Perioperative Antibiotics Prophylaxis in Equine Surgical Colic Patients - Are We Doing the Right Thing?

Perioperative prophylaxis is one of the most common reasons for antimicrobial administration. Its goal is to reduce postoperative infection at the surgical site, thereby reducing morbidity, mortality and treatment costs. When perioperative prophylactic treatment is used, several issues should be decided upon, including the drugs that are used, timing of first administration, re-administration after 2 half-lives of the drug if surgery is still ongoing and duration of treatment. Equine colic surgery is typically an emergency procedure, classified in the best circumstances as a clean-contaminated surgical procedure and carries a high rate of surgical site infection as an important short term complication. Information regarding the compliance with prophylaxis guidelines in veterinary medicine is limited and is often not detailed enough. The duration of prophylactic treatment is a more complicated topic due to the high rate of post-operative complications in horses undergoing colic surgery. Guidelines for the judicious use of antimicrobial therapy recommend that antimicrobials should be administered for the shortest effective period possible to prevent the development of resistant pathogens. A recent study in surgical colic patients has shown no difference in the rate of incision infection with the use of perioperative antimicrobial therapy for 72 hours and for 120 hours, resulting in the conclusion that there is no benefit for the longer duration of prophylactic antimicrobial administration. Clinician's awareness for guidelines or standard protocols for antimicrobial drug use for equine patients undergoing surgery for colic is important. Implementing such guidelines, which should be reviewed and updated regularly, and reducing the amounts of perioperative antimicrobials that are being used are important goals which we all should strive for in order to reduce the emergence of resistant strains of bacteria that could affect our patients.