ceftiofur and Fever

Acute puerperal metritis (APM) is an acute systemic illness with fever ≥ 39.5 °C and signs of toxemia due to an infection of the uterus occurring within 21 d after parturition. Because of the infectious nature of APM, antibiotics are considered beneficial for its treatment. Each use of an antimicrobial drug, however, is associated with selective pressure for the emergence of resistant bacteria. Hence, there is a significant need to encourage prudent use of antibiotics and alternative therapies to antibiotics. Therefore, the objective of this study was to systematically review the current literature on treatment of APM. A comprehensive and systematic literature search was conducted utilizing the PubMed and CAB Abstracts databases to identify literature focusing on the antibiotic therapy of puerperal metritis in the cow. After application of specific exclusion criteria, 21 publications comprising 23 trials remained for final evaluation. Data extraction revealed that the majority of the studies (n = 19) were attributable to the highest evidence level. Of 21 studies controlled, 11 had an untreated group and 3 a positive control group. The majority of the studies (n = 17) applied ceftiofur for the treatment of APM. Concerning the efficacy of ceftiofur, 7 studies observed clinical improvement, whereas none found improved reproductive performance. Fewer than half of the studies (n = 10) performed a bacteriological examination and only 4 implemented an antibiotic susceptibility test. Also, 3 studies (13.0%) described a self-cure rate per se. Little attention was given to the issue of bacterial resistance (n = 3), the need for reducing the application of antibiotics (n = 2), or guidelines for prudent use of antibiotics (n = 1). Our findings demonstrate that implementation of bacteriological examinations, sensitivity testing, and determination of minimum inhibitory concentrations, as well as reporting and discussion of critical issues (e.g., self-cure rates, resistance, prudent drug use), were suboptimal. On the other hand, the quality of studies on the treatment of APM was good, as indicated by evidence level 1. Nevertheless, more high-quality research considering self-cure rates is necessary to address critical issues related to APM and crucial to the dairy industry, such as resistance, prudent use of antibiotics, animal welfare, and cost-benefit ratios.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Drug Resistance, Bacterial; Endometritis; Female; Fever; Microbial Sensitivity Tests; Postpartum Period; Puerperal Disorders; Reproduction

Our objectives were to evaluate the efficacy of ampicillin trihydrate for the treatment of metritis in dairy cows compared with ceftiofur hydrochloride and the subsequent effects on pregnancy at first insemination (P/AI). Cows in the first 12 d in milk (DIM) with a uterine discharge score of 5 (watery, reddish or brownish discharge of foul smell) and rectal temperature <39.5°C were diagnosed with metritis based on the fetid discharge, and cows with metritis and rectal temperature ≥39.5°C were diagnosed as having puerperal metritis. Cows with metritis (n=528) were blocked by parity and type of metritis as fetid discharge or puerperal metritis and, within each block, assigned randomly to receive 11mg/kg of ampicillin (n=259) or 2.2mg/kg of ceftiofur (n=269) once daily for 5 d. Day of diagnosis of metritis was considered study d 1. A cohort of 268 cows without metritis was selected randomly at 12 DIM. Rectal temperature was measured in cows with metritis on study d 1 to 7, and 12, and vaginal discharge was scored on study d 5, 7, and 12. Metritis cure was characterized by vaginal discharge score of <5 or by vaginal discharge score of <5 and no fever. At 32±3 DIM, vaginal discharge was scored for diagnosis of purulent vaginal discharge. At 39±3 DIM, endometrial cytology was performed. At 53±3 and 67±3 DIM, ovaries were scanned to determine estrous cyclicity. Pregnancy was evaluated after the first AI. Cure of metritis based on vaginal discharge <5 was greater for ampicillin than ceftiofur on d 5 (37.1 vs. 25.2%) and 7 (57.2 vs. 46.3%), but not on d 12 (82.0 vs. 85.0%). Cure of metritis based on vaginal discharge <5 and no fever was greater for ampicillin than for ceftiofur only on d 7 (50.4 vs. 37.9%), but not on d 5 (23.1 vs. 17.6%) and 12 (66.1 vs. 67.4%). Cows with puerperal metritis had reduced cure compared with cows with fetid discharge on d 5 (30.5 vs. 12.8%), 7 (55.2 vs. 33.6%), and 12 (72.0 vs. 61.1%). The proportion of cows with fever on any day after therapy started did not differ between treatments. Fifty-three percent of cows with metritis based on fetid discharge developed fever after initiating antimicrobial therapy. Cows receiving ampicillin had less prevalence of purulent vaginal discharge than those treated with ceftiofur (57.7 vs. 67.8%), but they were both greater than cows without metritis (21.9%). Prevalence of cytological endometritis did not differ between ampicillin and ceftiofur (30.0 vs. 25.4%), but they were both greater than cows

