A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery
Authors: S. Stöckle, Dania Kannapin, A. Kauter, A. Lübke-Becker, B. Walther, R. Merle, H. Gehlen
Journal: Antibiotics
Summary
# Editorial Summary Equine practitioners commonly administer prophylactic antibiotics for five days following colic surgery, despite human and veterinary guidelines recommending shorter perioperative courses for clean and clean-contaminated procedures such as laparotomy. Stöckle and colleagues conducted a randomised non-inferiority pilot trial comparing single-dose prophylaxis (penicillin and gentamicin administered once perioperatively) against the standard five-day regimen in 67 horses undergoing colic surgery, tracking surgical site infections, postoperative colitis, and haemolytic anaemia as primary adverse outcomes whilst also measuring serum amyloid A and fibrinogen responses. Remarkably, both groups demonstrated equivalent complication rates across all monitored parameters, suggesting that single-dose perioperative prophylaxis presents a viable alternative to prolonged antimicrobial exposure in this surgical context. The findings carry significant implications for antimicrobial stewardship in equine practice, potentially reducing unnecessary antibiotic use and associated risks including selection pressure for resistant pathogens, whilst the authors emphasise that transitioning to shorter prophylaxis protocols must be accompanied by meticulous surgical site hygiene management and rigorous clinical and laboratory monitoring. Although limited by modest sample sizes and lack of blinding, this pilot data warrants further investigation through larger, properly powered trials to establish whether single-shot prophylaxis can safely become standard practice in equine abdominal surgery.
Read the full abstract on PubMed
Practical Takeaways
- •Single-dose perioperative antibiotics appear as effective as extended 5-day protocols for clean/clean-contaminated equine colic surgery when proper hygiene and monitoring are maintained
- •Consider adopting shorter prophylaxis protocols to reduce unnecessary antibiotic exposure and associated complications like colitis in colic cases
- •Continued close clinical monitoring and strict surgical site hygiene remain essential regardless of which antibiotic duration protocol is chosen
Key Findings
- •Single-shot perioperative antibiotic prophylaxis (penicillin and gentamicin) resulted in no significant difference in surgical site infections compared to 5-day protocol (primary outcome not numerically specified in abstract)
- •Postoperative colitis and haemolytic anaemia showed no significant differences between single-shot and 5-day antibiotic regimens
- •Serum amyloid A and fibrinogen were monitored postoperatively but no differential findings between groups are specified in the abstract