Antimicrobial Considerations for Horses

The treatment and management of bacterial diseases in horses require a portfolio of antimicrobials with good efficacy and safety profiles. This portfolio has been narrowed in the last decades, due to the overuse of antimicrobials both in human and veterinary medicine leading to a constant selection pressure of antimicrobial-resistant clinical bacterial isolates. Following the tools of antimicrobial stewardship can help to preserve the efficacy of the available portfolio, via minimising the need for antimicrobials. Efforts should be focused on minimising the of use of critically important antimicrobials. The biggest barrier to prudent use of antimicrobials in equine medicine is ‘tradition’. With the shortcomings of robust evidence-based selection of relevant antimicrobials or combination antimicrobials, including knowledge of factors such as pathogen/infection/target site of infection/animal (age) category, the authors provide an update and advice commentary, which can serve as a basis for responsible choices of antimicrobials. This is key for treatment, but conditions and individual characteristics of the animal treated should be considered as well. Some traditional uses of antimicrobials in equine medicine are challenged and refuted. Indications covered represent the most common diseases of respiratory, gastrointestinal, urinary and reproductive tract, as well as covering musculoskeletal, ophthalmologic, cardiovascular, neurological and skin infections. Recommendations are provided regarding dose, interval and route of administration together with specific remarks, where considered appropriate. The theme of the chapter is responsible and judicious use of antimicrobials, including perioperative prophylaxis. Being aware of equine medicine specifics then off-label and cascade use is covered and commented. Final remarks target the difficulties but also opportunities for the future use of antimicrobials.