ceftiofur and Uterine-Diseases

The objectives of this study were to assess the efficacy of antibiotic treatment for preventing postpartum uterine disease among cows at high risk of uterine disease, and to assess the efficacy of PGF(2α) for treating cytological endometritis (CYTO) and purulent vaginal discharge (PVD). A total of 2,178 Holstein cows in 6 herds were enrolled in a randomized clinical trial. Within 24h after parturition, cows were classified at being at high risk of uterine disease (HRUD; n=1,017) if they had twins, dystocia, or retained placenta. All remaining cows were classified as being at low risk of uterine disease (LRUD; n=1,161). Cows in the HRUD group were randomly allocated in a factorial design to receive ceftiofur crystalline free acid (CCFA) at 24h after parturition or be untreated, and to receive dinoprost (PGF(2α)) at 35 and 49 (±3) days in milk (DIM) or to be untreated. Cows in LRUD were randomly allocated to receive PGF(2α) at 35 and 49 (±3) DIM or to be untreated. Serum progesterone was measured at 21, 35, 49, and 63 (±3) DIM. Cows were examined at 35 (±3; exam 1) and 56 (±3; exam 2) DIM for CYTO (by cytobrush device; ≥6% polymorphonuclear cells in endometrial cytology) and for PVD (by Metricheck device; mucopurulent or purulent vaginal discharge). Statistical analyses were performed using multivariable logistic regression models accounting for herd clustering. Treatment with CCFA in HRUD cows was not associated with the probability of metritis overall, but interactions occurred such that CCFA decreased the incidence of metritis among HRUD cows that did not have retained placenta and among cows of parity ≥2. Treatment with CCFA in HRUD cows decreased the probability of PVD at exam 1. Treatment with PGF(2α) did not affect the probability of cure of CYTO or PVD irrespective of progesterone concentration at the time of treatment. Among cows affected by CYTO or PVD at exam 1, 66 and 63%, respectively, had spontaneously cured at exam 2. Cows persistently affected at exam 2 had an increased time to pregnancy and were more likely to have both CYTO and PVD at exam 1. Administration of PGF(2α) at both 5 and 7 wk postpartum did not mitigate the effects of CYTO or PVD on reproductive performance. Clinical approaches to treatment of chronic postpartum reproductive tract infection and inflammation should be reassessed.

Topics: Animals; Anti-Bacterial Agents; Cattle; Cattle Diseases; Cephalosporins; Endometritis; Female; Postpartum Period; Pregnancy; Prostaglandins; Reproduction; Risk Factors; Uterine Diseases; Uterus; Vaginal Discharge

