Prophylactic intra-uterine antibacterial therapy

Introduction

Endometritis in the mare can be classed as infectious (acute or chronic) or post mating-induced endometritis (PMIE). PMIE is a physiological inflammatory response to semen characterised by an influx of polymorphonuclear neutrophils (PMNs) into the uterine lumen causing myometrial contractions and the removal of inflammatory fluid leaving the uterus ready to accept an embryo on Day 5.5. This process is compete at 24–72 h after mating, such mares are resistant to persistent PMIE. A pathological post mating-induced endometritis is diagnosed if the inflammation persists beyond this time and has a negative effect on fertility, such mares are termed susceptible to persistent PMIE [1]. The use of prophylactic intra-uterine antibiotics is aimed at treating the persistent PMIE that may arise, their use has been common-place in the past but is their routine infusion justified in the current age of responsible antibiotic use?

Search method

A literature search using PubMed, University of Liverpool electronic library and IVIS was performed relating to studies for intra-uterine antibiotics AND endometritis AND horse.

Quantity of evidence

Eleven papers were selected showing relevance to the question, 3 were retrospective studies [2–4], 4 randomised controlled studies with one field based study [5].  […]