, Hondalus MK, Starai VJ. VapA of Rhodococcus equi binds phosphatidic acid.. Mol Microbiol 2018 Feb;107(3):428-444.
    doi: 10.1111/mmi.13892pubmed: 29205554google scholar: lookup
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