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Use of erythromycin-rifampin combination in treatment of Rhodococcus equi pneumonia
1Department of Medical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610.
Abstract:
The selection of lipid-soluble antibiotics capable of intracellular penetration is considered critical for the successful treatment of Rhodococcus equi pneumonia and lung abscesses in foals. Two such antibiotics: erythromycin (25 mg kg-1, three times daily) and rifampin (5 mg kg-1 twice daily) have been used in combination for this purpose at the University of Florida since 1981. Positive evidence of R. equi was present on culture of tracheal aspirates in 57 foals, most of which exhibited radiographic evidence of extensive lung abscessation. The duration of therapy ranged from 4 to 9 weeks. Mild diarrhea was sometimes noted, but was never severe enough to require the termination of therapy. No other adverse side effects were apparent. Judged by a return of chest radiographs and hematologic parameters to normal, 50 of the 57 foals were considered to have recovered from the disease; a success rate of 88%.
Insights
Erythromycin and rifampin combination therapy effectively treats Rhodococcus equi pneumonia in foals, achieving an 88% recovery rate. This treatment is crucial for foals with lung abscesses, showing minimal adverse effects.
Area of Science:
- Veterinary Medicine
- Equine Health
- Pharmacology
Background:
- Rhodococcus equi pneumonia is a significant cause of mortality in foals.
- Intracellular penetration by lipid-soluble antibiotics is essential for treating R. equi infections.
- Effective treatment strategies for Rhodococcus equi lung abscesses in foals are critical.
Purpose of the Study:
- To evaluate the efficacy of a combination therapy for Rhodococcus equi pneumonia in foals.
- To assess the success rate and adverse effects of erythromycin and rifampin treatment in foals with lung abscesses.
Main Methods:
- A retrospective study of 57 foals diagnosed with Rhodococcus equi pneumonia.
- Treatment involved a combination of erythromycin (25 mg/kg TID) and rifampin (5 mg/kg BID) for 4-9 weeks.
- Treatment success was determined by normalization of chest radiographs and hematologic parameters.
Main Results:
- Fifty of 57 foals (88% success rate) recovered from Rhodococcus equi pneumonia.
- Radiographic and hematologic evidence of extensive lung abscessation was present in most foals.
- Mild diarrhea was the only noted adverse effect, not requiring therapy termination.
Conclusions:
- Combination therapy with erythromycin and rifampin is highly effective for treating Rhodococcus equi pneumonia in foals.
- This treatment regimen demonstrates a favorable safety profile with minimal side effects.
- The study supports the use of this antibiotic combination for Rhodococcus equi-induced lung disease in foals.