A clinical trial to evaluate the effectiveness of antibiotic treatment of lactating cows with high somatic cell counts in their milk

Treatment of mastitis in cattle

The understanding of mastitis, its cause, and the rationale for treatment or nontreatment of mastitis under various circumstances continues to evolve. This article presents research-based evidence about the use or nonuse of drugs to treat mastitis. Nondrug factors involved in decision making about mastitis, including cow characteristics and the epidemiology of mastitis, are also briefly discussed. This article provides information that helps in the making of knowledgeable, evidence-based decisions about therapy for mastitis. Focus is primarily on the use of antimicrobial drugs.

Elimination of erythromycin in milk after intramammary administration in cows with specific mastitis: relation to dose, milking frequency and udder health

Elimination of erythromycin in milk following intramammary therapy of specific mastitis in cows was studied. Five cows received therapy in one quarter (G1), and eight in two quarters with five milked twice (G2) and three thrice a day (G3). Dose infused was 300 mg/quarter 12 h × 5 times. The drug concentrations in milk were determined using microbial assay technique with Micrococcus luteus as the test organism. Considerable variations occurred in the excretion of drug; levels for treated quarters being 8.25 to 37.61 μg/ml at first milking that declined rapidly at 24 h and no drug activity was observed beyond 36 h post treatment. In total, about 6-25% of the last infused dose appeared in the milk. Drug crossed to 1/15 quarter (G1), 6/10 quarters (G2) and all the six untreated quarters (G3). Crossover levels were significantly higher in mastitic quarters and for G3 cows, but duration of excretion remained same in all cases. It seems that crossover of erythromycin to untreated quarters is related to the udder health and dose infused.

MASTITE SUBCLÍNICA BOVINA: TEORES DE PROTEÍNA NO LEITE APÓS O TRATAMENTO DURANTE A LACTAÇÃO

RESUMO Verificou-se os teores protéicos do leite em 135 quartos mamários com mastite subclínica causada por Staphylococcus aureus divididos em dois grupos, tratados (67) e não tratados (68). Utilizou-se para a tratamento a dose de 150 mg de gentamicina, uma vez ao dia e por três dias consecutivos, em uma propriedade com rebanho leiteiro experimental localizada na região de Barretos, interior do Estado de São Paulo. Foram considerados curados os quartos mamários cujas amostras de leite mostraram-se negativas ao isolamento das cepas de S. aureus 30 dias após o tratamento. Determinou-se as frações de proteína total (PT), proteína verdadeira (PV), caseína (CAS) e soroproteínas (SP), antes e depois do tratamento durante a lactação. As análises do extrato seco total (EST), da contagem de células somáticas (CCS) e da produção de leite também foram efetuadas. Após as análises dos dados, verificou-se que não houve diferença significativa para PT, PV e SP após o tratamento, enquanto a mesma diferença encontrada em quartos mamários doentes para CAS, antes e após o tratamento, também foi verificada para os quartos sadios que serviram de controle. Dessa maneira, concluiu-se que o tratamento da mastite subclínica causada por S. aureus durante a lactação não acarretou melhoria na qualidade do produto quando os itens analisados foram os teores protéicos do leite.

Treatment of mastitis during lactation

Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

Systemic treatment of subclinical mastitis in lactating cows with penethamate hydriodide

A randomized controlled field trial was performed to evaluate the efficacy of a 3-d treatment regimen with i.m. penethamate hydriodide compared with no treatment in lactating cows with subclinical mastitis. To be included, a cow had to have 2 somatic cell counts (SCC) 300,000 cells/mL at the last 3 monthly controls, 1 or more quarters with SCC >250,000 cells/mL, and the same bacterial species isolated in 2 consecutive samples 2 to 4 d apart. A total of 151 quarters from 92 cows were monitored for 2 mo following treatment. Quarter milk samples were examined for bacteriological cure (BC) and SCC at 14, 28, and 60 d after treatment. Bacteriological cure was defined as not having the same bacterial species isolated from the quarter milk samples taken at 14 and 28 d posttreatment as in the samples taken before treatment. Systemic treatment with penethamate resulted in BC in 59.5% of quarters and 52.2% of cows, compared with 16.7 and 10.9% in the untreated cows. Somatic cell count decreased significantly in the penethamate-treated cows, steadily in the case of BC and transiently when the infections persisted. This study confirms that systemic treatment of subclinical mastitis with penethamate is effective and that BC of infected quarters has a sustained positive effect on milk SCC during the 2 mo following treatment.

