Equine Clinic, School of Veterinary Medicine, Hanover, Germany.
Veterinary Clinic, Destedt, Germany.
Equine Vet J. 2020 Jul;52(4):613-619. doi: 10.1111/evj.13211. Epub 2020 Feb 17.
Given the importance of rifampin in treatment protocols for tuberculosis in people, its use in veterinary medicine is under increasing scrutiny in some countries and alternatives might be needed in the near future.
This study was set up to evaluate whether azithromycin combined with doxycycline is effective for the treatment of bronchopneumonia in foals and noninferior to the combination of azithromycin and rifampin.
This is a controlled, randomised and double-blinded clinical trial. Two hundred and forty foals on a farm endemic for infections caused by Rhodococcus equi were involved.
Foals with ultrasonographic pulmonary lesions (lesion score 10-15 cm) were allocated to 3 groups: azithromycin-doxycycline orally (n = 81); azithromycin-rifampin orally (n = 81); or untreated controls (n = 78). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were considered treatment failures and removed from the study.
The proportion of foals that recovered was significantly higher for foals treated with azithromycin-doxycycline (80 of 81) or azithromycin-rifampin (81 of 81) compared with that of control foals (57 of 78). The difference in the percentage of efficacy of azithromycin-rifampin vs azithromycin-doxycycline was 1.2% (90% CI = -0.78% to 3.5%) which did not cross the predetermined noninferiority limit of 10%. Therefore, azithromycin-doxycycline was noninferior to azithromycin-rifampin within the predetermined noninferiority limit.
The study was performed on a single farm, and recovery rates may differ in other locations.
Azithromycin-doxycycline was noninferior to azithromycin-rifampin for the treatment of bronchopneumonia in this farm.
鉴于利福平在结核病治疗方案中的重要性，在一些国家，兽医领域对其使用的审查日益严格，在不久的将来可能需要替代品。
本研究旨在评估阿奇霉素联合多西环素治疗马驹支气管肺炎的疗效是否不劣于阿奇霉素联合利福平。
这是一项对照、随机、双盲临床试验。在一个罗得西亚放线菌感染流行的农场中，有 240 匹驹参与了研究。
有超声肺部病变（病变评分 10-15cm）的驹被分配到 3 组：口服阿奇霉素-多西环素（n=81）；口服阿奇霉素-利福平（n=81）；或未治疗对照组（n=78）。体格检查和胸部超声由不了解治疗组分配的人员进行。病情恶化的驹被视为治疗失败并从研究中移除。
与对照组相比（78 匹驹中有 57 匹驹恢复），接受阿奇霉素-多西环素（81 匹驹中有 80 匹驹）或阿奇霉素-利福平（81 匹驹中有 81 匹驹）治疗的驹恢复的比例显著更高。阿奇霉素-利福平与阿奇霉素-多西环素的疗效百分比差异为 1.2%（90%CI=-0.78%至 3.5%），未超过预定的非劣效性限值 10%。因此，阿奇霉素-多西环素在预定的非劣效性限值内不劣于阿奇霉素-利福平。
本研究在单个农场进行，在其他地点的恢复率可能不同。
在该农场，阿奇霉素-多西环素治疗支气管肺炎不劣于阿奇霉素-利福平。
