Vancomycin for the treatment of methicillin-resistant staphylococcal and enterococcal infections in 15 horses.
We retrospectively reviewed the cases of 15 foals and adult horses in which vancomycin was used, alone or in combination with an aminoglycoside, to treat methicillin-resistant staphylococcal and enterococcal infections. Signalment, presenting complaint, history (including history of treatment for the current complaint), results of bacterial culture and antimicrobial susceptibility testing, treatment, and outcome were reviewed. The average vancomycin dosage was 7.5 mg/kg q8h, administered by intravenous infusion over 30 min. The infection resolved in all 7 horses with soft tissue infections and in 6 of the 8 horses with infections involving a bone or a joint, or both. No adverse effects of vancomycin therapy were noted. Although the number of cases is small, our findings suggest that vancomycin, alone or in combination with an aminoglycoside, is safe and effective for the treatment of resistant staphylococcal and enterococcal infections in horses and foals. However, owing to the importance of staphylococci and enterococci in human medicine and the problems with emerging resistance, we recommend that the use of vancomycin in horses be limited to cases in which culture and susceptibility results clearly indicate that this agent is likely to be effective and in which there is no reasonable alternative.
New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348, USA. orsini@vet.upenn.edu
James A
JA
Orsini
Corinna
C
Snooks-Parsons
Lynne
L
Stine
Marie
M
Haddock
Charles F
CF
Ramberg
Charles E
CE
Benson
David M
DM
Nunamaker
D000617:Aminoglycosides / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000662:veterinary*; D006736:Horses; D007262:Infusions, Intravenous / Q000662:veterinary; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests / Q000662:veterinary; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000662:veterinary*; D016896:Treatment Outcome; D014640:Vancomycin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D000617:Aminoglycosides; D014640:Vancomycin