Therapeutic effects of systemic or intramammary antimicrobial treatment of bovine subclinical mastitis during lactation

The short- and long-term treatment efficacy of administrating penicillin for bovine subclinical mastitis during lactation when using intramuscular (IM; 9.5 mg [15,000 IU]/kg bodyweight of benzyl penicillin potassium) injections twice daily for 5 days, or intramammary (IMM; 0.3g [300,000 IU] penethamate hydroiodide) administration once daily for 5 days was compared with a control group receiving no treatment. One hundred and twenty-six cows met the inclusion criteria, which were lack of clinical symptoms, no recent treatment with antimicrobials, and findings of penicillin-sensitive Staphylococcus aureus, Streptococcus dysgalactiae, or Streptococcus uberis in combination with an inflammatory reaction. At follow-up 42-58 days after treatment, the proportion of cows negative for the original infection was significantly higher in IM and IMM groups compared to controls, but the difference between antimicrobial treatment groups was not significant. The udder quarter milk somatic cell count (SCC) was significantly lower at follow-up in IM and IMM groups than in controls, but milk production did not differ between treatments. The culling rate during the 10-month period following treatment was significantly higher in the group treated with IMM penicillin than in the other two groups, but the risk of new mastitis treatments within 10 months did not differ between the three groups. The cure rate was significantly affected by lactation number (lower in older cows), breed (lower in the Swedish Holstein breed), pathogen (lower for S. aureus), and pre-treatment SCC (higher for above average SCC). In conclusion, beneficial long-term effects of antimicrobial treatment during lactation of subclinical mastitis caused by S. aureus, Str. dysgalactiae or Str. uberis were not found in the present study.

Mastite subclínica causada por Staphylococcus aureus: custo-benefício da antibioticoterapia de vacas em lactação

Avaliou-se a relação custo-benefício do tratamento da mastite subclínica bovina causada por Staphylococcus aureus. Foram selecionados 270 quartos mamários com mastite subclínica e sadios, divididos em quatro grupos de acordo com o estádio de lactação e o tratamento. O grupo 1 foi formado por animais entre 10 e 60 dias da lactação e tratados contra mastites; o grupo 2 incluiu animais entre 61 dias da lactação e dois meses antes da secagem e tratados contra mastite; o grupo 3 foi formado por animais entre 10 e 60 dias da lactação, não tratados contra mastite; e o grupo 4 foi formado por animais entre 61 dias em lactação e dois meses antes da secagem, não tratados. O tratamento foi realizado pela infusão intramamária de 150mg de gentamicina, uma vez ao dia. A reavaliação foi efetuada após 30 dias. Para os cálculos dos custos com o tratamento, foram considerados uma prevalência de S. aureus de 5% e os gastos com medicamento, descarte do leite, antibiograma e mão-de-obra. Observou-se redução de 2% e 14% das receitas nos grupos 1 e 2, respectivamente, quando comparada com as receitas obtidas antes do tratamento, demonstrando ser economicamente inviável o tratamento da mastite subclínica bovina causada por S. aureus, durante a lactação.

Streptococcus dysgalactiae isolates at calving and lactation performance within the same lactation

The objective of the study was to investigate the association between early lactation Streptococcus dysgalactiae isolates and milk yield, somatic cell count (SCC), clinical mastitis, and culling in the same lactation. The 178 commercial dairy herds were randomly placed into 3 penicillin- or penicillin-dihydrostreptomycin-based dry-cow treatments and 3 different postmilking teat disinfection groups-negative control, iodine, or external teat sealant. All cows were sampled in early lactation, and Strep. dysgalactiae-positive and culture-negative cows were followed throughout the remainder of the lactation. Mixed models, including repeated measurements, with test-day observation as dependent variable, were used to compare milk yield, SCC, and available milk quality variables throughout the remaining lactation. Survival analyses, using a positive frailty model to account for any herd random effects, were used to estimate the hazard ratio for clinical mastitis and culling. Streptococcus dysgalactiae-positive cows had a significantly higher SCC throughout the lactation compared to culture-negative cows. For primiparous or multiparous cows, respectively, the differences in the geometric mean SCC between Strep. dysgalactiae-positive and culture-negative cows was 197,000 or 280,000 cells/mL at the beginning of the lactation, 24,000 or 46,000 cells/mL in mid lactation, and 39,000 or 111,000 cells/mL at the end of the lactation. Streptococcus dysgalactiae-positive primiparous or multiparous cows produced 334 or 246 kg less milk, respectively, during a 305-d lactation compared with culture-negative cows. Compared with culture-negative cows, the hazard ratios for clinical mastitis in Strep. dysgalactiae-positive cows were 2.3 (1.9 to 2.9) and 1.6 (1.3 to 2.0) for culling. For cows with both Strep. dysgalactiae and Staphylococcus aureus isolates, the hazard ratio for culling significantly increased to 2.5 (1.9 to 3.2).

Pharmacokinetic Profile of Erythromycin after Intramammary Administration in Lactating Dairy Cows with Specific Mastitis

