Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, Königsweg 65, D-14163 Berlin, Germany.
J Dairy Sci. 2013 Feb;96(2):1054-62. doi: 10.3168/jds.2012-6034. Epub 2012 Dec 20.
Acute puerperal metritis (APM) is one of the most common diseases during the puerperal period. Systemic administration of ceftiofur for 5 consecutive days has been shown to be effective for treatment of APM. The objective of this study was to determine concentrations of ceftiofur derivatives in serum, endometrial tissue, and lochia of cows with fever postpartum or APM 4 to 6d after treatment with a single subcutaneous dose of 6.6 mg of ceftiofur crystalline free acid (CCFA)/kg of estimated BW at the base of the ear. In the first experiment, samples from CCFA-treated cows with fever postpartum or APM (n=42) were taken on d 4, 5, or 6 after treatment. Concentrations of ceftiofur derivatives were quantified using an HPLC assay. Concentrations of active ceftiofur metabolite desfuroylceftiofuracetamide (DCA) were greatest at d 4 after treatment with CCFA in all samples, but they were considerably lower than the concentrations of DCA in healthy postpartum cows treated with the same dose of CCFA. The concentrations of DCA in serum, endometrial tissue, and lochia were affected by odor of vaginal discharge before treatment with CCFA. Mean concentrations of DCA could be detected above the reported minimal drug concentrations (minimum inhibitory concentrations, MIC) required to inhibit relevant pathogens such as Escherichia coli and Arcanobacterium pyogenes in serum on all days and in endometrial tissue and lochia only on d 4 in CCFA-treated cows with fetid vaginal discharge before treatment. In the second experiment, samples from CCFA-treated cows with APM (n=8) were taken on d 0 (before treatment) and d 4, 5, and 6 after treatment. Mean concentrations of DCA in serum and lochia were similar on d 4 to 6 in both laboratories. Furthermore, determined concentrations of DCA from both laboratories were correlated for serum and lochia. Mean concentrations of DCA could be detected above the reported MIC in serum and lochia only on d 4. Our 2 experiments demonstrated that in postpartum cows with fever postpartum or APM concentrations above the MIC for relevant bacteria (>0.5 μg/mL or >0.5 μg/g) of DCA could be sustained only for 4 (serum: 15/17; endometrial tissue: 2/17; lochia: 1/16) to 5d (serum: 10/13; endometrial tissue: 1/13; lochia: 2/12) after a single treatment with CCFA only in a certain proportion of cows. Overall, our data provide first pharmacological evidence that a single subcutaneous administration of 6.6g of CCFA/kg of BW might not be sufficient to efficaciously treat APM in postpartum dairy cows.
急性产后子宫内膜炎(APM)是产褥期最常见的疾病之一。连续 5 天全身给予头孢噻呋已被证明对 APM 的治疗有效。本研究的目的是确定在产后发热或 APM 后 4 至 6 天,单次皮下给予 6.6mg 头孢噻呋游离酸(CCFA)/估计 BW 的耳根底部后,奶牛血清、子宫内膜组织和恶露中头孢噻呋衍生物的浓度。在第一个实验中,从产后发热或 APM 的 CCFA 治疗奶牛(n=42)的样品在治疗后第 4、5 或 6 天采集。使用 HPLC 测定法定量测定头孢噻呋衍生物的浓度。在所有样品中,在 CCFA 治疗后第 4 天,活性头孢噻呋代谢物去呋喃酰基头孢噻呋酰胺(DCA)的浓度最高,但与相同剂量 CCFA 治疗的产后健康奶牛的 DCA 浓度相比,仍明显较低。DCA 在血清、子宫内膜组织和恶露中的浓度受 CCFA 治疗前阴道分泌物气味的影响。在所有天中,在 CCFA 治疗的有恶臭阴道分泌物的奶牛中,均能检测到 DCA 的平均浓度高于抑制相关病原体(如大肠杆菌和化脓隐秘杆菌)所需的报告最小药物浓度(最小抑菌浓度,MIC)在血清和子宫内膜组织和恶露中仅在 CCFA 治疗的奶牛中,在治疗前阴道分泌物有臭味的情况下,在第 4 天可以检测到 DCA 的平均浓度。在第二个实验中,从 APM 的 CCFA 治疗奶牛(n=8)的样品在第 0 天(治疗前)和第 4、5 和 6 天采集。在两个实验室中,DCA 在血清和恶露中的浓度在第 4 至 6 天相似。此外,两个实验室确定的 DCA 浓度在血清和恶露中呈相关性。仅在第 4 天,在血清和恶露中可检测到高于报告 MIC 的 DCA 平均浓度。我们的 2 项实验表明,在产后发热或 APM 的奶牛中,仅在一定比例的奶牛中,单次皮下给予 CCFA 6.6g/kg BW 后,仅在第 4(血清:15/17;子宫内膜组织:2/17;恶露:1/16)至 5 天(血清:10/13;子宫内膜组织:1/13;恶露:2/12)可维持高于相关细菌 MIC(>0.5μg/mL 或>0.5μg/g)的 DCA 浓度。总体而言,我们的数据首次提供了药理学证据,单次皮下给予 6.6g/kg BW 的 CCFA 可能不足以有效治疗产后奶牛的 APM。