Standing equine cheek tooth extraction: A multivariate analysis of the effect of antibiotics on the risk of post-operative complications.
Authors: Christiansen Mathias Schach, Rosenmeier Jesper Grud, Jensen Dan Børge, Lindegaard Casper
Journal: Equine veterinary journal
Summary
# Standing Cheek Tooth Extraction and Perioperative Antibiotics: What the Evidence Actually Shows Whether routine perioperative antibiotics reduce post-operative complications following standing cheek tooth extraction has never been properly examined, despite widespread clinical practice. Researchers analysed 305 horses that underwent extractions between 2016 and 2020, examining associations between antibiotic use, extraction method, and post-operative complications through multivariate logistic regression modelling. For standard oral extractions (264 horses), antibiotic administration made no difference to complication rates: 18.4% of antibiotic-treated horses versus 16.3% of untreated horses developed complications, a clinically and statistically insignificant finding. Notably, horses undergoing minimally invasive transbuccal extraction (MTE) showed a different pattern—those receiving antibiotics had a 22.7% complication rate compared to 52.6% without antibiotics—though this did not reach statistical significance after adjustment for multiple comparisons. The authors also identified younger age as a significant risk factor for post-operative complications. For practitioners performing standard extractions in standing horses, the findings suggest routine perioperative antibiotics lack evidence-based justification; however, the promising (though not conclusive) trend in MTE cases warrants further investigation before abandoning antibiotics in this more invasive technique.
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Practical Takeaways
- •For routine standing cheek tooth extraction, perioperative antibiotics may not be necessary to prevent complications, potentially reducing costs and antimicrobial use
- •Consider perioperative antibiotics for minimally invasive transbuccal extractions as complication rates were substantially higher without them, despite borderline statistical significance
- •Monitor younger horses more closely for post-operative complications regardless of extraction method or antibiotic use
Key Findings
- •Perioperative antibiotics showed no significant association with reduced complication rates in 264 horses undergoing standard oral cheek tooth extraction (18.4% with antibiotics vs 16.3% without, P=1.0)
- •In 41 horses undergoing minimally invasive transbuccal extraction (MTE), those receiving antibiotics had lower complication rates (22.7% vs 52.6%), though not statistically significant after multiple comparison adjustment (adjusted P=0.26)
- •Younger age was significantly associated with increased post-operative complications (P=0.02, OR=0.92 per year)