Use of erythromycin-rifampin combination in treatment of Rhodococcus equi pneumonia

Hillidge, C.J.

doi:10.1016/0378-1135(87)90121-0

Cited by 135 publications

(124 citation statements)

References 15 publications

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“…Previously, recommendations regarding the relative efficacy of antimicrobial agents for the treatment of pneumonia caused by R. equi were based exclusively on in vitro activity data, retrospective studies and comparisons to historical controls 8, 21, 22, 23. In the present study, GAM in monotherapy was noninferior to the combination of AZM‐RIF.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia

Hildebrand¹,

Venner

Giguère

2015

Veterinary Internal Medicne

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BackgroundGamithromycin is active in vitro against the bacterial agents most commonly associated with bronchopneumonia in older foals. However, the clinical efficacy and safety of this drug have not been investigated.HypothesisGamithromycin is effective for the treatment of bronchopneumonia in foals.AnimalsOne hundred and twenty‐one foals on a farm endemic for infections caused by Rhodococcus equi.MethodsIn a controlled, randomized, and double blinded clinical trial, foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0–20 cm) were randomly allocated in 3 treatment groups: (1) gamithromycin IM q7 days (n = 40); (2) azithromycin with rifampin, PO q24h (n = 40); or (3) no antimicrobial treatment (controls; n = 41). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study.ResultsThe proportion of foals that recovered without the need to be removed from the study was significantly higher for foals treated with gamithromycin (38 of 40) or azithromycin with rifampin (39 of 40) than for controls (32 of 41). Treatment with gamithromycin or with azithromycin‐rifampin resulted in a significantly faster decrease in the clinical score and abscess score compared to the controls. Adverse reactions characterized by colic (n = 18) and hind limb lameness (n = 14) were observed only in foals treated with gamithromycin.Conclusion and Clinical ImportanceGamithromycin was noninferior to azithromycin with rifampin for the treatment of bronchopneumonia in the study population but had a higher frequency of adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia

Hildebrand¹,

Venner

Giguère

2015

Veterinary Internal Medicne

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“…Because of the successful treatment of R. equi infections in foals with the combination of erythromycin and rifampin (253,294) and the ability of both drugs to penetrate macrophages and kill R. equi, the efficacy of these two antimicrobial agents alone and in combination has been studied. 36 antimicrobial agents for their R equi isolates.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

The medically important aerobic actinomycetes: epidemiology and microbiology

1994

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The aerobic actinomycetes are soil-inhabiting microorganisms that occur worldwide. In 1888, Nocard first recognized the pathogenic potential of this group of microorganisms. Since then, several aerobic actinomycetes have been a major source of interest for the commercial drug industry and have proved to be extremely useful microorganisms for producing novel antimicrobial agents. They have also been well known as potential veterinary pathogens affecting many different animal species. The medically important aerobic actinomycetes may cause significant morbidity and mortality, in particular in highly susceptible severely immunocompromised patients, including transplant recipients and patients infected with human immunodeficiency virus. However, the diagnosis of these infections may be difficult, and effective antimicrobial therapy may be complicated by antimicrobial resistance. The taxonomy of these microorganisms has been problematic. In recent revisions of their classification, new pathogenic species have been recognized. The development of additional and more reliable diagnostic tests and of a standardized method for antimicrobial susceptibility testing and the application of molecular techniques for the diagnosis and subtyping of these microorganisms are needed to better diagnose and treat infected patients and to identify effective control measures for these unusual pathogens. We review the epidemiology and microbiology of the major medically important aerobic actinomycetes.

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“…Second, erythromycin is l1.ighly lipid soluble and concentrates within neutrophils (Prokesch & Hand,, 1982). Third, it can be administered orally to foals for prolonged periods with ~~latively >few side effects (Hillidge, 1987).…”

Section: Introductionmentioning

confidence: 99%

Comparison of oral erythromycin formulations in the horse using pharmacokinetic profiles

Ewing

Burrows

MacAllister

et al. 1994

Vet Pharm & Therapeutics

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Ewing, P. J., Burrows, G., MacAllister, C, Clarke, C. Comparison of oral erythromycin formulations in the horse using pharmacokinetic profiles. J. vet. Pharmacol, Therap.17, 17–23. The pharmacokinetic properties of four erythromycin formulations were compared in six adult horses after administration of single and multiple oral doses. Formulations of erythromycin administered were estolate and phosphate given 37.5 mg/kg every 12 h and 25 mg/kg every 8 h, and stearate and ethylsuccinate given 25 mg/kg every 8 h. Areas under the curve (AUC) and maximum plasma erythromycin concentrations (Cmax) were equal or greater (P ≥ 0.05) following administration of erythromycin phosphate and stearate compared with those values following administration of erythromycin estolate or ethylsuccinate. In comparing an 8 h vs. a 12 h dosage interval for multiple doses of erythromycin phosphate or estolate, there were no significant differences observed in AUC(24–28 h), peak‐trough plasma concentrations or duration that plasma concentrations exceeded the minimal inhibitory concentration (MIC) for Rhodococcus equi. Comparisons of pharmacokinetic parameters between single and multiple doses were made for each formulation. Differences in Cmax, tmax, or t½β between single and multiple doses were demonstrated for erythromycin ethylsuccinate and estolate. Based on equivalent plasma antibiotic concentrations, erythromycin phosphate or stearate could be substituted for estolate in the treatment of Rhodococcus equi pneumonia. Furthermore, there was no advantage of an 8‐h interval, compared with an interval of 12 h.

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Use of erythromycin-rifampin combination in treatment of Rhodococcus equi pneumonia

Cited by 135 publications

References 15 publications

Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia

Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia

The medically important aerobic actinomycetes: epidemiology and microbiology

Comparison of oral erythromycin formulations in the horse using pharmacokinetic profiles

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