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  Discussion on Research Summary: Dangers of Antibiotic Use
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Moderator:
DrO

Posted on Sunday, Nov 4, 2007 - 10:49 am:

I consider it one of horseadvice.com's main missions to educate about the dangers of inappropriate antibiotic use in horses. It is a rampant problem among equestrians and equine veterinarians. Here is an article detailing one of these dangers to humans that has been in the news lately. Though the popular news has somewhat inflated the newness and seriousness of the problem at this time it could get that bad. In particular here is to note that one risk factor for developing resistant bacterial populations (like MeRSa) is prior administration of antibiotics. For more on this see the "Antibiotic Use Overview" article associated with this discussion. Just click on it off the navigation bar at the top of this page.
DrO

Can Vet J. 2007 Sep;48(9):921-6.
Risk factors for methicillin-resistant Staphylococcus aureus colonization in horses admitted to a veterinary teaching hospital.

Weese JS, Lefebvre SL.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1. jsweese@uoguelph.ca

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging problem in horses; however, the epidemiology of infection and colonization is poorly understood. This study evaluated factors associated with MRSA colonization at the time of admission to a veterinary teaching hospital. A case-control study evaluating historical factors was performed. Previous colonization of the horse, previous identification of colonized horses on the farm, antimicrobial administration within 30 days, admission to the neonatal intensive care unit, and admission to a service other than the surgical service were risk factors for community-associated colonization. A better understanding of risk factors for MRSA colonization is important to elucidate the epidemiology of this emerging veterinary and zoonotic pathogen, and to design evidence-based infection control programs.
Member:
nena

Posted on Tuesday, Nov 20, 2007 - 5:53 am:

Hi Dr. O. This may be long, hope that you have time. 5 days ago my 7 yo TWH gelding came down with 104 fever and substantial scrotal swelling. and mild back leg swelling, depression and lethergy, and not wanting to move around. There were no respiratory or gi problems. Eating and drinking fine, but chewing slowly. No neuro signs, though he was moving at a snails pace. We had been at a 2 day horse show exactly 2 weeks earlier. These symptoms came out of the blue. Vet came out immediately and diagnosed FUO, gave him banamine, dexamethazone and we hosed his scrotal area off as it was burning up and i monitored him through the nite. The next a.m. the fever was down, but otherwise no better. Did blood work and sent off blood for EVA test, routine blood showed elevated WBC, so started on daily IM injection of GEN-PEN with bute paste given by me every 12 hours. (He also started grinding his teeth, so we put him on Gastragaurd daily). Fast forward 3 days, scrotal swelling almost gone, fever continues to stay down, and no more teeth grinding, but still VERY slow moving, and slightly depressed and now he is locking his patella, which is being attributed to daily rump IM injection soreness and lack of wanting to walk around and basically just standing around for 4 days. He is usually a very active horse, pasture kept 24/7 with 3 other horses. One of the other horses did go to the same horse show, but NONE of my horses are showing any sign of sickness at this time. I did isolate Cody as soon as he became sick. Anyway, what are your thoughts on all this, especially the locking of the patella, would that be normal? The vet is going to keep him on the Genpen 4 more days with chest injections now, to help with the sore rump. EVA test won't be back until 3 more days. Thank you so much, sorry for the length.
Moderator:
DrO

Posted on Tuesday, Nov 20, 2007 - 8:28 am:

Hello Nena,
Rather than placing your post at the bottom of another's post, you should "Start a New Discussion" to post your problem. You will receive quicker and more responses that way. There is a better topic to learn and post about your topic and you will find it at "Treatments and Medications for Horses » Antibiotics and Antimicrobials » Penicillin. Be sure to study the article if you have not yet.

If after reviewing the article you still have questions you might see if some of the other discussions that are listed below the article answer your question. If not, you will find at the bottom of list of already present discussions a "Start New Discussion" button. For more on this see Help & Information » Posting Guidelines or where did my post go?.
DrO
Member:
cpacer

Posted on Wednesday, Jan 23, 2008 - 3:43 pm:

DrO, I read little piece in one of my horse magazines last night reminding equestrians to wash their hands often when working around horses because horses can carry MRSA.

