title: The association of erythromycin ethylsuccinate with acute colitis in horses in Sweden.
abstract: In Sweden there are several reports of mares developing acute colitis while their foals were being treated orally for Rhodococcus equi pneumonia with the combination of erythromycin and rifampicin. In this study 6 adult horses were given low oral dosages of these antibiotics, singly or in combination. Within 3 days post administration of erythromycin, in one case in combination with rifampicin, 2 horses developed severe colitis (one fatal). Clostridium difficile was isolated from one of the horses, whereas no specific pathogens were isolated from the other. Both horses had typical changes in blood parameters seen in acute colitis. Clostridium difficile was also isolated from the faeces of a third horse given an even lower dosage of erythromycin in combination with rifampicin. This horse developed very mild clinical symptoms and recovered spontaneously. In the fourth horse given erythromycin only, very high numbers of Clostridium perfringens were isolated. The horses given rifampicin only did not develop any clinical symptoms and there were no major changes in their faecal flora. In conclusion, it has been demonstrated that low dosages of erythromycin ethylsuccinate can induce severe colitis in horses associated with major changes of the intestinal microflora. Clostridium difficile has been demonstrated as a potential aetiological agent in antibiotic-induced acute colitis.
authors.affiliation: Department of Medicine and Surgery, Faculty of Veterinary Medicine, Swedish University of Agricultural sciences, Box 7018, S-750 07 Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Gustafsson
authors.forename: V
authors.initials: V
authors.lastname: Båverud
authors.forename: A
authors.initials: A
authors.lastname: Gunnarsson
authors.forename: M H
authors.initials: MH
authors.lastname: Rantzien
authors.forename: A
authors.initials: A
authors.lastname: Lindholm
authors.forename: A
authors.initials: A
authors.lastname: Franklin
mesh_terms: D000193:Actinomycetales Infections / Q000188:drug therapy / Q000662:veterinary; D000208:Acute Disease; D000818:Animals; D000833:Animals, Suckling; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000254:growth & development / Q000302:isolation & purification*; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced / Q000382:microbiology / Q000662:veterinary*; D015643:Erythromycin Ethylsuccinate / Q000008:administration & dosage / Q000009:adverse effects*; D005243:Feces / Q000382:microbiology; D005260:Female; D006734:Horse Diseases / Q000139:chemically induced / Q000382:microbiology*; D006736:Horses; D008297:Male; D016929:Rhodococcus equi / Q000187:drug effects; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects; D013548:Sweden
chemical_list: D000900:Anti-Bacterial Agents; D015643:Erythromycin Ethylsuccinate; D012293:Rifampin