Rationele antimicrobiële therapie voor sepsis bij runderen in het licht van de nieuwe wetgeving over kritisch belangrijke antibiotica

Abstract

Sepsis is a life-threatening condition in cattle, as in humans. Successful sepsis treatment requires a fast initiation of antimicrobial therapy with a broad-spectrum, bactericidal drug, administered intravenously. However, the new legislation limits the use of critically important fluoroquinolones and cephalosporins in food animal medicine, drugs which are considered highly effective for sepsis treatment and were previously frequently used for this indication. This article aims at providing an overview of the current knowledge of sepsis in cattle to aid practitioners in adapting their decision making process to treat sepsis. Sepsis incidence in cattle is likely seriously underestimated. This disease is almost unexplored in cattle, which makes it particularly difficult to design species specific guidelines. Sepsis diagnosis by blood culture reaches sufficient accuracy with the current laboratory technology. When adapting this procedure to a field environment, difficulties might arise, and the availability of adapted incubators in veterinary laboratories may be limited. However, these difficulties are likely to be overcome. Severe sepsis and septic shock are likely the only indications where the ‘urgency’ criterion of the new legislation would apply, but it is important to realize that alternative antimicrobial treatments with possibly similar efficacy are available.

Case Report: Multidrug Resistant Raoultella ornithinolytica in a Septicemic Calf

“…The increasing availability of MALDI-TOF MS in hospitals and diagnostic laboratories will likely result in a better and more frequent recognition of R. ornithinolytica in the years to come ( 6 ). On the other hand, this bacterium is likely underdiagnosed in septicemic animals, because blood culture enrichment is rarely used in veterinary practice and particularly not in food-producing animals, even though blood culture is the most appropriate sampling technique for presumed sepsis cases ( 1 ).…”

“…Sepsis is a high mortality risk disease for which rapid appropriate antibiotic treatment is critical to increase survival rates, both in cattle and in humans ( 1 , 2 ). A multitude of bacteria have been described as causative agents, but in cattle mainly Enterobacteriaceae , more specifically Escherichia coli , are typically isolated from ill calves ( 3 ).…”

Evaluation of Fluoroquinolone Resistance in Clinical Avian Pathogenic Escherichia coli Isolates from Flanders (Belgium)

“…However, it is critical to use this class of antimicrobial drugs with the utmost prudence in order to mitigate the development of antimicrobial resistance. In Belgium, fluoroquinolone use in the veterinary sector is tightly regulated and administration of this class of antimicrobial drugs is only possible if several conditions are met [ 73 , 74 ]. This has led to a significant decrease in the veterinary use of fluoroquinolones [ 75 ].…”

Creating an innovation ecosystem for rapid diagnostic tests for livestock to support sustainable antibiotic use

“…In certain clinical scenarios, rapid initiation of antibiotic treatment is essential for health, welfare and production reasons, e.g. a life-or-death scenario such as sepsis in cattle requires the use of broad-spectrum, critically important antibiotics (Pardon and Deprez 2018) and RDT-ABL could help to speed up diagnosis and initiation of treatment in these situations.…”