Incorporating Non-antibiotic Anti-infective Agents Into the Treatment of Equine Endometritis

Abstract

Chronic endometritis remains an important cause of fertility in the mare. Conventional therapy (antibiotics and antifungals) aimed at resolving chronic endometritis sometimes fails due to a variety of reasons including uncorrected anatomic abnormalities and the presence of abnormal mucus or biofilm in the uterus. With increasing frequency, bacteria with multiple resistance patterns are being recovered from the equine uterus. Therefore, alternative methods to treat microbial infections are needed to reduce the reliance on traditional antimicrobials. The rationale, preparation, and protocols for use of non-antibiotic anti-infective agents including mucoactive agents (N-acetylcysteine), buffered chelators (EDTA-Tris and TricideTM), non-classified solutions (dimethyl sulfoxide, dilute vinegar and povidone-iodine solutions, hydrogen peroxide) and immunomodulatory agents (glucocorticoids, cell-wall extract of Mycobacterium phlei, Proprionibacterium acnes) are discussed. [...]