Comparison of danofloxacin with baquiloprim/sulphadimidine for the treatment of experimentally induced Escherichia coli diarrhoea in calves

Use of antimicrobials in the treatment of calf diarrhea: a systematic review

The objective of this study was to conduct a systematic review of the scientific literature evaluating the efficacy and comparative efficacy of antimicrobials (AMs) for the treatment of diarrhea in calves. Eligible studies were non- and randomized controlled trials evaluating an AM intervention against a positive and negative control, with at least one of the following outcomes: fecal consistency score, fever, dehydration, appetite, attitude, weight gain, and mortality. Four electronic databases were searched. Titles and abstracts (three reviewers) and full texts (two reviewers) were screened. A total of 2899 studies were retrieved; 11 studies met the inclusion criteria. The risk of bias was assessed. Most studies had incomplete reporting of trial design and results. Eight studies compared AMs to a negative control (placebo or no treatment). Among eligible studies, the most common outcomes reported were diarrhea severity (n = 6) and mortality (n = 6). Eligible studies evaluated very different interventions and outcomes; thus, a meta-analysis was not performed. The risk of bias assessment revealed concerns with reporting of key trial features, including disease and outcome definitions. Insufficient evidence is available in the scientific literature to assess the efficacy of AMs in treating calf diarrhea.

Feeding an acetate-based oral electrolyte reduces the ex vivo Escherichia coli growth potential in the abomasum of calves fed oral electrolytes alone or 30 minutes following a milk feeding when compared to feeding a bicarbonate-based oral electrolyte

Oral electrolyte solutions (OES) are a common, on-farm therapy to reestablish hydration and electrolyte balances in scouring and stressed calves. The objectives were to determine the effects of OES alkalinizing agent and the presence of a milk replacer feeding before OES administration on the abomasal environment in healthy Holstein calves. Abomasum cannulation was performed on 16 Holstein bull calves at 5 d of age. One calf was removed from the study before the calves were randomly assigned to treatments at 9 d of age. Treatments were arranged as a 2-by-2 factorial, with the following factors: oral electrolyte alkalinizing agent [acetate (A) or bicarbonate (B)] and liquid meal type milk replacer (MR) + OES (MR-A, MR-B), or OES only (OES-A, OES-B)]. The OES differed only by alkalinizing agent. On d 9, calves assigned to MR-A (n = 4) or MR-B (n = 4) received their morning MR aliquot 0.5 h before feeding 2 L of OES; the OES-A (n = 3) and OES-B (n = 4) treatment groups were fed 2 L of OES only. Peripheral blood samples and postprandial abomasal fluid samples were collected to assess abomasal pH, abomasal emptying rate (AER), and ex vivo abomasal Escherichia coli growth potential. Postprandial pH was greater in calves fed MR or B-based OES. Abomasal emptying rate was slower in calves receiving MR + OES, regardless of the alkalinizing agent. Ex vivo E. coli colony-forming unit counts were greater in calves fed either MR + OES or bicarbonate-based OES. Supplementing bicarbonate OES in addition to MR alters abomasal dynamics and may promote E. coli growth in postprandial abomasal fluid, partially due to sustained elevations in gastric pH and delayed gastric emptying rates. The OES containing sodium acetate limited ex vivo E. coli growth potential in abomasal fluid, thereby potentially reducing the risk of additional enteric bacterial complications associated with OES therapy.

Effect of orally administered electrolyte solution formulation on abomasal luminal pH and emptying rate in dairy calves

OBJECTIVE

To determine the effects of 3 commercially available, orally administered electrolyte solutions (OAEs) on abomasal luminal pH and emptying rate in dairy calves, compared with the effect of orally administered milk replacer.

DESIGN

Randomized crossover study.

ANIMALS

6 male dairy calves (age, 12 to 31 days).

PROCEDURES

Calves were surgically instrumented with an abomasal cannula and were administered 4 treatments in randomized order: all-milk protein milk replacer, high-glucose high-bicarbonate OAE, high-glucose high-bicarbonate OAE containing glycine, and low-glucose OAE containing acetate and propionate. Abomasal luminal pH was measured with a miniature glass pH electrode prior to treatment administration and every second afterward for 24 hours.

