Initial antimicrobial treatment of foals with sepsis: Do our choices make a difference?

Thee­len et al, Vet J. 2019 Jan

Abstract

The study objec­tives were to pro­vide cumu­la­tive antimi­cro­bial sus­cep­ti­bil­i­ty data at the patient lev­el and to eval­u­ate the effect of ini­tial antimi­cro­bial treat­ment on sur­vival in foals with sep­sis. Foals below 30days of age with a diag­no­sis of sep­sis, con­firmed by iso­la­tion of bac­te­ria from nor­mal­ly ster­ile sites on the day of hos­pi­tal admis­sion, were includ­ed. Sus­cep­ti­bil­i­ty test­ing was per­formed using the broth microdi­lu­tion pro­ce­dure. In total, 213 foals and 306 bac­te­r­i­al iso­lates were includ­ed. The like­li­hood of sur­vival for foals from which all bac­te­ria were sus­cep­ti­ble to the ini­tial antimi­cro­bial treat­ment was 65.4% (n=106/162; 95% con­fi­dence inter­val (CI) 57.6% to 72.7%) ver­sus 41.7% (n=10/24; 95% CI 22.1% to 63.4%) if one or more iso­lates were resis­tant (rel­a­tive risk 1.57, 95% CI 0.96 to 3.06). Based on this study, amikacin com­bined with ampi­cillin remains an appro­pri­ate antimi­cro­bial drug com­bi­na­tion for ini­tial treat­ment of foals with sep­sis.