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Tulathromycin versus florfenicol in beef cattle with pneumonia

Clinical Scenario

Matt Brown, one of your beef clients, purchases large numbers of weaned suckler calves in the autumn and rears them through to finishing weight. Despite his best efforts to prevent the disease, pneumonia remains a significant problem on his unit. Historically he has used an antibiotic containing florfenicol to treat these animals; however at a recent beef expo event he was talking to one of the large pharmaceutical companies about a new antibiotic containing tulathromycin. Whilst very few animals with pneumonia die, he is conscious that affected animals have poorer growth rates and lower carcass quality when they are killed. He asks you whether you think the new antibiotic will be better than his standard treatment in this respect, and you wonder if there is a difference...

3-Part Question (PICO)

In [beef cattle with pneumonia] does [the administration of tulathromycin compared to florfenicol] [improve growth rate to killing and carcass quality]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(calf.mp. OR calves.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp Cattle/)

AND

(pneumonia.mp. OR respiratory infection.mp. OR respiratory diseases.mp OR respiratory infections.mp. OR respiratory disease.mp OR pneumonic.mp OR exp Pneumonia/ OR exp Respiratory Tract Infections/ OR exp Respiratory Tract Diseases/)

AND

(tulathromycin.mp. OR triamilide.mp. OR draxxin.mp.)

AND

(florfenicol.mp. OR fenflor.mp. OR selectan.mp. OR shotaflor.mp. OR florkem.mp. OR kefloril.mp. OR nuflor.mp.)

CAB Abstracts 1910 to Present using the OVID interface

(calf.mp.OR calves.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp cattle/ OR exp calves/)

AND

(pneumonic.mp. OR pneumonia.mp. OR respiratory infection.mp. OR respiratory diseases.mp OR respiratory infections.mp. OR respiratory disease.mp OR exp pneumonia/ OR exp respiratory diseases/)

AND

(tulathromycin.mp. OR triamilide.mp. OR draxxin.mp.)

AND

(florfenicol.mp. OR fenflor.mp. OR selectan.mp. OR shotaflor.mp. OR florkem.mp. OR kefloril.mp. OR nuflor.mp.)

Search Outcome

MEDLINE

  • 28 papers found in MEDLINE search
  • 25 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 3 total relevant papers from MEDLINE

CAB Abstracts

  • 47 papers found in CAB search
  • 42 papers excluded as they don't meet the PICO question
  • 1 papers excluded as they are in a foreign language
  • 2 papers excluded as they are review articles/in vitro research/conference proceedings
  • 2 total relevant papers from CAB

Total relevant papers

3 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Schunicht et al. (2007) USA

Title:

An evaluation of the relative efficacy of tulathromycin for the treatment of undifferentiated fever in feedlot calves in Nebraska.

Patient group:

200 recently weaned, crossbred beef calves (5 to 9 months of age) with a clinical attitude score of 1-3, a temperature of more than or equal to 40 C and an absence of abnormal clinical signs referable to organ systems other than the respiratory system.

Study Type:

Randomised controlled trial

Outcomes:
  • Response to treatment—first and second relapse rates
  • Wastage (salvage slaughter rates)
  • Mortality - bovine respiratory disease (BRD) and overall
  • Weight gain and average daily gain (ADG)
  • Slaughter weight
  • Carcass weight and quality (USDA yield grade and quality grade)
  • Economic analysis



Key Results:
  • There were no significant differences in slaughter weight, carcass weight, average daily gain, wastage, overall quality grade of carcass and overall yield grade of carcass between the two treatment groups (p> or equal to 0.05).
  • Significantly more carcasses were yield grade USDA 4 in the tulathromycin group compared to the florfenicol group (20.0% for tulathromycin vs 7.7% for florfenicol, p<0.05).
  • First relapse rate was significantly lower in the tulathromycin group (relative risk 0.65, p<0.001). No significant difference in the second relapse rate between the 2 groups (p> or equal to 0.05).
  • Overall mortality and BRD mortality were significantly lower in the tulathromycin group compared to the florfenicol group (relative risk 0.33, p
  • In US dollars it was more cost effective to treat using tulathromycin compared to florfenicol due to lower first relapse rates and lower overall mortality rates.

 



Study Weaknesses:
  • The study was performed in the USA so there are differences in cattle management (e.g. the farm unit itself contains 85000 cattle, vaccination protocols differ)
  • Multiple stressful procedures completed on admission to study (vaccination, antibiotic injection, hormone implantation, ear tagging)
  • Vaccination protocols may affect outcomes
  • If cattle did not respond to the initial treatment they were highlighted as non-responders, given a different class of antibiotics and returned to the study. It is unclear the overall effect this may have had on the outcomes for each group
  • No sample size justification conducted
  • Allocation/administration of therapy was not blinded
  • Included animals diagnosed with undifferentiated fever with an absence of abnormal clinical signs referable to organ systems other than the respiratory system - i.e. they were not definitely diagnosed with pneumonia
  • Lack of comparison of baseline characteristics between the treatment groups
Attachment:
No attachments.

Perrett et al. (2008) USA

Title:

A comparison of florfenicol and tulathromycin for the treatment of undifferentiated fever in feedlot calves.

Patient group:

Cross bred beef steer calves with temp > or equal to 105o F and absence of other body system signs (other than respiratory). Moribund animals were not included.