Wouldn't a horse have to pick it up from somewhere just like anyone or anything else, or are they somehow more susceptible?

I'm hoping it was just the magazine trying to apply the latest headlines to their readers. Horses don't have germs!?!
Moderator:
DrO

Posted on Wednesday, Jan 23, 2008 - 7:55 pm:

Yes they would have to pick it up somewhere but surveys of healthy people find a large percentage of people carry the bug around in their nasal passages and they have no clinical signs and no known history of exposure.
DrO
Member:
cpacer

Posted on Wednesday, Jan 23, 2008 - 9:23 pm:

So we know we'd be more likely to get it from a person or just being in public than we would from our horses.

They should have specified that so rumors don't start flying about horses spreading MRSA! Then again this may be the same magazine that claims to care about horse over population while publishing 'breeding for dummies' articles.

Do you believe that hand sanitizers build a more resistant bacteria over time like antibiotics and wormers?
Member:
corinne

Posted on Thursday, Jan 24, 2008 - 12:09 am:

Folks I hate to say it but MRSA is colonizing in lots of places where it wasn't prominent years before. Which initially scared me because we use isolation precautions on patients in the hospital with MRSA and the thought of people walking around colonized or actively infected while taking no precautions such as gowns and gloves frightened me....however it's a sign of the times. We have created the situation by overuse of antibiotics in everything!
CP...I worked in the lab last year as I didn't want to take on nursing shifts while in grad school full time. Anyway, I spent many an hour speaking with infection control over the recent MRSA outbreaks amongst the youth in our area. I did find horses as carriers in my research as there were a couple of kids with outbreaks of infected MRSA wounds at our barn and I wondered how they got it but then she said that a lot of people are colonized like Dr. O stated. What bothered me was all kids were being sent home with what was initially diagnosed as an infected bug bite when in fact these kids were colonized with MRSA and it was a carbuncle that cultured out CA-MRSA that surfaced, not a bug or spider bite (CA meaning community acquired) and they were spreading it to each other. Just an FYI if you or your child develops what you think is an infected spider bite go to the ER or your clinic and have it cultured for MRSA. In our town it's now protocol for those who present with infected bug bites....
Anyway, sorry I digress, It wasn't long ago that this bacterium was typically only thought of as infecting those in hospitals because of the high rate of antibiotic use there...we called them nosocomial infections...or hospital acquired. Now it's in the environment (may have been there all along) and it's very virulent because it has had to survive in the elements. And...lots of folks are carriers but asymptomatic.
To help decrease such dangerous strains until something is cultured so I know what antibiotic, dosing, spectrum etc. I stay clear away from antibiotics in wound care for me and my animals and I keep it out of the house, including house hold cleaners and wipes, soaps etc. We are just creating them and asking for trouble. Everyone can play a part throw those cleaners out.
Anyway, in my long conversations with the MT about infection control she said sodium hypochlorite was the only thing she used to clean and kill MRSA on surfaces...which is essentially Clorox. I use Clorox Everywhere which is safe to use around pets and children. As for yourself...good hand washing before touching your face and eating etc and those hand sanitizers are typically alcohol so they won't change the protein coat of the bacteria or cause it to mutate to become resistant. At least to my knowledge. Although they are very rough on the hands. I like the new Vicks Early Defense which is Triclosen which I believe we used as to scrub in the NICU before starting shift. It seems to me, as a nurse who has had to wash my hands sometimes 100s of times in a day that it's much gentler. As for wormers I think the general consensus is that by alternating (I use the schedule here on HA) the dewormers the worms don't become resistant to the dewormer through constant exposure. Not just name brands but active ingredients. You can check on the dewormers section for more information on that.

Final word....chuck your antibiotic use detergents etc. We need not contribute to the problem.

Ok...off soap box...back to bed. Great article Dr. O.
Moderator:
DrO

Posted on Thursday, Jan 24, 2008 - 6:51 am:

cp, if the point of the article was that horses are "dangerous" to be around because of possible MRSA, I agree the article is a bit hyperbolic. After all MRSA is a increasingly common organism isolated from many places. The very small but very real danger it represents comes from lots of different places.