RESULTS

Feeding of orally administered milk replacer resulted in a rapid increase in mean abomasal luminal pH from 1.3 to 5.8, followed by a gradual decrease to preprandial values by 8 hours afterward (mean 24-hour pH, 3.2). High-glucose high-bicarbonate OAEs caused a large and sustained increase from 1.3 to 7.5 (mean 24-hour pH, 4.1 for the solution without glycine and 3.5 for the solution with glycine). In contrast, feeding of the acetate-containing OAE was followed by only a mild and transient increase (mean 24-hour pH, 2.1); luminal pH returned to preprandial values by 3 hours after ingestion.

CONCLUSIONS AND CLINICAL RELEVANCE

Ingestion of a bicarbonate-containing OAE resulted in sustained abomasal alkalinization in dairy calves. Because persistently high abomasal luminal pH may facilitate growth of enteropathogenic bacteria, administration of OAEs containing a high bicarbonate concentration (> 70mM) is not recommended for calves with diarrhea.

Treatment of calf diarrhea: oral fluid therapy

Diarrhea remains the leading cause of mortality in beef and dairy calves. Calves that have diarrhea frequently develop dehydration, strong ion acidosis, and electrolyte abnormalities, and are in a state of negative energy balance. Oral electrolyte therapy is a simple and economical method of addressing all of these potential complications. This article gives an overview of oral electrolyte therapy of calves, including indications, guidelines for administration, and how to choose an electrolyte product.

Effect of suckling an isotonic solution of sodium acetate, sodium bicarbonate, or sodium chloride on abomasal emptying rate and luminal pH in calves

OBJECTIVES

To compare abomasal emptying rates in calves after suckling milk replacer or 3 common orally administered electrolyte solution components.

ANIMALS

5 male calves < 35 days of age.

PROCEDURES

Calves with a cannula fitted in the abomasal body were fed 2 L of milk replacer with or without parenteral administration of atropine (0.01 mg/kg, i.v., then 0.02 mg/ kg, s.c., q 30 min) or isotonic (150 mM) solutions of sodium acetate, NaHCO(3), or NaCl in a randomized crossover design. Abomasal emptying rates were determined via scintigraphy, acetaminophen absorption, ultrasonography, and change in abomasal luminal pH.

RESULTS

Scintigraphic half-emptying time, time of maximal plasma acetaminophen concentration, ultrasonographic half-emptying time, and pH return time indicated similar abomasal emptying rates following suckling of isotonic sodium acetate, NaHCO(3), and NaCl solutions, whereas the emptying rate of milk replacer was significantly slower. Mean maximal abomasal luminal pH was highest following suckling of NaHCO(3) (pH(max)=7.85) and lowest following suckling of NaCl (pH(max)=4.52); sodium acetate (pH(max)=6.59) and milk replacer (pH(max)=5.84) yielded intermediate pH values.

CONCLUSIONS AND CLINICAL RELEVANCE

Isotonic solutions of sodium acetate, NaHCO(3), and NaCl were rapidly emptied from the abomasum but varied markedly in their ability to alkalinize the abomasum. Sodium bicarbonate-containing orally administered electrolyte solution might increase the frequency of infection or severity of clinical disease in diarrheic calves treated for dehydration by causing prolonged abomasal alkalinization.

Antimicrobial use in the treatment of calf diarrhea

Calves with diarrhea often have small intestinal overgrowth with Escherichia coli bacteria, regardless of the inciting cause for the diarrhea, and 30% of systemically ill calves with diarrhea have bacteremia, predominantly because of E coli. Antimicrobial treatment of diarrheic calves should therefore be focused against E coli in the small intestine and blood, the 2 sites of infection. Fecal bacterial culture and antimicrobial susceptibility testing is not recommended in calves with diarrhea because fecal bacterial populations do not accurately reflect small intestinal or blood bacterial populations and because the break points for susceptibility test results have not been validated. Antimicrobial efficacy is therefore best evaluated by the clinical response of a number of calves to treatment, with calves randomly assigned to treatment groups. Amoxicillin, chlortetracycline, neomycin, oxytetracycline, streptomycin, sulfachloropyridazine, sulfamethazine, and tetracycline administered PO are currently labeled in the United States for the treatment of calf diarrhea. On the basis of published evidence for the oral administration of these antimicrobial agents, only amoxicillin can be recommended for the treatment of diarrhea. Dosage recommendations are amoxicillin trihydrate (10 mg/kg PO q12h) or amoxicillin trihydrate-clavulanate potassium (12.5 mg combined drug/kg PO q12h) for at least 3 days; the latter constitutes extra-label drug use. Parenteral administration of broad-spectrum beta-lactam antimicrobials--ceftiofur (2.2 mg/kg IM or SC q12h) and amoxicillin or ampicillin (10 mg/kg IM q12h)--or potentiated sulfonamides (25 mg/kg IV or IM q24h) is recommended for treating calves with diarrhea and systemic illness; both constitute extra-label drug use. In calves with diarrhea and no systemic illness (normal appetite for milk, no fever), it is recommended that the health of the calf be monitored and that oral or parenteral antimicrobials not be administered.

