Equine Health Update EHU Vol 21 Issue 02 | Page 35

CPD Article | EQUINE (Guidelines for the Prevention & Containment of Antimicrobial Resistance in South African Hospitals 2018) What’s Not? 1. Prolonged Surgical Prophylaxis Most guidelines for antibiotic use in equine practice (including those published by SAEVA) recommend 24 hours penicillin for a clean surgery, 5 days penicillin and gentamicin for a contaminated surgery and 10 days penicillin and gentamicin for a high-risk surgery. This is not in line with guidelines in small animal or human medicine. BSAVA (British Small Animal Veterinary Association) recommends no antibiotics for clean surgeries and < 24 hours antibiotics for clean- contaminated/contaminated surgeries (https://www. bsava.com/Resources/Veterinary-resources/PROTECT/ Reducing-Prophylaxis). WHO guidelines for prevention of surgical site infection recommend < 24 hours surgical prophylaxis. There are limited studies investigating efficacy of duration of surgical prophylaxis in preventing surgical site infection in horses. However, in a series of elective arthroscopies in horses in which no surgical prophylaxis was used the frequency of joint sepsis was similar to that reported in populations in which surgical prophylaxis was used (Borg and Carmalt 2013). There are different risk factors for surgical site infection in equine veterinary medicine although <25% respondents gave surgical conditions as a reason to use or not use antibiotics in an Australian survey of antibiotic • Volume 21 Issue 2 | May 2019 • 35