Administration of trimethoprim-sulphadimidine does not improve healing of glandular gastric ulceration in horses receiving omeprazole: a randomised, blinded, clinical study.
Authors: Sykes Ben W, Sykes Katja M, Hallowell Gayle D
Journal: BMC veterinary research
Summary
# Editorial Summary Growing recognition that glandular gastric ulceration in horses behaves differently from squamous disease—particularly in its poor response to omeprazole alone—has prompted investigation of adjunctive therapies; this randomised, blinded clinical trial examined whether adding trimethoprim-sulphadimidine (TMS) to omeprazole treatment would enhance healing outcomes in naturally occurring glandular ulcers. Horses with endoscopically confirmed glandular ulceration received either omeprazole monotherapy or omeprazole plus TMS, with gastric healing assessed via repeat endoscopy after the treatment period. Contrary to the hypothesis that antimicrobial therapy might support mucosal recovery, the addition of TMS to omeprazole provided no significant improvement in ulcer healing compared with omeprazole treatment alone. These findings indicate that practitioners seeking to optimise management of glandular EGUS should focus on other potential adjunctive approaches rather than antimicrobial supplementation, whilst reinforcing the need for continued investigation into the underlying pathophysiology of glandular disease and identification of genuinely effective combination therapies.
Read the full abstract on PubMed
Practical Takeaways
- •Adding trimethoprim-sulphadimidine to omeprazole provides no additional benefit for treating glandular gastric ulcers in horses — omeprazole monotherapy remains standard
- •Recognize that glandular ulcers respond differently to treatment than squamous ulcers and may require different therapeutic approaches
- •Further research is needed to identify effective adjunctive therapies for glandular EGUS, as current antimicrobial adjuncts are ineffective
Key Findings
- •Addition of trimethoprim-sulphadimidine to omeprazole did not improve healing of glandular gastric ulceration compared to omeprazole monotherapy
- •Glandular gastric ulceration shows poor response to omeprazole monotherapy alone
- •Squamous and glandular disease have different pathophysiology, epidemiology, and treatment responses