Morin D E, Shanks R D, McCoy G C
Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana 61802, USA.
J Am Vet Med Assoc. 1998 Sep 1;213(5):676-84.
To determine whether antibiotic and supportive treatment would improve outcome for dairy cows with naturally developing clinical mastitis, compared with supportive treatment alone.
Randomized controlled trial.
124 cows in one herd with 172 episodes of clinical mastitis.
Cows were examined at the onset of clinical mastitis, assigned a severity score, and randomly assigned to receive antibiotic (intramammary administration of cephapirin, i.v. administration of oxytetracycline, or both) and supportive treatment (administration of oxytocin, stripping of affected glands, and, in severely affected cows, administration of flunixin meglumine or fluids) or supportive treatment alone. Treatment was continued until 24 hours after signs of clinical mastitis resolved (clinical cure). Milk samples from affected glands were submitted for bacterial culture before initial treatment and every 2 weeks thereafter until the causative organism was no longer isolated (bacteriologic cure).
When mastitis was caused by Streptococcus spp or coliform bacteria, clinical cure rate by the tenth milking was significantly higher if antibiotics were used. Bacteriologic cure rate at 14 days was significantly higher when antibiotics were used, particularly if mastitis was caused by Streptococcus spp. Cows receiving antibiotics developed fewer subsequent episodes of clinical mastitis during the 60 days after the initial episode of mastitis and had less severe clinical disease than cows that did not.
Results suggest that, in herds in which mastitis is often caused by environmental bacteria, antibiotic and supportive treatment may result in a better outcome for cows with clinical mastitis than supportive treatment alone.
与单纯支持性治疗相比,确定抗生素和支持性治疗是否能改善自然发生临床型乳房炎的奶牛的预后。
随机对照试验。
一个牛群中的124头奶牛,发生172次临床型乳房炎。
在临床型乳房炎发病时对奶牛进行检查,评定严重程度评分,然后随机分配接受抗生素(乳房内注射头孢匹林、静脉注射土霉素或两者皆用)和支持性治疗(注射催产素、挤净患侧乳腺,对严重患病奶牛注射氟尼辛葡甲胺或补液)或单纯支持性治疗。治疗持续至临床型乳房炎症状消失后24小时(临床治愈)。在初始治疗前以及此后每2周采集患侧乳腺的牛奶样本进行细菌培养,直至不再分离出致病微生物(细菌学治愈)。
当乳房炎由链球菌属或大肠菌引起时,如果使用抗生素,到第十次挤奶时的临床治愈率显著更高。使用抗生素时,14天时的细菌学治愈率显著更高,尤其是乳房炎由链球菌属引起时。与未接受抗生素治疗的奶牛相比,接受抗生素治疗的奶牛在首次乳房炎发作后的60天内发生临床型乳房炎的后续发作次数更少,临床疾病也较轻。
结果表明,在乳房炎常由环境细菌引起的牛群中,抗生素和支持性治疗可能比单纯支持性治疗能使临床型乳房炎奶牛获得更好的预后。