Ceftiofur use and antimicrobial stewardship in the horse.
Authors: Ryan Clare A, McNeal Christina D, Credille Brenton C
Journal: Equine veterinary journal
Summary
# Ceftiofur Use and Antimicrobial Stewardship in Horses Antimicrobial resistance poses a genuine threat to equine medicine, yet prescribing practices within the veterinary profession remain inconsistent with stewardship principles—particularly regarding cephalosporin antibiotics, which are classified as critically important for human medicine. Clare, McNeal and Credille's 2023 review synthesises current evidence on ceftiofur (a third-generation cephalosporin) in horses, examining both the pharmacological properties that make it clinically valuable and the resistance patterns that emerge from inappropriate use. Key findings highlight that whilst ceftiofur demonstrates excellent tissue penetration and efficacy against common equine pathogens when used judiciously, current prescribing patterns often fail to account for resistance risk or alternative options—a gap that reflects broader gaps in antimicrobial categorisation frameworks within veterinary practice. For equine professionals, the practical takeaway is substantial: resistance to cephalosporins in horses is documented and rising, yet many infections can be managed with narrower-spectrum agents if guided by appropriate diagnostics and evidence-based protocols. Implementing structured stewardship—including culture-directed therapy, adherence to licensed dosing intervals, and restraint in prophylactic use—protects both individual patient outcomes and the utility of these critical medicines for cases where they are genuinely irreplaceable.
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Practical Takeaways
- •Evaluate your prescribing practices against current antimicrobial stewardship guidelines to ensure you are not contributing to resistance development in your patient population
- •Use ceftiofur judiciously and only when indicated by clinical evidence; follow equine-specific dosing and duration recommendations rather than extrapolating from other species
- •Stay informed about local and regional resistance patterns to cephalosporins in horses to make informed treatment decisions
Key Findings
- •Current antimicrobial stewardship standards in veterinary community are inadequate, particularly regarding antimicrobial categorisation and prescribing practices
- •Ceftiofur is a third-generation cephalosporin with medical importance in equine practice that requires careful stewardship to prevent resistance development
- •Evidence-based recommendations for appropriate ceftiofur use in horses are available to guide practitioners in reducing antimicrobial resistance