The pharmacokinetics of erythromycin was studied in five lactating dairy cows following single intramammary infusion of 300 mg erythromycin in each of two quarters per cow with specific mastitis. Levels of erythromycin in plasma and quarter milk samples were measured by agar plate diffusion assay using Micrococcus luteus (ATCC 9341) as the test organism. Erythromycin level in plasma reached a peak concentration value (C(max)) of 0.07 +/- 0.01 microg/ml at 30 min; thereafter, levels declined gradually to reach 0.05 +/- 0.00 microg/ml 12 h post drug administration. The pharmacokinetic profile of the drug revealed mean absorption half life (t(1/2 ka)) as 0.26 +/- 0.05 h. The drug was eliminated slowly with elimination half-life (t(1/2 beta)) of 13.75 +/- 0.35 h and elimination rate constant (k(el)) of 0.04 +/- 0.00 h(-1). The volume of distribution based on the zero-time plasma concentration intercept of the least-squares regression line of the elimination phase (V(d(B))) was 0.032 L/kg. The drug crossed to untreated quarters also; mean drug levels of 0.20 +/- 0.07, 0.23 +/- 0.07, 0.17 +/- 0.04, and 0.17 +/- 0.04 microg/ml were found at 3, 6, 8 and 12 h, respectively. The mean drug concentration for treated quarters was measured as 22.97 +/- 2.31 microg/ml milk at first milking (12 h) following drug infusion. No apparent adverse reaction was seen in cows administered erythromycin. It is concluded that following intramammary infusion erythromycin diffuses readily and extensively in various body fluids and tissues and adequate concentration is maintained in udder tissues for at least 12 h post intramammary administration. Thus, erythromycin may be recommended for local therapy of acute mastitis caused by Gram-positive bacteria in lactating dairy cows.

Biofilms: a role in recurrent mastitis infections?

Mastitis remains one the most important diseases in dairy cattle despite the progress made in improving general udder health in recent years. Epidemiological studies have revealed that following treatment with antimicrobials, bacteriological cure rates vary between 0% and 80% but with no evidence of a significant loss of activity of the major classes of antibiotics licensed for the treatment of bovine mastitis. Recurrent infections are often attributable to biofilm growth of bacteria and this review provides an overview of those mechanisms related to bacterial biofilm growth in mastitis. Biofilm formation is accompanied by significant genetic and subsequent physiological changes in the microorganisms resulting, inter alia, in a loss of sensitivity to virtually all classes of antibiotics.

Invited Review: The Role of Cow, Pathogen, and Treatment Regimen in the Therapeutic Success of Bovine Staphylococcus aureus Mastitis

Staphylococcus aureus is an important cause of udder infections in dairy herds. Both lactational and dry cow therapy are part of Staph. aureus control programs. Reported cure rates for Staph. aureus mastitis vary considerably. The probability of cure depends on cow, pathogen, and treatment factors. Cure rates decrease with increasing age of the cow, increasing somatic cell count, increasing duration of infection, increasing bacterial colony counts in milk before treatment, and increasing number of quarters infected. Staphylococcus aureus mastitis in hind quarters has a low cure rate compared with front quarters. Antimicrobial treatment of intramammary infections with penicillin-resistant Staph. aureus strains results in a lower cure rate for treatment with either beta-lactam or non-beta-lactam antibiotics. Other strain-specific factors may affect the probability of cure but routine diagnostic methods for use in bacteriology laboratories or veterinary practices are not yet available. The most important treatment factor affecting cure is treatment duration. Increased duration of treatment is associated with increased chance of cure. Economically, extended treatment is not always justified, even when indirect effects of treatment such as prevention of contagious transmission are taken into consideration. Usefulness of treatment trials could be improved by standardization of case definitions, consideration of host and strain factors, and sufficient statistical power. Treatment of young animals with penicillin-sensitive Staph. aureus infections is often justified based on bacteriological cure and economic outcome, whereas treatment of older animals, chronic infections, or penicillin-resistant isolates should be discouraged.

Pilot study--parenteral treatment of recently acquired subclinical mastitis during lactation

OBJECTIVE

To conduct a pilot study to investigate the effect of parenteral antibiotic treatment with penethamate hydriodide on recently acquired sub-clinical mastitis.

DESIGN

Sixty-nine cows from five Western Victorian dairy farms were enrolled in a pilot trial. Cows that had an Individual Cow Cell Count (ICCC) of greater than 250,000 cells per mL in their milk at their first or second herd test were enrolled in the trial if they were in their first lactation, or if they had a history of ICCCs below 250,000 cells per mL at all herd tests during the previous lactation. These criteria were used in an effort to exclude cows with chronic subclinical mastitis and include cows with recently acquired subclinical mastitis.

PROCEDURE

Cows were divided into control and treatment groups on the basis of having an odd or even ear tag number. The treatment group was treated with penethamate hydriodide shortly after the first or second herd test; the control group was left untreated. The ICCCs of subsequent herd tests were recorded for the remainder of lactation.

RESULTS

In 58% of the treatment group, and 25% of the control group, all subsequent ICCCs for that lactation were less than 250,000 cells per mL (p < 0.05). If only first and second lactation cows were considered, 72% of the treatment group, and 11% of the control group, had subsequent ICCCs less than 250,000 cells per mL (p < 0.05).

CONCLUSION

An ICCC of greater than 250,000 cells per mL is a good predictor for more high ICCCs at subsequent herd tests. This effect was significantly altered in our trial by treatment with penethamate hydriodide at or near the first or second herd test. Whilst in general treatment of high ICCC cows during lactation is considered to be unrewarding, this pilot study suggests that treatment of cows and heifers appropriately selected on the basis of a previous history of low ICCCs can lead to sustained reductions in cell counts. These results support the case for further study into this area.