Study Type:

Randomised controlled trial

Outcomes:
  • Mortality - overall, BRD, histophilosis, lameness, BVD/enteritis, metabolic, other
  • Slaughter weight
  • Carcass weight
  • Weight gain and average daily gain (ADG)
  • Days on feedlot
  • Carcass weight and quality (USDA yield grade and quality grade)
  • Wastage (salvage slaughter rates)
  • Response to treatment – first, second and third relapse rates
  • Economic analysis



Key Results:
  • There were no significant differences in carcass weight based ADG, weight gain, slaughter weight, carcass weight, carcass yield or quality variables between the two treatment groups (p>0.05).
  • Overall mortality (relative risk = 0.78, p=0.45) and BRD mortality (relative risk = 0.76, p=0.05) rates were significantly lower in the florfenicol group compared to the tulathromycin group.
  • There were no significant differences detected in relapse rates, overall chronicity, overall wastage rates, or other cause-specific mortality rates between the two treatment groups (p>0.05).
  • When using Canadian pharmacy prices it was more cost effective to treat using florfenicol due to lower costs of initial treatment and lower mortality.
Study Weaknesses:
  • No sample size calculation
  • Limited baseline characteristics reported (only weight)
  • Animals were given metaphylactic antibiotics (all animals received tulathromycin before the study started which could potentially affect the outcomes)
  • Study completed in the USA on one farm only (different management systems to the UK)
  • Multiple stressful procedures completed on admission to study (castration, vaccination, steroids, antibiotic injection, bulls were castrated)
  • Vaccination treatments may affect outcomes
  • Allocation/administration of therapy was not blinded
  • If cattle did not respond to the initial treatment they were highlighted as non-responders, given a different class of antibiotics and returned to the study. It is unclear the overall effect this may have had on the outcomes for each group
  • Included animals diagnosed with undifferentiated fever with an absence of abnormal clinical signs referable to organ systems other than the respiratory system - i.e. they were not definitely diagnosed with pneumonia
  • Funded by Schering-Plough Animal Health (who manufacture florfenicol)
Attachment:
No attachments.

Skogerboe et al. (2005) USA

Title:

Comparative efficacy of tulathromycin versus florfenicol and tilmicosin against undifferentiated bovine respiratory disease in feedlot cattle.

Patient group:

Castrated male calves and heifer calves with a clinical attitude score of 1-3 and pyrexia >104oF

Study Type:

Randomised Controlled Trial

Outcomes:
  • Cure rate
  • Treatment failures
  • Carcass weight and quality (USDA yield grade and quality grade)
  • Carcass fat content
  • Carcass rib eye size
  • Body weight and average daily weight gain
  • Cure rate - determined by clinical attitude score (CAS) and BRD mortality or CAS, rectal temperature, and BRD mortality

 

Key Results:
  • Average daily gain from day 0-28 was significantly higher in the tulathromycin group compared to the florfenicol group at the Nebraska study site (p<0.05) but there was no significant difference at the Greeley, CO site. There were no significant differences from day 0 to day of harvest between the two treatment groups at either study site (p>0.05).
  • Cure rates were significantly higher for calves receiving tulathromycin compared to florfenicol (p<0.05) at both study sites.
  • Chronic cases and mortality rates were significantly lower for tulathromycin compared to florfenicol at the Nebraska study site (p<0.05) but not at the Greeley, CO study site.
  • Final live body weights and hot carcass weights were not significantly different between the two treatment groups at either study site (p<0.05).
  • Except for a significantly greater (P = .0396) rib eye area in tulathromycin- treated cattle at the Greeley, CO site, differences in the other carcass variables were not significant (P>0.05).
Study Weaknesses:
  • No sample size calculation
  • Baseline characteristics of the two treatment groups not reported
  • Treatment administration was not blinded
  • Results were split up by location and no combined results given
  • Calves were enrolled in the study based on clinical attitude scores and rectal temp only, no description of assessment as to whether the clinical signs related to the respiratory tract or not i.e. they were not definitely diagnosed with pneumonia or respiratory tract disease
  • If cattle did not respond to the initial treatment they were highlighted as non-responders, given a different class of antibiotics and returned to the study. It is unclear the overall effect this may have had on the outcomes for each group
  • No funding source stated but when checked the main author works for Pfizer animal health, the makers of tulathromycin
Attachment:
No attachments.

Comments

This BET only addresses carcass quality and growth rate to killing; while the included studies also looked at efficacy of these drugs, this was not the focus of this BET. This BET should therefore not be used to draw conclusions regarding clinical efficacy of these treatments. The studies included in this BET have significant differences between them in terms of vaccination protocols and metaphylactic use of antibiotics, therefore extrapolating their results to other management systems is difficult.

Bottom line

Overall it appears that there is no significant difference between florfenicol and tulathromycin when looking at growth rates and carcass quality.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Schunicht OC, Booker CW, Guichon PT, Jim GK, Wildman BK, Pittman TJ, Perrett T (2007). An evaluation of the relative efficacy of tulathromycin for the treatment of undifferentiated fever in feedlot calves in Nebraska. Canadian Veterinary Journal 48: 600-6.

Perrett T, Abutarbush SM, Wildman BK, Fuchs MT, Schunicht OC, Pollock CM, Fenton RK, Jim GK, Guichon PT, Booker CW, Berg J, Roder J, Spire M (2008). A comparison of florfenicol and tulathromycin for the treatment of undifferentiated fever in feedlot calves. Veterinary Therapeutics  9: 128-140.

Skogerboe TL, Rooney KA, Nutsch RG, Weigel DJ, Gajewski K, Kilgore WR (2005). Comparative efficacy of tulathromycin versus florfenicol and tilmicosin against undifferentiated bovine respiratory disease in feedlot cattle. VeterinaryTherapeutics 6: 180-196.

About this BET

First author:
Martin Downes
Second author:
Kathryn Wareham
Institution:

University of Nottingham

Search last performed:
2018-01-22 12:53:29
Original publication date:
2013-09-13 12:53:29
Last updated:
2018-01-22 12:53:29
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