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Body Temperature; Cattle; Cattle Diseases; Cephalosporins; Diet; Endometritis; Female; Fertility; Fever; Housing, Animal; Postpartum Period; Pregnancy; Prevalence; Vaginal Discharge

In this field trial, a new combination product containing florfenicol and flunixin meglumine (FLOR-FM) was compared with commercially available products that contained only tulathromycin (TULA) or ceftiofur crystalline free acid (CCFA) for the treatment of undifferentiated fever (UF; rectal temperature >/=105.0 degrees F) in beef calves that received long-acting oxytetracycline at feedlot arrival. The overall mortality rate of the FLOR FM group (2.0%) was significantly (P less than .050) lower than the rates in the TULA and CCFA groups (10.0% and 20.0%, respectively; 50 animals/group), even though the first UF relapse rate of the FLOR FM group was significantly (P less than .050) higher than that of the TULA group. In the FLOR FM group, this resulted in per-animal economic advantages of Can$46.23 (versus TULA) and Can$108.77 (versus CCFA) based on equal costs for initial UF therapy. These results demonstrate that it is more cost-effective to administer FLOR FM than TULA or CCFA for initial UF therapy in feedlot calves at high risk for bovine respiratory disease that receive metaphylactic long-acting oxytetracycline at feedlot arrival.

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Cattle; Cattle Diseases; Cephalosporins; Clonixin; Disaccharides; Drug Combinations; Fever; Heterocyclic Compounds; Housing, Animal; Thiamphenicol

To evaluate the effect of ceftiofur for treatment of postpartum cows with fever.. Multilocation randomized complete block design trial.. 330 cows.. Cows with rectal temperature > or = 39.5 C (103.1 F) during the first 10 postpartum days were randomly assigned to a treatment (ceftiofur; 1 mg/kg [0.45 mg/lb] of body weight daily for 3 days) or untreated control group. Cure (no additional or alternative antimicrobial treatment used, rectal temperature < 39.5 C, and no other concurrent clinical signs of disease when evaluated at 9 or 10 days after enrollment), milk production, and rectal temperature were evaluated.. Ceftiofur-treated cows were significantly more likely to be cured than control cows (56.0 vs 28.9%, respectively), with an odds ratio of 3.14 when vaginal discharge (a factor with moderate interaction with treatment) was present at enrollment. Among cows that had an abnormal calving (a significant interaction factor), treated cows had first milking yield 2.27 kg (5 lb) greater than control cows. Treated cows had a significantly greater reduction in rectal temperature (1.19 C [2.14 Fl), compared with control cows (1.04 C [1.87 F]).. Parenteral administration of ceftiofur significantly improved cure rate, milk yield, and rectal temperature in postpartum cows with fever and vaginal discharge or dystocia. These findings provide information to determine appropriate treatment for postpartum cows, which for years has been debated in the dairy industry.

Topics: Animals; Case-Control Studies; Cattle; Cattle Diseases; Cephalosporins; Dystocia; Endometritis; Female; Fever; Odds Ratio; Postpartum Period; Pregnancy; Treatment Outcome

