Treatments for Endometritis in Mares Caused by Streptococcus equi Subspecies zooepidemicus: A Structured Literature Review.
Authors: Li Jing, Zhao Yufei, Gao Yu, Zhu Yiping, Holyoak G Reed, Zeng Shenming
Journal: Journal of equine veterinary science
Summary
Streptococcus equi subspecies zooepidemicus (SEZ) remains the predominant bacterial cause of endometritis in mares, yet evidence-based guidance on optimal treatment protocols remains limited. Through a systematic PRISMA-compliant literature review spanning three decades (1990–2020), researchers identified ten clinical trials encompassing 116 mares and 17 distinct treatment interventions, extracting data from PubMed, CAB and Agricola databases. Antibiotic therapy, immunomodulatory agents and infusions of fresh white blood cells demonstrated superior efficacy compared to conventional approaches, whilst oxytocin administration and uterine lavage as standalone treatments appeared less effective than traditionally assumed. Given the relatively small evidence base and heterogeneity of protocols currently reported, practitioners should recognise that robust randomised controlled trials remain scarce in this area—a gap that has clear implications for standardising treatment recommendations and improving fertility outcomes in breeding mares. For farriers and physiotherapists working alongside veterinary teams, understanding these treatment hierarchies helps contextualise why ancillary care must be integrated into comprehensive endometritis management rather than viewed as primary interventions.
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Practical Takeaways
- •For SEZ endometritis cases, prioritize antibiotic therapy combined with immunomodulatory agents or fresh white blood cell treatments rather than relying on oxytocin or lavage alone
- •Current evidence suggests multimodal treatment approaches outperform single-modality protocols; consider combining antibiotics with immune support when available
- •More rigorous clinical trials are needed to establish definitive best-practice treatment guidelines for SEZ endometritis in your practice population
Key Findings
- •Antibiotics, immunomodulatory agents, and fresh white blood cell treatments demonstrated superior efficacy for treating SEZ-caused endometritis in mares across 10 studies (116 horses, 17 interventions)
- •Oxytocin and uterine lavage monotherapy showed lower effectiveness compared to other treatment approaches
- •Structured review identified substantial variation in treatment protocols published 1990-2020, suggesting need for more randomized controlled trials