But if the article says that horses (and other animals) are a potential source of spread it is correct.

Corinne gives an excellent review of current thoughts on minimizing exposure. I differ in one detail however, I avoid the use of antibacterial soaps. Though she is correct that MRSA is not resistant to its effects I believe the elimination of normal bacterial flora is one way pathogens get a hold. Think of your pastures as an analogy: the singly best way to keep weeds out of the pasture is by maintaining a healthy stand of grass. I prefer the frequent use of mild hand soaps and use vinyl gloves for protection of both me and my patients in cases where bacterial contamination a possibility.
DrO
Member:
aannk

Posted on Thursday, Jan 24, 2008 - 8:43 am:

Dr O.,
I believe, as you do, that we over use antibiotics. I do have a question about a recent event and the use of antibiotics.
I posted about this before, but thought it might be good to discuss it here so we can see what kind of use would be appropriate in a similar case.
My mare got cast under a fence in the field. She suffered trauma to her left hind leg in the stifle area, with a small cut and some scratches. She was treated for shock and given pain meds the first day. Within three days, the area had swollen up to 10 times the original size.
The vet decided to lance open the wound, and stuffed it with antibiotic dressing and had us flush it and stuff it for about a month. He also put her on a course of penicillin, a very large dose, for about three weeks.
Was this, you think, the right course of action in this particular case? It took her about 2 months for the wound to completely fill in.
Alicia
Member:
cpacer

Posted on Thursday, Jan 24, 2008 - 11:33 am:

Scary Corinne.

So what about building up germ resistance in people? Is there any truth in what those non-hand-washers say, or is that essential what the colonized people have done, somehow?

What if you find out you have colonized MRSA, what are you supposed to do?

DrO, that's the thing, it didn't mention any other species. I'm sure they didn't intend to pinpoint horses, but they did, and not everyone has access the kind of info HA'ers do. Maybe I'll write them.
Member:
corinne

Posted on Thursday, Jan 24, 2008 - 2:22 pm:

Oh my is Triclosen an antibiotic? I thought it was was antiseptic. Is so it's in the garbage! For the same reasons you state I like my normal floura which I can liken to the analogy that women tend to get yeast infections wherever while on antibiotics because the normal floura are eradicated along with the bad bacterium. They are solo beneficial. I eat yogurt to keep them plentiful.
One more thing to note, household Listerine works better in lab conditions than antibiotics in the petrie dish inhibiting bacterial growth. We use it to disinfect the water buckets at my internship barn then we rinse......

CP to my knowledge if you are colonized then you have to ensure every cut in your skin is cared for and monitored. I hear Betadine scrubs to clean initially work well. And of course if you are immunocompromized than you need to consult with your physician as your more likely to show active signs of the disease but if you are immune down then you should be under the pursue of a physician anyway. For healthy individuals it's rarely a problem. In the NICU all transfer babies from Asia (where I worked in Okinawa) were treated as if they had active MRSA and we used bacitracin to the nares until the culutures were negative and it loves to hide in the nose but that's because all the premies were in danger from any bacteria.
Board Administrator
Username: admin

Posted on Thursday, Jan 24, 2008 - 8:48 pm:

No you are correct Corinne, triclosen is a antiseptic but would be just as devastating to the normal flora as an antibiotic. Understand there are times when antiseptic soaps are probably warranted, but I minimize the use to just those essential times.
DrO
Member:
corinne

Posted on Thursday, Jan 24, 2008 - 11:20 pm:

I echo your statement Dr. O. Nothing at times is better than the good old 30 seconds of friction hand wash with soap and water, ensuring the hands are pointed down to allow germs to run off your hands as opposed to down your arms. Additionally, use that paper towel to turn off the faucet and open doors etc. so you don't recontaminate yourself. Thanks for pointing out the facts. I should have reiterated that I too only use those hand cleaners when needed like in health care situation etc. or when I can't get to water.
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