Acute puerperal metritis (APM) is one of the most common diseases during the puerperal period. Systemic administration of ceftiofur for 5 consecutive days has been shown to be effective for treatment of APM. The objective of this study was to determine concentrations of ceftiofur derivatives in serum, endometrial tissue, and lochia of cows with fever postpartum or APM 4 to 6d after treatment with a single subcutaneous dose of 6.6 mg of ceftiofur crystalline free acid (CCFA)/kg of estimated BW at the base of the ear. In the first experiment, samples from CCFA-treated cows with fever postpartum or APM (n=42) were taken on d 4, 5, or 6 after treatment. Concentrations of ceftiofur derivatives were quantified using an HPLC assay. Concentrations of active ceftiofur metabolite desfuroylceftiofuracetamide (DCA) were greatest at d 4 after treatment with CCFA in all samples, but they were considerably lower than the concentrations of DCA in healthy postpartum cows treated with the same dose of CCFA. The concentrations of DCA in serum, endometrial tissue, and lochia were affected by odor of vaginal discharge before treatment with CCFA. Mean concentrations of DCA could be detected above the reported minimal drug concentrations (minimum inhibitory concentrations, MIC) required to inhibit relevant pathogens such as Escherichia coli and Arcanobacterium pyogenes in serum on all days and in endometrial tissue and lochia only on d 4 in CCFA-treated cows with fetid vaginal discharge before treatment. In the second experiment, samples from CCFA-treated cows with APM (n=8) were taken on d 0 (before treatment) and d 4, 5, and 6 after treatment. Mean concentrations of DCA in serum and lochia were similar on d 4 to 6 in both laboratories. Furthermore, determined concentrations of DCA from both laboratories were correlated for serum and lochia. Mean concentrations of DCA could be detected above the reported MIC in serum and lochia only on d 4. Our 2 experiments demonstrated that in postpartum cows with fever postpartum or APM concentrations above the MIC for relevant bacteria (>0.5 μg/mL or >0.5 μg/g) of DCA could be sustained only for 4 (serum: 15/17; endometrial tissue: 2/17; lochia: 1/16) to 5d (serum: 10/13; endometrial tissue: 1/13; lochia: 2/12) after a single treatment with CCFA only in a certain proportion of cows. Overall, our data provide first pharmacological evidence that a single subcutaneous administration of 6.6g of CCFA/kg of BW might not be sufficient to efficaci

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Endometritis; Endometrium; Female; Fever; Puerperal Infection; Vaginal Discharge

The objective of this study was to compare 2 strategies for the management of dairy cows having retained fetal membranes (RFM) with regard to clinical traits, milk yield, and reproductive performance. In contrast to recent studies evaluating optimal strategies for the management of cows with RFM, this trial was conducted on small dairy farms with 26 to 166 cows per herd. In the systemic (SYS) group (n = 116), cows having RFM and a rectal temperature > or = 39.5 degrees C were treated with 1 mg/kg of body weight of ceftiofur on 3 to 5 consecutive days. The RFM cows without fever remained untreated. In the intrauterine (IUT) group (n = 115), all RFM cows received an intrauterine treatment with 6 g of tetracycline on 3 consecutive days combined with an attempt to remove the fetal membranes manually. The IUT cows with a fever received an additional systemic treatment with 10 mg/kg of body weight of amoxicillin on 3 to 5 consecutive days. Body temperature, daily milk yield, prevalence of vaginal discharge 28 to 35 d in milk (DIM), and reproductive performance traits within 200 DIM were monitored. The proportion of cows experiencing fever within 5 d after enrollment was greater in SYS compared with IUT. The proportion of cows with mucopurulent or purulent vaginal discharge 28 to 34 DIM did not differ between the groups. Furthermore, no significant differences between groups were found in daily milk yield in the first 10 d after enrollment, or in reproductive performance or proportion of cows culled. Significant differences in the proportion of cows with a fever in SYS and IUT have not been reported in studies with similar study designs conducted on large dairy farms. Further results on milk yield and reproductive performance, however, support findings that a management strategy for RFM based on a selective systemic treatment of feverish cows is at least as efficacious as a strategy based on intrauterine treatments of all cows and a systemic antibiotic treatment of feverish cows.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Extraembryonic Membranes; Female; Fever; Germany; Lactation; Logistic Models; Placenta, Retained; Pregnancy; Uterus

