Standing equine cheek tooth extractions: comparison of short-term complications with and without the use of peri-/postoperative antimicrobials
Schnierer M1, Nekouei O2, Huber CL1, Jehle M3, Biermann NM*1
1University of Veterinary Medicine, Vienna, Austria, 2City University of Hong Kong, Jockey Club College of Veterinary Medicine and Life Science, Department of Infectious Diseases and Public Health, Kowloon, Hong Kong, 3Equine Clinic Gessertshausen, Gessertshausen, Germany.
Objectives:
Considering the emergence of antimicrobial resistance (AMR) and the fact that antimicrobials are still used prophylactically in many routine procedures, our profession needs antimicrobial-use guidelines based on scientific proof for surgical antimicrobial prophylaxis.
This study aims to examine the association between short-term complications and the use of antimicrobials in equine standing cheek tooth extractions, identifying risk factors and clinical decision-making regarding antimicrobial use.
Methods:
Medical records were reviewed for all horses undergoing cheek teeth extractions between January 2018 and January 2022. Simple and multi-variable logistic regression models were used to examine the association between occurrence of complications, clinical and treatment features (e.g. concurrent disease, antimicrobial use).
Results:
Three-hundred and seven cases undergoing 449 dental extractions of which 197 cases (64.17%) received prophylactic antimicrobials compared to 110 cases (35.83%) that did not, were included. Short term complications occurred in 57 cases (18.57%), with most being mild and transient (39 cases; 68.4%).
Multivariable analysis showed that antimicrobial use was associated with a nearly threefold increase in complications (OR 2.78; P = 0.014). The presence of concurrent diseases (OR = 4.43; P < 0.001), extraction of a tooth from the lower jaw versus the upper jaw (OR 2.52; P = 0.006), as well as extraction during the warmer seasons (OR 1.99; P = 0.038) were also significantly associated with an increased risk of complications.
Conclusions:
Complication rates after cheek tooth extraction can be considered low and administration of antimicrobials was rather associated with an increased chance of complications. In the face of AMR, clinicians are challenged to use the slowly appearing scientific evidence to critically reflect and reconsider their antimicrobial administration practices.