The association of erythromycin ethylsuccinate with acute colitis in horses in Sweden

Abstract

Summary 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.

A Survey of Agents Associated with Neonatal Diarrhea in Iowa Swine Including Clostridium Difficile and Porcine Reproductive and Respiratory Syndrome Virus

“…2,7,10,17,20,23 In this study, reliable information on antibiotic usage was only available in 14 of the 29 piglets in which C. difficile toxin was detected. In 10 of these 14 animals, C. difficile enteritis was preceded by antibiotic administration either at processing or as treatment for diarrhea.…”

The Comparative Pathology ofClostridium difficile-associated Disease

“…54,114 Affected segments are often edematous with superficial ulcers or erosions, but in more severe cases, hemorrhagic necrotizing typhlocolitis has been reported. 54,114 Microscopic lesions do not differ remarkably from those associated with CDAD in other species, and include edema, variable vascular necrosis, and multifocal mucosal necrosis, erosions, and ulcers that vary with severity of the disease. 114 In contrast to adult horses and most other susceptible species, foals consistently develop severe lesions in the small intestine.…”

Equine Colitis X Associated with Infection by Clostridium Difficile NAP1/027

“…1,10,23,30 Milder forms of antibiotic-associated colitis can also occur. 10 The search for a microbial etiologic component has focused on members of the genus Clostridium. Horses developing colitis X in response to inoculation with antimicrobials and intestinal contents from horses with natural disease yielded an organism resembling C. cadaveris.…”

“…22 Tetracyclines, lincomycin, and erythromycin have been implicated in predisposition of horses to colitis X. 1,10,23,30 Milder forms of antibiotic-associated colitis can also occur. 10 The search for a microbial etiologic component has focused on members of the genus Clostridium.…”