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Antibiotic associated diarrhea in horses

with special reference to Clostridium difficile

Gustafsson, Agneta (2004). Antibiotic associated diarrhea in horses. Diss. (sammanfattning/summary) Uppsala : Sveriges lantbruksuniv., Acta Universitatis Agriculturae Sueciae. Veterinaria, 1401-6257 ; 166
ISBN 91-576-6652-0
[Doctoral thesis]

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Antibiotic associated diarrhea is a serious illness in horses with high mortality. Affected horses are often hospitalized, with the disease appearing after a few days of antibiotic treatment. Another risk group for developing this acute diarrhea appears to be healthy mares with foals under treatment with oral erythromycin and rifampicin for Rhodococcus equi pneumonia. In humans, C. difficile is the agent most often implicated in antibiotic associated diarrhea. When the present work was initiated this organism was not reported as a pathogen in adult horses. The aim of this thesis was to evaluate the impact of antibiotic treatment on the equine intestinal microflora with focus on the risk for development of antibiotic associated diarrhea and its connection to C. difficile. C. difficile and/or its cytotoxin was demonstrated in 40% of horses with acute colitis developing during antibiotic treatment but not found in other groups. All of these horses were treated with β-lactam antibiotics. The influence of different antibiotics was further evaluated in experimental studies. It was demonstrated that very low oral doses of erythromycin could induce acute colitis associated with C. difficile, thus, suggesting that the fatal colitis affecting the mares with foals under treatment for R. equi pneumonia was due to accidental ingestion of erythromycin. In contrast, very low oral doses of rifampicin and therapeutic doses of both oral and i.v. trimethoprim/sulfadiazine induced neither gastrointestinal disturbances nor major changes in the intestinal flora. In an oral infection model, C. difficile was cultured from faecal samples on significantly more sampling occasions from horses pre-treated with penicillin than from untreated horses indicating that penicillin treatment can predispose to establishment of C. difficile in the horse intestine. This work demonstrates that antibiotic treatment is one of the most important risk factors for development of acute colitis in the horse. Antibiotics known to be associated with a high risk for development of colitis, such as erythromycin should be avoided. However even pencillin poses a risk. As C. difficile is associated with acute colitis in adult horses being treated with antibiotics, routine examination for C. difficile is recommended in cases of antibiotic associated diarrhea.

Authors/Creators:Gustafsson, Agneta
Title:Antibiotic associated diarrhea in horses
Subtitle:with special reference to Clostridium difficile
Series Name/Journal:Acta Universitatis Agriculturae Sueciae. Veterinaria
Year of publishing :January 2004
Number of Pages:59
ALLI. Båverud, V., Gustafsson, A., Franklin, A., Lindholm, A. and Gunnarsson, A. (1997). Clostridium difficile associated with acute colitis in mature horses treated with antibiotics. Equine Veterinary Journal 29, 279-284. II. Gustafsson, A., Båverud, V., Gunnarsson, A., Horn af Rantzien, M., Lindholm, A. and Franklin, A. (1997). The association of erythromycin ethylsuccinate with acute colitis in horses in Sweden. Equine Veterinary Journal 29, 314-318. III. Gustafsson, A., Båverud, V., Franklin, A., Gunnarsson, A., Ögren, G. and Ingvast-Larsson, C. (1999). Repeated administration of trimethoprim / sulfadiazine in the horse – pharmacokinetics, plasma protein binding and influence on the intestinal microflora. Journal of Pharmacology and Therapeutics 22, 20-26. IV. Gustafsson, A., Båverud, V., Gunnarsson, A., Pringle, J. and Franklin, A. Study of shedding of Clostridium difficile in horses treated with penicillin. Equine Veterinary Journal. In press.
Place of Publication:Uppsala
ISBN for printed version:91-576-6652-0
Publication Type:Doctoral thesis
Full Text Status:Public
Agris subject categories.:L Animal production > L73 Animal diseases
Subjects:Not in use, please see Agris categories
Agrovoc terms:diarrhoea, horses, colitis, clostridium difficile, clostridium perfringens, salmonella, toxins, penicillins, erythromycin, trimethoprim, experimental infection
Keywords:C.difficile, C. perfringens, Salmonella, toxin, penicillin, erythromycin, rifampicin, trimethoprim/sulfadiazine, experimental infection
Permanent URL:
ID Code:440
Department:(VH) > Institutionen för kirurgi och medicin, Stordjur (970101-040630)
Deposited By: Agneta Gustafsson
Deposited On:12 Jan 2004 00:00
Metadata Last Modified:02 Dec 2014 10:04

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