Can the use of antimicrobials in adult equine patients with acute colitis be justified in the era of antimicrobial stewardship?

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Summary: The use of antimicrobials in adult horses with acute colitis is controversial and clear antimicrobial guidelines are lacking. It is generally accepted that antimicrobials should be reserved for patients with specific bacterial enterocolitis such as Neorickettsia risticii or Clostridium difficile ; however, in practice, horses show similar clinical signs independently of the underlying aetiology. The clinician is therefore often confronted with the dilemma of rapid initiation of treatment to avoid mortality vs. delayed and selective targeted antimicrobial treatment based on faecal diagnostic testing. The risk of antibiotic associated diarrhoea and the emergence of antimicrobial resistance are other important considerations.

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