To assess the efficacy of antibiotic usage for the treatment of puerperal metritis (PM) and its association with reproductive performance, a retrospective cohort study including a total of 9168 records of cows from a dairy farm in Argentina was run.. Cows having a PM3 (metricheck, scale 0-3) and treated with ceftiofur (ceftiofur crystalline free acid, 6.6 mg/kg) at 0-21 days postpartum (p. p.) (n = 2688), and cows having a PM 1-2 and not treated with an antibiotic at 0-21 days p. p. (n = 6480) were included in the study. All cows were reexamined with metricheck to assess the clinical cure (vaginal discharge [VD] score 0), partial cure (VD score similar or lower than previous), no cure (VD score higher than previous). Cows with a metricheck VD1-3 after 0-21 days p. p. were diagnosed as clinical endometritis (CE) 1-3. The occurrence of PM1-3, cure rate, calving to conception interval, the hazard of pregnancy, odds for non-pregnancy, and odds for CE were analyzed using SAS software.. A total of 8876 PM1-3 records were included, 2435 records of PM3 treatments with ceftiofur (27.43 %), and 6441 records of PM1-2 (72.57 %) with no treatment. Cows having PM1 and PM2 became pregnant 14 and 12 days earlier than cows with PM3 (p < 0.001). The PM3 ceftiofur treated cows had a clinical cure of 24.85 % (PM0); 53.63 % had a partially cure; and 18.52 % no cure. Conversely, cows with PM1-2 had a 51.96 %, 20.70 %, and 24.53 % cure rate, respectively (p < 0.001). Cows having complete cure became pregnant 13 and 11 days earlier than cows having partial cure and no cure (p < 0.001). Cows that had PM3 during the first 21 days p. p. had twice the chances of developing CE compared to cows having PM1-2 (41.28 % vs. 24.14 %, p < 0.001). After 21 days p. p., less than 1 % of cows with clinical cure developed CE compared to 63.32 % that developed CE with partial cure, and 38.21 % with no cure (p < 0.001).. After ceftiofur treatment, 78 % of cows were cured when measured by disappearance of fetid VD but only 25 % of cows had clinical cure when measured by appearance of a clear VD. The cows that remained with clinical metritis had more chances of having CE after 21 days p. p. and had more days open than cows with clear normal VD.. ZIEL: Bewertung der Wirksamkeit von Antibiotika zur Behandlung der puerperalen Metritis (PM) und ihres Effekt auf die Reproduktionsleistung von Milchkühen.. Die retrospektive Kohortenstudie wertete 9168 Datensätzen von Kühen eines Milchviehbetriebs mit ganzjähriger Weidehaltung in Argentinien aus. Es handelte sich um Kühe mit einer PM 3. Grades (PM3, diagnostiziert mittels Metricheck, Skala 0–3), die 0–21 Tage post partum (p. p.) mit Ceftiofur (freie kristalline Säure, 6,6 mg/kg) behandelt worden waren (n = 2688), sowie unbehandelte Kühe mit einer PM 1. und 2. Grades (PM1–2; n = 6480). Alle Kühe wurden 21 Tage p. p. erneut mittels Metricheck untersucht, um die klinische Heilung (Vaginalausfluss [VD], Score 0), eine teilweise Heilung (VD-Score gleich oder niedriger als zuvor) oder keine Heilung (VD-Score höher als zuvor) festzustellen. Bei Kühen mit VD1–3 wurde die Diagnose klinische Endometritis (KE) 1–3 gestellt. Das Auftreten von PM1–3, die Heilungsrate, die Güstzeit, das Risiko einer Trächtigkeit, einer nicht eintretenden Trächtigkeit sowie einer KE wurden mittels SAS-Software analysiert.. Die finale Auswertung berücksichtigte 8876 Datensätze (PM3: n = 2435, 27,43 %; PM1–2: n = 6441, 72,57 %). Kühe mit PM1 und PM2 wurden 14 bzw. 12 Tage früher trächtig als Kühe mit PM3 (p < 0,001). Die mit Ceftiofur behandelten PM3-Kühe wiesen zu 24,85 % eine klinische Heilung auf, zu 53,63 % eine teilweise Heilung und zu 18,52 % keine Heilung. Dagegen ergab sich bei Kühen mit PM1–2 eine Heilungsrate von 51,96 %, eine teilweise Heilung bei 20,70 % und keine Heilung bei 24,53 % (p < 0,001). Vollständig geheilte Kühe wurden 13 bzw. 11 Tage früher trächtig als teilweise oder nicht geheilte Kühe (p < 0,001). Bei Kühen mit PM3 in den ersten 21 Tagen p. p. war im Vergleich zu Kühen mit PM 1–2 die Wahrscheinlichkeit, später eine KE zu entwickeln, doppelt so groß (41,28 % vs. 24,14 %, p < 0,001). Weniger als 1 % der Kühe mit klinischer Heilung wiesen später eine KE auf. Bei Tieren mit teilweiser oder ohne Heilung betrug dieser Anteil 63,32 % bzw. 38,21 % (p < 0,001).. Nach der Ceftiofur-Behandlung galten 78 % der PM3-Kühe als geheilt, wenn die Heilung als fehlender übelriechender VD beurteilt wurde. Als vollständig geheilt (klarer Ausfluss) wurden jedoch nur 25 % der Kühe bewertet. Kühe mit diagnostizierter Metritis bei der Nachuntersuchung hatten nach mehr als 21 Tagen p. p. ein höheres Risiko einer KE und längere Güstzeiten als Kühe mit physiologischem klarem VD.

Topics: Animals; Anti-Bacterial Agents; Argentina; Cattle; Cattle Diseases; Cephalosporins; Dairying; Endometritis; Female; Pregnancy; Puerperal Infection; Retrospective Studies; Uterine Diseases; Vaginal Discharge

The use of antimicrobials for the management of equine uterine disease is commonplace, with antibiotic selection generally based on empirical evidence or in vitro sensitivity results. However, the potential disconnect between these laboratory results and clinical efficacy in the mare raises concern for antibiotic failure and subsequent development of resistant organisms. In this work, we attempt to bridge this gap by using an ex vivo model of the equine postpartum uterus to quantitatively evaluate the antimicrobial activity of two commonly used antibiotic treatments in the mare (ceftiofur and penicillin with gentamicin). The activity of both of these treatments was evaluated in two different fluid environments (standard bacterial culture broth and equine postpartum uterine fluid) against clinical isolates of E. coli and S. zooepidemicus. Although treatment with ceftiofur was effective at reducing growth of S. zooepidemicus in equine postpartum uterine fluid, it did not reduce bacterial growth of E. coli. Treatment with procaine penicillin G with gentamicin achieved at least bacteriostatic activity against E. coli in both fluid types, and bactericidal activity against S. zooepidemicus in both fluid types. The intrauterine infusion of procaine penicillin G with gentamicin in cases of postpartum uterine disease caused by E. coli or S. zooepidemicus is supported by the results of this work.

