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Veterinary medicine and science2020; 7(2); 279-288; doi: 10.1002/vms3.382

Use of aminoglycoside antibiotics in equine clinical practice; a questionnaire-based study of current use.

Abstract: Veterinary use of the aminoglycoside antibiotics is under increasing scrutiny. This questionnaire-based study aimed to document the use of aminoglycosides with a particular focus on gentamicin. An online questionnaire was delivered to generalist equine veterinary surgeons and specialists in internal medicine to determine the perceived importance, frequency of use and routes of administration of the aminoglycoside antibiotics. A series of hypothetical scenarios were also evaluated regarding gentamicin. Data were compared to evaluate the impact of the level of specialisation on prescribing practices for different antibiotics using Chi-squared and Fischer's exact tests. Data were analysed from 111 responses. Gentamicin was commonly used empirically without culture and susceptibility testing. Generalists were more likely to use gentamicin only after susceptibility testing than specialists in a variety of clinical presentations including respiratory diseases, septic peritonitis, acute febrile diarrhoea, cellulitis and contaminated limb wounds (p < 0.01). Intravenous administration of gentamicin was most common, although inhaled and regional administration of gentamicin and amikacin were also described. Amikacin was most commonly used by intra-articular administration. Gentamicin was more likely to be used in high-risk procedures or contaminated surgeries (86% and 74%, respectively) compared with clean surgery (32%; p < 0.0001). Gentamicin was often used perioperatively in horses undergoing exploratory celiotomy and more commonly used in horses undergoing an enterotomy (90%) than without and enterotomy (79%; p = 0.04). Most respondents (86%) used gentamicin at a dose of 6.6 mg/kg in adults, with few changing their dosing strategies based on the presence of sepsis, although higher doses were more reported in foals (7-15 mg/kg) irrespective of the presence of sepsis. Aminoglycosides are widely used in equine practice and use outside current EU marketing authorisations is common. Stewardship of the aminoglycoside antibiotics could be enhanced in both generalists and specialists through the more frequent use of susceptibility testing, regional administration and dose adjustment, especially in foals.
© 2020 The Authors. Veterinary Medicine and Science published by John Wiley & Sons Ltd.
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Publication Date: 2020-10-24 PubMed ID: 33099884PubMed Central: PMC8025607DOI: 10.1002/vms3.382Google 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 survey explores the usage of aminoglycoside antibiotics, particularly gentamicin, in equine clinical practice. It highlights that while gentamicin is commonly used, it is often used without culture and susceptibility testing, and it suggests that antibiotic stewardship could be enhanced through more frequent usage of such testing, regional administration, and dose adjustment.

About the Research

  • The study conducted was a questionnaire-based survey aimed at understanding the usage pattern of aminoglycoside antibiotics in equine clinical practice, emphasizing the usage of gentamicin.
  • Veterinary surgeons and specialists in internal medicine were invited to participate in the online questionnaire that sought to extract their views on the importance, frequency of use, and the administration routes of these antibiotics.
  • The questionnaire also involved hypothetical scenarios that pertained to gentamicin use and compared the data to assess how specialization impacted the antibiotic prescribing practices.

The Results

  • The study analyzed 111 responses and discovered that gentamicin was commonly used empirically without any culture and susceptibility testing.
  • It was noted that generalist practitioners were more likely than specialists to resort to gentamicin use only after susceptibility testing in a range of clinical cases such as respiratory diseases, septic peritonitis, acute febrile diarrhoea, cellulitis, and contaminated limb wounds.
  • In terms of administration, gentamicin was mostly given intravenously. In some cases, inhaled and regional administration of gentamicin and another aminoglycoside antibiotic, amikacin, were reported. Amikacin was frequently used by intra-articular administration.

Usage of Gentamicin

  • Gentamicin was primarily used in high-risk procedures or contaminated surgeries rather than in clean surgeries.
  • It was similarly used perioperatively in horses undergoing exploratory celiotomy, and especially in horses undergoing enterotomy.
  • Most respondents used gentamicin at a dose of 6.6 mg/kg in adults, with few changing their dosing strategies based on the presence of sepsis. However, higher doses were reported in foals, regardless of the presence of sepsis.

Conclusions and Recommendations

  • It was concluded that aminoglycosides, including gentamicin, are widely used in equine medical practice, often outside of the current EU marketing authorizations.
  • The study suggests enhancements in the stewardship of aminoglycoside antibiotics in both generalists and specialists through more regular use of susceptibility testing, regional administration, and dose adjustment. This is especially so for foals, given that higher doses are usually reported in their treatment.

Cite This Article

APA
Redpath A, Hallowell GD, Bowen IM. (2020). Use of aminoglycoside antibiotics in equine clinical practice; a questionnaire-based study of current use. Vet Med Sci, 7(2), 279-288. https://doi.org/10.1002/vms3.382

Publication

Veterinary medicine and science
ISSN: 2053-1095
NlmUniqueID: 101678837
Country: England
Language: English
Volume: 7
Issue: 2
Pages: 279-288

Researcher Affiliations

Redpath, Adam
  • Oakham Veterinary Hospital, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.
Hallowell, Gayle D
  • School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.
Bowen, Ian Mark
  • Oakham Veterinary Hospital, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK.

MeSH Terms

  • Aminoglycosides / therapeutic use
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Horses
  • Surveys and Questionnaires
  • Veterinary Medicine / statistics & numerical data

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Citations

This article has been cited 4 times.
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