34th Annual Scientific Meeting proceedings

Post-operative orthopaedic infections are a serious complication that affect the welfare and can threaten the life of affected horses. Continuous, intensive, effective antimicrobial therapy, as well as client commitment, remain mainstay in the treatment of these infections for the best outcome of patients. Combination of systemic and loco-regional antimicrobial therapies are commonly used. When loco-regional antimicrobial therapies are administered, drug-dependent pharmacokinetic and pharmacodynamic principles are to be observed, similar to when those antimicrobial drugs are administered systemically. These principles include:

• Suitable antimicrobial
• Adequate route of administration
• Adequate dosing ranges and timing
• Drainage and debridement if suitable to the condition

Attention to these principles may seem routine and well-known; however, habits may negatively affect the efficacy of local antimicrobial therapies.

In addition, selection of adequate antimicrobial drug is dependent on laboratory bacterial culture and sensitivity. Bacterial culture may be negatively affected by presence of antimicrobial concentrations in the tissues, and therefore reduce the likelihood of a positive bacterial culture.

We are in an era of increased use and sometimes abuse of antimicrobial drugs, which represents a serious concern for human and animal health. Judicious use of antimicrobials remains extremely important as widely use of antimicrobial may have a negative effect on antimicrobial stewardship.

Finally, when dealing with postoperative infections, diagnosis of presence of infection often relies on laboratory results on samples obtained from the suspected infected site. However, surgical procedures and therapeutic interventions can have an important effect on those results and markers used to define presence of sepsis, leaving the diagnosis of sepsis uncertain.