Antimicrobial use in the treatment of calf diarrhea

Calves with diarrhea often have small intestinal overgrowth with Escherichia coli bacteria, regardless of the inciting cause for the diarrhea, and 30% of systemically ill calves with diarrhea have bacteremia, predominantly because of E coli. Antimicrobial treatment of diarrheic calves should therefore be focused against E coli in the small intestine and blood, the 2 sites of infection. Fecal bacterial culture and antimicrobial susceptibility testing is not recommended in calves with diarrhea because fecal bacterial populations do not accurately reflect small intestinal or blood bacterial populations and because the break points for susceptibility test results have not been validated. Antimicrobial efficacy is therefore best evaluated by the clinical response of a number of calves to treatment, with calves randomly assigned to treatment groups. Amoxicillin, chlortetracycline, neomycin, oxytetracycline, streptomycin, sulfachloropyridazine, sulfamethazine, and tetracycline administered PO are currently labeled in the United States for the treatment of calf diarrhea. On the basis of published evidence for the oral administration of these antimicrobial agents, only amoxicillin can be recommended for the treatment of diarrhea. Dosage recommendations are amoxicillin trihydrate (10 mg/kg PO q12h) or amoxicillin trihydrate‐clavulanate potassium (12.5 mg combined drug/kg PO q12h) for at least 3 days; the latter constitutes extra‐label drug use. Parenteral administration of broad‐spectrum β‐lactam antimicrobials–eftiofur (2.2mg/kg IM orSCq12h) and amoxicillin or ampicillin (10 mg/kg IM q12h)–rpotentiatedsulfonamides(25 mg/kg IV or IM q24h) is recommended for treating calves with diarrhea and systemic illness; both constitute extra‐label drug use. In calves with diarrhea and no systemic illness (normal appetite for milk, no fever), it is recommended that the health of the calf be monitored and that oral or parenteral antimicrobials not be administered.

Pharmacokinetics and PK-PD modelling of danofloxacin in camel serum and tissue cage fluids

The pharmacokinetics and pharmacodynamics of danofloxacin were studied in the camel in a two period cross-over study. After intravenous (i.v.) administration at a dose rate of 1.25 mg/kg, the pharmacokinetics of danofloxacin indicated a high volume of distribution (V(d(area))=3.43 L/kg), relatively rapid clearance (0.44 L/kg/h) and half-life of 5.37 h. After intramuscular (i.m.) dosing absorption was complete (F=114.5) and rapid (T((1/2)abs)=0.12 h) and terminal half-life was 5.71 h. Danofloxacin penetrated fairly slowly into both inflamed (exudate) and non-inflamed (transudate) tissue cage fluids and was cleared slowly from these fluids, elimination half-life being at least twice that for serum for both exudate and transudate after both i.v. and i.m. dosing. The antibacterial actions of danofloxacin against the camel pathogen Escherichia coli 0157-H7 were determined by measurement of minimum inhibitory concentration (MIC) in vitro (single measurement) and ex vivo measurements of bacterial count at nine times between one and 48 h after i.m. dosing in each of the fluids, serum, exudate, and transudate. Using in vitro MIC data and in vivo pharmacokinetic parameters, the surrogate markers of antimicrobial activity, C(max)/MIC, AUC/MIC and T>MIC, were determined for all three fluids. The ex vivo serum AUC(24 h)/MIC data were integrated with reduction in bacterial count to provide values producing a bacteriostatic action (no change in bacterial count), inhibition of bacterial count by 50%, reduction in bacterial count by 99.9% (bactericidal action) and elimination of bacteria. Mean AUC(24h)/MIC values were 17.20, 20.07, 21.24, and 68.37 h, respectively. To describe the latter, the introduction of a new term to supplement MIC and minimum bactericidal concentration (MBC) is proposed, namely minimum elimination concentration (MEC). A novel means of designing antimicrobial drug dosage schedules for evaluation in clinical trials is proposed, using ex vivo AUC(24h)/MIC values for bactericidal activity and elimination of bacteria together with MIC(90) data for camel pathogens.