Use of cephalosporins for the treatment of dairy cows suffering of puerperal metritis and endometritis.

A clinical study was performed including 265 diseased cows in 9 dairies to test the efficacy of the systemic administration of a 3(rd) generation (ceftiofur, injectable) and the local application of a 4(th) generation (cefquinome, intrauterine suspension) cefalosporine for the treatment of bovine puerperal metritis (PM). Both products were used after establishing the diagnosis of PM, typically on days 8-14 post partum. Ceftiofur was injected in a dose of 1 ml/kg bw daily for 5 consecutive days, while cefquinome 900 mg suspension was administered once for each cow and the treatment was repeated 72 hours later in 60% of the animals on clinical assessment. A meta-analysis of three recently published studies of the authors on cefapirine and prostaglandine F2 alpha (PGF2 alpha) treated cows with clinical endometritis (EM) on days 28-35 post partum was performed, as compared to untreated control group. Products were administered once or twice with 7 days interval on clinical assessment. Single parameter of the studies was the re-conception rate. A fixed effect model was used for the meta-analysis, since each study separately also revealed a certain, although not significant effect of the treatments. Odds ratios (OR) and their 95% confidence interval (CI) for each trial, as well as the pooled OR and CI 95% were calculated. Hypothesis testing was done according to Mantel-Haenszel and Peto-Yusuf methods. Pooled relative risk (RR) for re-conception was 1.3 in the cefapirine treated groups as compared to the control, while OR was 1.9, (CI 95% 1.16-3.12) proved to be significant (p=0,0104). Pooled RR for pregnancy of the PGF2 alpha treated cows was 1.2, odds ratio 1.5, (CI 95% 1.03-2.30), which revealed also significant difference (p=0.0306). The generally good sensitivity of Arcanobacterium pyogenes, the most important causative agent of EM to cefapirin allows the effective use of this 1(st) generation cephalosporin for the therapy of EM. PGF2a can also be efficacious, because 4-5 weeks post partum high proportion of cows already have cyclic ovarian activity.