ceftiofur and Puerperal-Disorders

Metritis is a cause of postparturient uterine disease in dairy cattle and is most commonly associated with watery fetid red-brown uterine discharge occurring in the first 21 days postpartum. The most severe form of metritis (puerperal metritis) often warrants antibiotic therapy. This article analyzes the current literature to determine the efficacy of ceftiofur in the treatment of metritis. Evidence-based review of the current literature suggests that there is evidence for the use of ceftiofur in the treatment of metritis. However, review of the literature also reveals the need for more studies with negative control groups.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Endometritis; Female; Puerperal Disorders

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

The objective of this field trial was to evaluate effects of a single administration of 2.2 mg/kg of body weight (BW) of flunixin meglumine (FM) in addition to a systemic antibiotic treatment in cows with acute puerperal metritis (APM). Outcome variables tested were proportion of cows with a fever, prevalence of chronic endometritis 18 to 22 and 32 to 35 d in milk (DIM), and reproductive performance measures in the current lactation. In addition, serum concentrations of haptoglobin and fibrinogen were analyzed. Daily milk yield within 6 d after the first treatment was recorded. Cows were examined 4 to 5 DIM by rectal palpation and vaginoscopy, and rectal temperature was measured. Fetid vulvar discharge and a body temperature > or = 39.5 degrees C were signs of APM. Cows with APM were treated in the reference group with 1.0 mg/kg of BW of ceftiofur on 3 to 5 consecutive days (CEF, n = 119). In the study group, cows received the same antibiotic treatment as in CEF and 2.2 mg/kg of BW of FM on treatment d 1 (CEF + FM, n = 119). Blood samples were collected 4, 6, and 10 DIM and analyzed for concentrations of haptoglobin and fibrinogen. A group of cows without APM remained untreated and served as controls (n = 9). There were no significant differences between CEF and CEF + FM in the proportion of cows with fever 1 d after the first treatment (33.6 vs. 46.2%), milk yield per milking 10 DIM (7.5 +/- 0.3 vs. 7.6 +/- 0.3 kg in primiparous, 9.6 +/- 0.4 vs. 10.6 +/- 0.4 kg in multiparous cows), prevalence of chronic endometritis 32 to 35 DIM (64.3 vs. 52.2%), and in reproductive performance (31.5 vs. 34.3% conception to first AI, 58.0 vs. 54.6% pregnancy rate, 107.8 +/- 36.9 vs. 101.6 +/- 41.4 d open). Compared with the control, CEF and CEF + FM had significantly greater concentrations of haptoglobin (1.1 +/- 0.28 vs. 1.9 +/- 0.06 and 1.8 +/- 0.07 mg/mL at 4 DIM; 0.3 +/- 0.15 vs. 1.1 +/- 0.06 and 1.2 +/- 0.07 mg/mL at 10 DIM) and fibrinogen (2.2 +/- 0.17 vs. 3.9 +/- 0.14 and 3.7 +/- 0.13 g/L at 4 DIM; 1.9 +/- 0.1 vs. 2.6 +/- 0.1 and 3.0 +/- 0.13 g/L, respectively, at 10 DIM) on all test days. The additional treatment with FM had no effect on these acute phase proteins. In conclusion, the single administration of 2.2 mg/kg of BW of FM in addition to a systemic antibiotic treatment of cows having APM did not result in beneficial effects on clinical cure, milk yield within 6 d after the first treatment, or reproductive performance.

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Blood Chemical Analysis; Cattle; Cattle Diseases; Cephalosporins; Clonixin; Dairying; Drug Therapy, Combination; Endometritis; Female; Fibrinogen; Haptoglobins; Lactation; Postpartum Period; Puerperal Disorders; Reproduction

