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Editorial
Antimicrobial use during colic surgery: finding the right strategy
  1. David E. Freeman, MVB, PhD, Dip ACVS
  1. College of Veterinary Medicine, University of Florida, Large Animal Clinical Sciences, PO Box 100136, Gainesville, FL 32610-0136, USA
  1. e-mail: freemand{at}ufl.edu

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A MAJOR goal of prophylactic antimicrobial administration is to prevent incisional infection, an important cause of morbidity after equine colic surgery. The inclusion criteria used in the study by Durward-Akhurst and others (2012), which is summarised on p 287 of this issue of Veterinary Record, created two comparable sets of colic cases at two referral hospitals to study the timing of antimicrobial administration to prevent this complication. The study found no difference between 72 hours and 120 hours of prophylactic antimicrobial administration in preventing incisional infections and, therefore, the shorter period should be preferable; postoperative antimicrobial use for long durations in horses could promote emergence of resistant organisms (Morley and others 2005) and induce diarrhoea (Cohen and Woods 1999).

The critical question is whether or not we should give antimicrobial agents to horses at all after colic surgery is completed. One option is to follow the evidence-based practice for human clean-contaminated surgery, in which antimicrobial prophylaxis is not recommended after wound closure (Bratzler and others 2013). In the two groups of horses described by Durward-Akhurst and others (2012) almost 17 per cent had exploratory surgery only. Such procedures should be regarded as clean and, therefore, should not qualify for antimicrobial prophylaxis according to the strictest guidelines (Brown 1999) and …

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