Changes in Perioperative Antimicrobial and Anti-Inflammatory Drugs Regimens for Colic Surgery in Horses: A Single Center Report
Authors: M. Gandini, A. Cerullo, P. Franci, G. Giusto
Journal: Veterinary Sciences
Summary
# Editorial Summary Over five years at a single referral centre, Gandini and colleagues documented substantial shifts in postoperative antimicrobial and anti-inflammatory protocols following emergency colic surgery, moving away from routine prophylaxis towards a complication-driven approach. Of 234 cases reviewed between 2017 and 2021, only 92 horses received postoperative antibiotics while 142 received pre-operative cover only; simultaneously, the range of anti-inflammatory agents expanded, with varied dosing regimens of flunixin meglumine supplemented by additional non-steroidal and corticosteroid options. Notably, restricting routine postoperative antimicrobials did not increase postoperative complications, challenging the traditional empirical practice of prolonged antibiotic cover in post-laparotomy cases. These findings align with current antimicrobial stewardship guidelines emphasising shortest effective durations and support evidence-based de-escalation protocols that reserve treatment for horses showing genuine postoperative complications rather than routine prophylaxis. For practitioners, this single-centre experience suggests that thoughtful individualisation of postoperative regimens—reserving antibiotics for documented need and optimising anti-inflammatory selection for analgesia and gastrointestinal protection—may safely reduce unnecessary drug exposure without compromising outcomes.
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Practical Takeaways
- •Routine postoperative antibiotics after colic surgery may not be necessary—consider using antibiotics only when clinical signs of infection develop, supporting antimicrobial stewardship without compromising outcomes
- •Multi-modal anti-inflammatory approaches (combining NSAIDs with corticosteroids at lower flunixin doses) may provide better analgesia and reduce gastrointestinal side effects compared to high-dose NSAID monotherapy
- •Moving from empirical postoperative drug protocols to complication-directed therapy appears safe and may reduce unnecessary drug exposure and costs in colic surgery cases
Key Findings
- •Progressive reduction in routine postoperative antimicrobial prophylaxis over 2017-2021 did not increase incidence of postoperative complications
- •Increasing use of multiple anti-inflammatory drug molecules over the study period, including NSAIDs and corticosteroids
- •142 horses received antimicrobials only preoperatively while 92 received postoperative prophylactic antimicrobials with comparable outcomes
- •Therapeutic antimicrobials were administered only when complications justified their use rather than as routine prophylaxis