The objective of this study was to evaluate the efficacy and economic efficiency of a systemic treatment of toxic puerperal metritis in dairy cows with ceftiofur. Cows with abnormal vaginal discharge at a postpartum examination (d 4 to 6 after calving) and a rectal temperature > or = 39.5 degrees C were assigned to three treatment groups. Cows in group 1 (n = 70) received 600 mg of ceftiofur intramuscularly (i.m.) on 3 consecutive days. Cows in group 2 (n = 79) received an intrauterine treatment with antibiotic pills consisting of 2500 mg of ampicillin and 2500 mg of cloxacillin and an additional 6000 mg (i.m.) of ampicillin. This treatment was performed on 3 consecutive days. Cows in group 3 (n = 78) received the same intrauterine treatment as in group 2. In addition, 600 mg of ceftiofur was administered i.m. on 3 consecutive days. Body temperature was recorded daily for 6 d after first treatment. There were no significant differences among the groups regarding clinical efficacy at d 6 after first treatment. The cure rates based on rectal temperatures declining to below 39.5 degrees C on d 6 after treatment were 82.9, 84.8, and 84.6% for groups 1, 2, and 3, respectively. Reproductive performance did not differ significantly between group 1 and groups 2 and 3 for any of the measures tested. A financial analysis with 87 different cost scenarios demonstrated that a systemic treatment of toxic puerperal metritis in cattle with ceftiofur is an effective alternative to the combination of local and systemic treatments.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Cloxacillin; Costs and Cost Analysis; Drug Therapy, Combination; Endometritis; Female; Injections, Intramuscular; Puerperal Disorders; Reproduction; Treatment Outcome

Holstein cows (n = 51) that had been diagnosed with toxic puerperal metritis were used to determine the treatment efficacy of various antibiotics. On the day of diagnosis, cows affected with toxic puerperal metritis were assigned randomly to three treatment groups. Cows in groups 1 and 2 received 22,000 IU/kg of procaine penicillin G i.m. for 5 d. In addition, cows in group 2 received an intrauterine infusion of 6 g of oxytetracycline on d 1, 3, and 5. Cows in group 3 received 2.2 mg/kg of ceftiofur sodium i.m. for 5 d. Dependent variables used to determine antibiotic efficacy included milk yield on d 1 through 12, rectal temperature on d 1 through 5, and serum haptoglobin concentration on d 1, 3, and 5. No difference was observed among groups for milk yield on d 1 and 12 or for temperature on d 1 and 5. Serum haptoglobin was elevated to > 10 mg/dl for cows in all groups; however, no difference was observed among groups on d 1 and 5. Because all groups showed a favorable response, this study suggests that there is no difference in treatment efficacy among antibiotics used to treat cows affected with toxic puerperal metritis.

Topics: Animals; Anti-Bacterial Agents; Body Temperature; Cattle; Cattle Diseases; Cephalosporins; Endometritis; Female; Haptoglobins; Metrial Gland; Oxytetracycline; Penicillin G Procaine; Puerperal Disorders

The aim of this study was to determine how puerperal metritis influences the resumption of estrous cycle in dairy cows. The ovaries of 72 multiparous Holstein cows (38 healthy and 34 metritic - after treatment) were ultrasonographically scanned until the first ovulation postpartum and 7 days after to confirm the ovulation. All 72 cows were divided in to 4 groups: HSO (healthy with single ovulation) (n=29), MSO (metritic with single ovulation) (n=21), HDO (healthy with double ovulation) (n=9), and MDO (metritic with double ovulation) (n=13). The proportion of cows that had DO in the first ovulation postpartum was similar between M and H groups, 38.2% and 23.6%, respectively (p>0.05). There was a difference between HDO and MDO groups comparing the first dominant follicle ovulation postpartum (11.4±2.7 and 20±1 days, respectively p⟨0.05) and the diameter of the ovulatory follicles (15.3±1.9 mm and 17.3±1.7 mm, respectively p0.05). The percentage of cows that had double follicle dominance in the first follicular wave after first ovulation was higher in the M groups (33.3% (MSO) vs. 6.9% (HSO) (p⟨0.05) and (69.2% (MDO) vs. 22.2% (HDO) (p⟨0.05)). The MSO group dominant follicle diameter was bigger for cows which had one dominant follicle (p⟨0.05). It might be concluded that dairy cows after puerperal metritis need more time until the first ovulation. Also, metritic cows have a higher risk for double dominance in the first follicular wave, after the first ovulation.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Endometriosis; Estrous Cycle; Female; Ovulation; Puerperal Disorders

