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Danofloxacin in dairy cattle with E. coli mastitis

Clinical Scenario

During a visit to one of your dairy farms, the owner Steve Jones comments that he has had a number of cows sick with mastitis, which he thinks are caused by E. coli. He finds these cases very difficult to treat. Previously you have told Steve that treatment with antibiotics in these cases does not influence the outcome, however, he has recently seen an advert for an antibiotic containing danofloxacin which claims that it will improve the recovery rate. He is aware that the antibiotic is expensive so asks for your opinion before he considers using it. You wonder how good the evidence is for using danofloxacin in cows with toxic mastitis...

3-Part Question (PICO)

In [dairy cattle with E. coli mastitis] does [the administration of danofloxacin compared to no antibiotic treatment] [improve clinical recovery]?

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

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR Bos.mp. OR bovidae.mp. OR exp Cattle/)

AND

(mastitis.mp. OR E-coli.mp. OR Escherichia coli.mp. OR exp Mastitis/ OR exp Mastitis, Bovine/ OR exp Escherichia coli/)

AND

(danofloxacin.mp. OR advocin.mp.)

CAB Abstracts 1910 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR bovidae.mp. OR exp cows/ OR exp dairy cows/ OR exp cattle/ OR exp Bovidae/ OR exp Bos/)

AND

(mastitis.mp. OR E-coli.mp. OR Escherichia coli.mp. OR exp mastitis/ OR exp bovine mastitis/ OR Escherichia coli.od. OR Escherichia coli infections.mp. OR Escherichia infections.sh. OR Escherichia.od. OR exp Escherichia coli/)

AND

(danofloxacin.mp. OR advocin.mp. OR exp danofloxacin/ OR danofloxacin.sh.)

Search Outcome

MEDLINE

  • 17 papers found in MEDLINE search
  • 16 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
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 61 papers found in CAB search
  • 60 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
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Poutrel et al. (2008) United Kingdom

Title:

Evaluation of the efficacy of systemic danofloxacin in the treatment of induced acute Escherichia coli bovine mastitis.

Patient group:

20 lactating primiparous Holstein dairy cows with experimentally induced E. coli mastitis

Study Type:

Randomised placebo controlled trial

Outcomes:
  • Bacteriological cure rates
  • SCC
  • Number of clotted/missing samples
  • Milk yield 
  • Rectal temperature
  • Milk quality
  • Inflammation of the udder
  • Clinical cure
  • General behavior and appetite
Key Results:
  • On study day 7 there was an 89% (8/9 samples) bacteriological cure rate for the danofloxacin treated group compared to 44% (4/9 samples) in the saline treated group (no p value given)
  • All samples had bacteriologic cure by day 14
  • The SCC was significantly lower in the danofloxacin treated group compared to the saline treated group (P=0.0091), but there were only a small number of cows in each group. 
  • Neither group returned to the pre-study milk production but the milk yield in the danofloxacin group was significantly higher than the saline treated (p=0.0004) 
  • No significant difference in rectal temperatures between groups in the week after treatment
  • No significant difference between groups in terms of milk quality and inflammatory markers
  • Danofloxacin treated cows had statistically significantly lower udder inflammation scores than saline treated group (p=0.004)
  • No statistically significant difference between treatment groups for appetite or behaviour 
  • 1 death reported in the placebo group
Study Weaknesses:

 

  • The internal validity may be poor as the two treatment groups were not similar prior to intervention (no statistics provided) 
  • Scoring systems used for quarter assessment, behavior, appetite and milk quality were subjective and not previously validated
  • Small sample size (20) with no justification
  • Infection was experimentally induced and the majority of cows did not get very ill
  • One of the authors works for Pfizer (who manufacture a danofloxacin antibiotic)

 

Attachment:
No attachments.

Comments

The cows in this study had experimentally induced mastitis and did not get very ill. It is therefore difficult to know how this reflects naturally occurring disease in the field. The study size was small (20) and many of the statistics were done with an even smaller number of cows and the control and danofloxacin group may have been too different prior to intervention, so these findings must be interpreted with care. Further evidence would be needed to support the paper’s suggested beneficial effect of danofloxacin, through the use of field trials or other studies.

Bottom line

The evidence is not strong enough to support the administration of danofloxacin in dairy cattle with E. coli mastitis in order to improve clinical recovery. 

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

Poutrel B, Stegemann MR, Roy O, Pothier F, Tilt N, Payne-Johnson M, (2008). Evaluation of the efficacy of systemic danofloxacin in the treatment of induced acute Escherichia coli bovine mastitis. Journal of Dairy Research 75: 310-318.

About this BET

First author:
Rachel Dean
Second author:
Hannah Doit
Institution:

CEVM, University of Nottingham

Search last performed:
2016-12-14 14:36:12
Original publication date:
2015-01-30 14:36:12
Last updated:
2016-12-14 14:36:12
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