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    A pilot randomised clinical trial comparing a short-term perioperative prophylaxis regimen to a long-term standard protocol in equine colic surgery (2021)

    Art
    Zeitschriftenartikel / wissenschaftlicher Beitrag
    Autoren
    Stöckle, Sabita Diana (WE 17)
    Kannapin, Dania A. (WE 17)
    Kauter, Anne M. L.
    Lübke-Becker, Antina (WE 7)
    Walther, Birgit
    Merle, Roswitha (WE 16)
    Gehlen, Heidrun (WE 17)
    Quelle
    Antibiotics : open access journal
    Bandzählung: 10
    Heftzählung: 5
    Seiten: Artikel 587
    ISSN: 2079-6382
    Sprache
    Englisch
    Verweise
    URL (Volltext): https://www.mdpi.com/2079-6382/10/5/587
    DOI: 10.3390/antibiotics10050587
    Pubmed: 34065712
    Kontakt
    Institut für Veterinär-Epidemiologie und Biometrie

    Königsweg 67
    14163 Berlin
    +49 30 838 56034
    epi@vetmed.fu-berlin.de

    Abstract / Zusammenfassung

    Background:
    For surgical interventions classified as clean or clean-contaminated, including laparotomy, guidelines in human and veterinary medicine recommend a short-term perioperative antibiotic prophylaxis (PAP). In equine colic surgery, however, PAP commonly exceeds 24 h.

    Objectives:
    The aim of this study was to compare a single-shot to a 5-day lasting PAP considering surgical site infections (SSI) and other adverse effects probably associated with the particular antimicrobial regimen.

    Study design:
    The study was designed as a randomised non-inferiority pilot study including horses subjected to colic surgery while receiving one of two distinct PAP regimens.

    Methods:
    All horses (n = 67) included in the study received the standard physical examination before and after surgery. Colic surgery was performed according to the current standard of the clinic. Horses were randomly assigned to two groups, receiving either the "single-shot" or the "5-day lasting" antibiotic prophylaxis. The "single-shot" group (n = 30) received penicillin and gentamicin only once before and, if needed, during surgery, whereas the "5-day lasting" group (n = 37) received antibiotics for five days. In addition to the standard laboratory examinations, serum amyloid A and fibrinogen were determined preoperatively and during five days after surgery. SSI, postoperative colitis and haemolytic anaemia were classified as postoperative complications potentially related to antibiotic use.

    Results:
    The outcome of this preliminary non-inferiority clinical trial showed that the occurrence of postoperative adverse events (i.e., SSI, postoperative colitis and haemolytic anaemia) lacked significant differences between the study groups.

    Main limitations:
    The main limitations of this study are the limited group sizes and our inability to blind the study.

    Conclusions:
    Single-shot PAP seems to be an alternative approach considering the 5-day lasting protocol commonly used in equine abdominal surgery. However, a proper hygiene management together with a close clinical and laboratory monitoring of the equine patient is indispensable.