In this field trial, a protocol for the treatment of retained fetal membranes (RFM) without any intrauterine therapy was compared with 3 protocols based on the intrauterine use of antibiotic pills (AP), the manual removal (MR) of the fetal membranes, or the combination of both (PR). The study was conducted on 5 commercial dairy farms in Germany. Cows with RFM for at least 24 h after calving were assigned to 1 of 4 treatment groups. Cows of all groups with a rectal temperature >or= 39.5 degrees C received a systemic antibiotic treatment with ceftiofur (1 mg/kg per d) for 3 to 5 consecutive days. In case of continued fever after 5 treatments, cows received a different antibiotic as an escape therapy. In the reference group (REF; n = 131), cows did not receive any additional treatment. All cows in group AP (n = 119) received intrauterine treatment with antibiotic pills consisting of 1,000 mg of ampicillin and 1,000 mg of cloxacillin for 3 consecutive days. In group MR (n = 121), an attempt was made to remove the fetal membranes manually, but uterine pills were not administered. In group PR (n = 130), an attempt was made to remove the fetal membranes manually and all cows received a local antibiotic treatment as in group AP. All cows received 2 doses of 25 mg of PGF(2alpha): one dose between 18 and 24 d and another between 32 and 38 d postpartum. Statistical analyses were performed using binary logistic regression models and survival analyses with group REF as reference. Of all animals, 79.8% had a body temperature of >or= 39.5 degrees C at least once within 10 d postpartum and were treated with ceftiofur. Occurrence of fever within 10 d postpartum was significantly lower in groups AP and PR compared with reference group REF, but was not different between groups MR and REF. Risk of receiving an escape therapy in case of fever after 5 treatments with ceftiofur did not differ among groups. Reproductive performance measures did not differ significantly between group REF and any of the comparison groups. Compared with a treatment protocol based only on systemic treatment with antibiotics for cows with a fever, neither intrauterine antibiotics nor manual removal of fetal membranes alone or in combination reduced proportions of cows needing an escape therapy nor did those treatments improve reproductive measures in the current lactation. Systemic treatment alone based on elevated rectal temperature was effective and reduced use of antibiotics compared with therapie

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Cloxacillin; Extraembryonic Membranes; Female; Fever; Logistic Models; Parity; Placenta, Retained; Pregnancy

The objective of this study was to evaluate the efficacy of a blanket systemic preventive treatment (PT) of cows having retained fetal membranes (RFM) with 1 mg/kg of ceftiofur administered the first day after calving regardless of their body temperature. This strategy was compared with a selective treatment (ST) strategy in which only cows having RFM and a rectal temperature > or = 39.5 degrees C within 10 d postpartum received ceftiofur. Cows that retained their fetal membranes for at least 24 h after calving were allocated to 2 groups. Rectal temperature was measured daily for 10 d postpartum. Sixty PT cows having RFM received a daily ceftiofur (1 mg/kg of body weight) treatment, administered subcutaneously during the first 3 d after diagnosis of RFM. If rectal temperature was > or = 39.5 degrees C after 3 daily treatments, cows received ceftiofur for 2 more days. Therapy in 53 ST cows was based on selective administration of ceftiofur to cows having fever during the first 10 d postpartum. Treatment was conducted for 3 to 5 consecutive days as described for PT cows, beginning on the first day of fever. In both groups, manual removal of the placenta was not attempted and antibiotic drugs were not administered into the uterus. For every cow having RFM enrolled in PT or ST, 1 cow without RFM that had calved on the same day was enrolled in a healthy control group (n = 113). All cows received two 25-mg doses of PGF(2alpha): 1 dose between 18 and 24 d and 1 dose between 32 and 38 d postpartum. The PT did not reduce the proportion of cows experiencing fever during 10 d postpartum compared with ST cows (71.7 vs. 69.8%). Results were compared using logistic regression models and survival analyses. The artificial insemination submission rate between 42 and 62 d postpartum was greater in PT (41.2 vs. 20.8 vs. 24.5%), but total conception rate was less in ST and control cows, respectively (25.0 vs. 38.9 vs. 36.2%). In this trial, a preventive systemic antibiotic treatment of all cows having RFM was not superior to a selective antibiotic treatment of cows only in case of fever.

Topics: Animals; Anti-Bacterial Agents; Body Temperature; Cattle; Cattle Diseases; Cephalosporins; Dinoprost; Female; Fever; Insemination, Artificial; Logistic Models; Placenta, Retained; Postpartum Period; Pregnancy; Reproduction