A review of the use of ceftiofur sodium sterile powder for the treatment of equine endometritis

Transient acute endometritis enevitably follows breeding and foaling in mar es. Mares that develop persistent endometritis exhibit poor fertility, whic h can be costly to breeders. Persistent endometritis usually is treated by intrauterine irrigation (infusion) with antibiotic solutions effective agai nst the implicated pathogens; correction of predisposing anatomic factors, such as pneumovagina; and cycling the mare with prostaglandin. Ceftiofur is a late-generation cephalosporin that is active against a wide range of bacterial pathogens. It is approved in the UK, US, and several oth er countries for intramuscular administration in the horse for treatment of bacterial respiratory disease associated with Streptococcus zooepidemicus, Streptococcus equi, Pasteurella spp, and Staphylococcus spp. It is hypothe sized that its broad spectrum of activity also might make it suitable for t reating equine endometritis. Ceftiofur sodium has demonstrated activity against aerobic bacterial isolat es from mares with endometritis. It was equivalent to or significantly more active in vitro than gentamicin, amikacin, penicillin G, and ticarcillin a gainst Staphylococcus, Streptococcus, and Enterobacteriaceae spp. Serum and endometrial tissue concentrations of ceftiofur peaked at 1 hour after intr amuscular administration of 2 mg/kg body weight, and endometrial levels exc eeded the minimal inhibitory concentrations (MIC) for S zooepidemicus and E scherichia coli. In field trials, ceftiofur administered as an intrauterine treatment proved significantly better than treatment with saline solution, in increasing th e conception rate, decreasing services to conception, and improving the fer tility rate. It was also less irritating to the endometrial mucosae than wa s sterile saline. Finally, resolution of acute endometritis (based on endom etrial culture and cytologic studies) in ceftiofur-treated mares occurred n umerically more frequently than in mares treated with a mixture of benzylpe nicillin, neomycin, polymixin, and furaltadone. A review of the existing mi crobial susceptibility, pharmacokinetic, and efficacy data suggests that ce ftiofur will be both safe and effective for the treatment of equine endomet ritis.