Alternatives to antimicrobial use in the uterus

The global use of antibiotics over the last several decades has resulted in significant antibiotic resistance being observed. With a serious concern of antibiotic resistance resulting in the inability to treat common bacterial infections in the future practitioners are looking for alternative therapies for treating routine infections. Historically multiple non-antibiotics have been used for the successful treatment of uterine infections. A few of the more common ones are dilute povidone Solution (titratable iodine 1%, 15 mls povidone solution in 1 liter of saline or LRS), hydrogen peroxide (1% solution as infusion or used in lavage) and tris-EDTA (50 mM tris with 3.5 mM EDTA as a lavage or infusion). Recently there has been a surge in new alternatives to antibiotics for treating uterine infections such as ozone, anti-microbial peptides or platelet rich plasma. However, the practitioner needs to use caution when deciding if alternatives to antibiotics will be better than traditional therapy with antibiotics. The first major decision that needs to be determined is the safety and efficacy ideally reported both in vitro and in vivo for the compound to be used. The clinical case you are treating should be evaluated to determine if the clinical case supports consideration of treatment with non-antimicrobials. For example a post breeding antibiotic infusion in a “normal” mare likely would benefit with non-antibiotic replacement as compared to antibiotic infusion. However a mare diagnosed with a uterine infection via endometrial culture and cytology may still require antibiotic treatments. In the end as you consider alternative antibiotic treatments you must consider as the practitioner are you doing the right thing for the horse and your client.

Ryan A Ferris, DVM, MS, Diplomate, American College of Theriogenologists, Owner, Summit Equine, Inc. Newberg Oregon Dr. Ferris graduated from veterinary school at Washington State University in 2007. Ryan completed an internship in equine surgery, medicine and reproducJon at the Equine Medical Center of Ocala in 2008. Followed by a residency in Equine ReproducJon at Colorado State University. He received a MS in Clinical Science from Colorado State University, passed the board examinaJons for the College of Theriogenologists and was an assistant professor at Colorado State University from 2010-2017. In 2017 Dr. Ferris and his family moved to Newberg, Oregon and established Summit Equine, Inc. Summit Equine is a referral equine reproducJon pracJce for mares and stallions. Offering services in breeding management (fresh, cooled or frozen), embryo transfer, problem mares, oocyte aspiraJon, stallion collecJons for fresh, cooled or frozen semen, internaJonal shipment of semen, stallion evaluaJons. Interests: Bacterial and fungal endometriJs, biofilm, post maJng induced endometriJs, and embryo transfer