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  Discussion on 4 year old Standardbred
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New Member:
sears

Posted on Sunday, Jun 12, 2016 - 12:17 pm:

Vet recommended Clarithromycin 150mg/ml with Rifampin 150mg/ml be given to this horse as the bacteria grown did not respond to anything else. After second dose horse stopped eating and developed diarrhea. Vet said to stop immediately which we did. Horse seemed to be a little better but now has much worse diarrhea and seems to be getting even looser. Gave him 5L of lactated ringers this morning (Sunday); Biosponge and Omeprazole. Also yogurt. My question is if all this helps, how long before we would see improvement? There doesn't seem to be very much information on this antibiotic. The lab compound date is May 13, 2016 but not much info on label. Horse is running a slight temperature. Would appreciate any insight offered.
Moderator:
DrO

Posted on Monday, Jun 13, 2016 - 12:09 pm:

Welcome Georgette,
Clarithromycin is in the family of macrolide antibiotics and is known to have an increase incidence of diarrhea associated with its use. This diarrhea can vary to a minor nuisance to a a life threatening event, it is not clear from your post exactly what you are dealing with. There is no specific amount of time before you will see "improvement" but you want to have vital signs and signs of sepsis evaluated then stabilized and improving without delay. If what you are doing is not achieving that and deterioration continues, you must immediately step up the aggressiveness of therapy in particular fluid therapy for more on this see, HorseAdvice.com » Diseases of Horses » Colic, Diarrhea, GI Tract » Diarrhea in Horses » Initial Evaluation of Colitis in Horses.
DrO
New Member:
sears

Posted on Friday, Jun 17, 2016 - 3:16 pm:

Dr. Oglesby,

Re: Clarithromycin/Rifampin 150/mg each compounded by Wedgewood Pharmacy

I wish to thank you for your prompt reply to my post. I wasn't very clear because I was just trying to get information on this particular drug to know what we were facing. Your article on the Colitis is fantastic.

We have spent the last several days giving intravenous fluids and stomach tubing 24/seven to try to stop the diarrhea. There was only one time when it looked better and we had hope. Then, all the secondary problems started and last night we had to put him down. I will not go into any further details on all the suggested advice tried (given by vets and companies alike) as there is nothing that was going to help. At one point we were advised that the death rate is 80%; but learning this we still tried everything we could. This colt was bred, foaled, raised and trained by my husband and the best colt we have had to date. We learned about this antibiotic the HARD WAY and I sincerely hope no one else will go through this. It is hard to understand why this antibiotic is on the market at all. After the initial ONE DAY dose and the diarrhea starting, I looked up this drug anywhere I could find it and repeatedly I found "Do not use on adult horses." Why isn't this on the label? The label states nothing! No warnings; no dosing info. If our experience can help someone else in the future our horse will not have died in vane.

Your website and the information it contains is great! Information is key to saving a lot of horses and owners from pain and suffering.

Thank you for your assistance.}
Member:
moxshi

Posted on Friday, Jun 17, 2016 - 4:23 pm:

Georgette and husband,
I am so sorry to hear of your trials with your 4-year old and all you have done to help him. You know you did your best. My sincere condolences on your loss. Yes, this drug needs to be labeled differently at once! I am reminded of all the horrors that are announced on every TV advertisement for all the new drugs that are available. There should definitely be more information re: the bad effects of Clarithromycin/Rifampin.
Moderator:
DrO

Posted on Sunday, Jun 26, 2016 - 4:12 pm:

My condolences Georgette, I too hope this will help others. Once I get back in the office I will be sure to include this with the article on the more commonly used macrolide, erythromycin, which already has warnings about use in adults. I will research to see if those warnings should be strengthened.
DrO
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