Respiratory infections
Respiratory tract diseases are common in horses, and
one of the most frequent reasons for antimicrobial
administration (Table 10.3). Causes for respiratory
tract diseases are multi-factorial. Recommended treatments
are variable and some references still endorse
the use of broad-spectrum antimicrobials for equine
respiratory tract diseases, even to cover the possibility
of secondary bacterial pneumonia from a primary
viral infection, despite the absence of data supporting
these approaches. It is important for equine clinicians
to remember that most respiratory diseases in horses
are non-infectious or viral and do not require antimicrobial
treatment. Furthermore, secondary bacterial
pneumonia is rare. The use of broad-spectrum antimicrobials for respiratory tract diseases based on
clinical signs alone (e.g. fever, cough, nasal discharge)
can no longer be justified. There are a number of
diagnostic techniques (e.g. trans-tracheal wash, tracheal
aspirate, broncho-alveolar lavage, lung biopsy)
that are simple and safe to perform whereby representative
samples can be obtained for culture and
sensitivity (13). Regardless of the causal agent of a
lower respiratory tract infection, adequate stall rest in
a well-ventilated stable and supportive care, including
good-quality hay and water, are the most important
components of recovery. Exercise during clinical disease
and recovery may worsen the clinical disease. Stall
rest for three weeks after clinical resolution has been
used as guideline for bacterial lower airway diseases.
The direct delivery of antimicrobials to the lower
airways through nebulization has been an enticing
method to deliver maximal drug concentrations to the
site of infection, gaining rapid onset of action, while
minimizing systemic exposure. Aerosol particle sizes
between 1 and 5 μm are thought to be ideal for therapy,
using ultrasonic or jet nebulizers. Aminoglycoside
Respiratory infectionsRespiratory tract diseases are common in horses, andone of the most frequent reasons for antimicrobialadministration (Table 10.3). Causes for respiratorytract diseases are multi-factorial. Recommended treatmentsare variable and some references still endorsethe use of broad-spectrum antimicrobials for equinerespiratory tract diseases, even to cover the possibilityof secondary bacterial pneumonia from a primaryviral infection, despite the absence of data supportingthese approaches. It is important for equine cliniciansto remember that most respiratory diseases in horsesare non-infectious or viral and do not require antimicrobialtreatment. Furthermore, secondary bacterialpneumonia is rare. The use of broad-spectrum antimicrobials for respiratory tract diseases based onclinical signs alone (e.g. fever, cough, nasal discharge)can no longer be justified. There are a number ofdiagnostic techniques (e.g. trans-tracheal wash, trachealaspirate, broncho-alveolar lavage, lung biopsy)that are simple and safe to perform whereby representativesamples can be obtained for culture andsensitivity (13). Regardless of the causal agent of alower respiratory tract infection, adequate stall rest ina well-ventilated stable and supportive care, includinggood-quality hay and water, are the most importantcomponents of recovery. Exercise during clinical diseaseand recovery may worsen the clinical disease. Stallrest for three weeks after clinical resolution has beenused as guideline for bacterial lower airway diseases.The direct delivery of antimicrobials to the lowerairways through nebulization has been an enticingmethod to deliver maximal drug concentrations to thesite of infection, gaining rapid onset of action, whileminimizing systemic exposure. Aerosol particle sizesbetween 1 and 5 μm are thought to be ideal for therapy,using ultrasonic or jet nebulizers. Aminoglycoside
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