Topics: Animals; Anti-Bacterial Agents; Cephalosporins; Drug Resistance, Bacterial; Escherichia coli; Female; Gentamicins; Horse Diseases; Horses; Humans; Penicillins; Postpartum Period; Streptococcus equi; Uterine Diseases

Uterine disease such as metritis is associated with multiple bacterial infections in the uteri after parturition. However, treatment of metritis is challenging due to considerably high antibiotic treatment failure rate with unknown reason. Recently, chitosan microparticles (CM) have been developed to exert broad spectrum antimicrobial activity against bacterial pathogens, including multi-drug resistant bacteria, without raising CM resistant mutants. In this study, we tested, using metagenomics analysis, if CM maintain strong antimicrobial activity against pathogenic bacteria such as Fusobacteriaceae and Bacteroidaceae in cow uteri and evaluated CM's potency as an alternative antimicrobial agent to cure metritis in cows. Here, we report that efficacy of CM treatment for metritis was comparable to the antibiotic ceftiofur, and CM greatly altered uterine microflora of sick animals to healthy uterine microflora. Among uterine bacteria, CM significantly decreased Fusobacterium necrophorum, which is known pathogenic bacteria within the uterus. Taken together, we observed the broad spectrum antimicrobial activity of CM in vivo with an animal model, and further evaluated treatment efficacy in cows with metritis, providing insights into promising use of CM as an alternative antimicrobial agent for controlling uterine disease.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents; Bacteroidaceae Infections; Cattle; Cephalosporins; Chitosan; Disease Models, Animal; Female; Fusobacteriaceae Infections; Fusobacterium necrophorum; Humans; Treatment Outcome; Uterine Diseases; Uterus

Objectives were to determine the effects of intrauterine (i.u.) infusion of ceftiofur hydrochloride on uterine health and fertility of dairy cows already receiving PGF(2alpha) for estrous synchronization. Holstein cows at 44 +/- 3 d in milk (DIM) were blocked by parity and diagnosis of metritis in the first 14 DIM and of other illnesses and, within each block, randomly assigned to 1 of 2 treatments: a single i.u. infusion of 125 mg of ceftiofur hydrochloride at 44 +/- 3 DIM (ceftiofur, n = 396), or no i.u. infusion (control, n = 416). All cows received 25 mg of PGF(2alpha) at 37 +/- 3 and 51 +/- 3 DIM as part of an estrous synchronization protocol. A subset of 547 cows was evaluated for clinical endometritis immediately before treatment, and 202 cows had an aseptic uterine sample collected before the injection of PGF(2alpha) at 51 +/- 3 DIM for bacteriology and diagnosis of subclinical endometritis (> or =5% neutrophils). Pregnancy on d 38 +/- 3 and 180 +/- 7 after the first artificial insemination, pregnancy loss, and interval from calving to pregnancy in the first 300 DIM were evaluated. The proportions of cows diagnosed with clinical endometritis before treatment were similar between ceftiofur and control treatments. Intrauterine infusion with ceftiofur did not influence prevalence of subclinical endometritis and positive uterine culture 7 d after treatment; however, it reduced the prevalence of positive uterine culture in cows with clinical endometritis (29.0 vs. 51.4%) and reduced the overall prevalence of Arcanobacterium pyogenes (1.0 vs. 7.6%) at 51 +/- 3 DIM. Cows with clinical endometritis had increased prevalence of A. pyogenes (10.3 vs. 1.5%), Escherichia coli (5.9 vs. 0.75%), and overall positive uterine culture (41.2 vs. 22.4%); however, cows with subclinical endometritis only had an increased prevalence of A. pyogenes (10.2 vs. 1.5%). Ceftiofur did not affect pregnancy per artificial insemination in all cows or in cows previously diagnosed with metritis or clinical endometritis. Interval to pregnancy was similar for control and ceftiofur cows. Intrauterine infusion of ceftiofur hydrochloride reduced the prevalence of uterine infection in cows with clinical endometritis, and the prevalence of A. pyogenes, but did not affect the prevalence of subclinical endometritis or fertility of dairy cows already receiving PGF(2alpha).

Topics: Animals; Anti-Bacterial Agents; Bacteria; Cattle; Cattle Diseases; Cephalosporins; Dairying; Dinoprost; Estrus Synchronization; Female; Fertility; Kaplan-Meier Estimate; Pregnancy; Random Allocation; Uterine Diseases; Uterus