The emergence of antimicrobial resistance raises concerns about using antibiotics in veterinary medicine, particularly in cases of bronchopneumonia in foals diagnosed early based on a screening programme. Many subclinical foals recover spontaneously, thus, interest in more restrictive antibiotic usage is increasing. To determine whether initiating antimicrobial therapy at a later stage of bronchopneumonia decreases antimicrobial usage without compromising successful resolution of pathology in affected foals. A total of 1,200 warmblood foals born in 2020, 2022, 2023 and 2024 on a single stud farm, all diagnosed with bronchopneumonia, were investigated. All foals in this cohort study were randomly selected and underwent clinical, haematological and thoracic ultrasonographical examinations once weekly. Diagnosis of bronchopneumonia required a total abscess score (sum of abscess diameters) ≥ 1.0 cm. Treatment thresholds were ≥ 15.0 cm in 2020/2022 and ≥ 20.0 cm in 2023/2024. Treated foals (n = 279) received rifampin/tulathromycin. Treatment duration, recurrence and failure were compared statistically between early and later treatment groups. The proportion of foals treated decreased significantly from 29.0% in 2020/2022 to 17.5% in 2023/2024, whilst mortalities remained unchanged (both 1.0%). There was no statistical difference in the proportions of foals with treatment failure (2.8% in 2020/2022 vs. 8.6% in 2023/2024) and recurrence (2.3% in 2020/2022 vs. 0.95% in 2023/2024). The initial treatment duration increased from 21 (2020/2022) to 25 days (2023/2024). Delaying antimicrobial treatment until foals exhibit more advanced pulmonary lesions significantly reduced the proportion of foals treated. Failure, recurrence and mortality remained comparable. • Later treatment threshold reduced antibiotic use in foals with bronchopneumonia • Proportion of treated foals declined from 29.0% to 17.5% without higher mortality • Failure and recurrence rates were not significantly different between groups
Boeger et al. (Sun,) studied this question.