Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery.
Authors: Durward-Akhurst S A, Mair T S, Boston R, Dunkel B
Journal: The Veterinary record
Summary
Incisional infections remain a significant source of morbidity following exploratory coeliotomy in horses, yet optimal perioperative antimicrobial duration remains unclear—a knowledge gap particularly relevant given rising resistance concerns and the clinical drive to minimise unnecessary drug exposure. Durward-Akhurst and colleagues conducted a randomised controlled trial across two referral centres, enrolling 92 horses that recovered from surgery and survived beyond 120 hours post-operatively; 42 received 72 hours of perioperative antimicrobial cover whilst 50 received 120 hours, with incisional complications tracked as the primary outcome. Incisional complications developed in 42.2% of horses overall, with no statistically significant difference between the shorter and longer treatment protocols. These findings suggest that extending antimicrobial therapy beyond 72 hours offers no protective advantage against incisional infection, supporting a more conservative approach to post-colic surgery prophylaxis that aligns with antimicrobial stewardship principles. For practitioners, this evidence provides reassurance that shorter perioperative courses are justified, reducing exposure to multiresistant pathogens whilst maintaining comparable infection prevention outcomes in uncomplicated colic surgery recoveries.
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Practical Takeaways
- •After exploratory coeliotomy, you can safely reduce antimicrobial therapy from 120 hours to 72 hours without increasing incisional infection risk
- •Shortening perioperative antimicrobial duration helps reduce antibiotic exposure and limits selection pressure for multiresistant bacteria
- •Nearly 42% of horses still develop incisional complications regardless of antimicrobial duration, suggesting other infection control measures warrant attention
Key Findings
- •Overall incisional complication rate was 42.2% across both treatment groups
- •No significant difference in incisional complications between 72-hour (Group 1, n=42) and 120-hour (Group 2, n=50) antimicrobial regimens
- •72 hours of perioperative antimicrobial therapy is as effective as 120 hours at preventing postoperative incisional infections