Two protocols for the treatment of retained fetal membranes in dairy cattle were evaluated in a field trial. Cows that retained the fetal membranes for more than 12h were assigned to two treatment groups in an alternating order. In both groups rectal temperature was measured daily for 10 days after enrollment. In Group 1 (n=35) cows with a rectal temperature >or=39.5 degrees C received a systemic antibiotic treatment with 600mg ceftiofur intramuscularly on three consecutive days. No manual removal of the fetal membranes or intrauterine treatment was conducted. In case of elevated temperature of >or=39.5 degrees C on Day 3 treatment was conducted for another 2 days. In Group 2 (n=35) cows received a local antibiotic treatment (2500 mg ampicillin, 2500 mg cloxacillin) and an attempt was made to remove the fetal membranes manually. In case of a rectal temperature >or=39.5 degrees C 6000 mg of ampicillin were administered intramuscularly. Treatment was repeated on three consecutive days. If temperature did not decrease below 39.5 degrees C systemic treatment was extended for another 2 days. During 10 days of observation 33 and 34 cows showed fever, i.e. a body temperature >or=39.5 degrees C in Groups 1 and 2, respectively (94.3 versus 97.1%). The proportion of cows considered as cured (temperature <39.5 degrees C on Day 10 after enrollment) was 65.7 and 68.6% in Groups 1 and 2, respectively. All cows showed signs of chronic inflammation of the genital tract on Day 14 after calving. Within 4 weeks postpartum three (8.6%) and four (11.4%) cows were culled in Groups 1 and 2, respectively. Days to first service and days open did not differ significantly between the groups. Proportion of cows pregnant on Day 200 postpartum was 71.4 and 54.3% for Groups 1 and 2, respectively (P>0.05). Results indicate that treatment of retained fetal membranes without intrauterine manipulation and treatment can be as effective as conventional treatment including detachment and local antibiotic treatment.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Cloxacillin; Extraembryonic Membranes; Female; Injections, Intramuscular; Placenta, Retained; Pregnancy; Puerperal Disorders; Reproduction; Time Factors; Treatment Outcome

The objective of this study was to compare the effect of ceftiofur hydrochloride and estradiol cypionate (ECP) administration for metritis prevention and reproductive performance in dairy cows affected with retained fetal membranes (RFMs). After parturition, 97 dairy cows affected with RFM from a single dairy herd were randomly allocated to 1 of 3 treatment groups. Cows in-group 1 (n=31) were treated daily for 5 days with ceftiofur hydrochloride (2.2mg/kg, i.m.); cows in group 2 (n=33) were treated once with ECP (4 mg, i.m.); and cows in group 3 (n=33) were not treated. The proportion of cows with metritis, uterine involution patterns and the calving-to-conception interval were compared between groups. The proportion of cows that developed metritis was significantly different (P<0.05) in cows treated with ceftiofur hydrochloride (13%), compared with cows treated with ECP (42%) or cows that received no treatment (42%). Uterine involution patterns (i.e. median time to complete retraction of the uterus and mean diameter measure of cervix and uterine horns) were not significantly different between groups. Cows treated with ECP were 0.40 times as likely to conceive as control cows (P=0.05); median time to conception in cows treated with ECP (192 days) was longer, compared to control cows (124 days). We conclude that systemic administration of ceftioufur hydrochloride is beneficial for prevention of metritis, but its effect on reproductive performance was not significantly different to that of ECP or no treatment. In addition, administration of ECP did not have beneficial effects on metritis prevention and reproductive performance.

Topics: Animals; Cattle; Cattle Diseases; Cephalosporins; Contraceptive Agents, Female; Endometritis; Estradiol; Female; Injections, Intramuscular; Placenta, Retained; Pregnancy; Puerperal Disorders; Random Allocation; Reproduction; Treatment Outcome