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Institute
Lactational treatment of bovine mastitis is a major contributor to antibiotic consumption in dairy cattle and is, therefore, important to address in light of the increasing problem of antibiotic resistance. In this large-scale database-based retrospective observational study, we combined electronic health records and routinely measured somatic cell counts from individual cows to create an overview of lactational mastitis treatment in Danish dairy herds from 2010 to 2019. Furthermore, posttreatment somatic cell count was used to approximate treatment success in terms of cytological cure. A generalized logistic regression with mixed effects was performed to combine knowledge on cow-level factors (treatment-, pathogen-, and cow-related) with the new infection risk at the herd level, and to explore the relative effect on cytological cure. The investigation revealed that the total number of lactational treatments appears to have decreased steadily over the study period, whereas treatment duration increased slightly. The proportion of cases treated with penicillin-based protocols and the proportion of milk samples sent for pathogen analysis also decreased. Meanwhile, results from the statistical analysis confirm the importance of cow-related factors, such as parity and lactation stage, for the probability of cytological cure following lactational treatment of mastitis. However, they also disclose that factors that are easier to adjust, such as optimizing treatment duration, including knowledge on causative pathogens and improving the herd-level new infection risk that can be used to positively influence the outcome. Application of this knowledge could potentially assist in promoting a more prudent use of antibiotics for dairy cattle in the future.
Mastitis is a major health problem for bovines and can be categorized as non-severe or severe, based on clinical symptoms. A severe case of clinical mastitis is usually defined by the cow being affected systemically. It is important to consider how to handle severe cases because these cases can be fatal and cause high production losses. However, there are generally few detailed treatment guidelines. By conducting a scoping review on the topic, we aimed to synthesize the information that is available on treatment and outcomes, as reported from clinical trials and observational studies. This was facilitated by following the PRISMA-guidelines with a stepwise systematic screening of scientific literature on the subject, retrieved via Pubmed and Web of Science, using pre-defined selection criteria. The results yielded a total of 14 reports of treatment and outcomes in cases of naturally occurring severe clinical mastitis. Cross-trial comparison was difficult due to the different exclusion criteria and outcome definitions. Many studies focused on cases caused by gram-negative bacteria treated with intensive antibiotic protocols, often containing antibiotics that are categorized as critical for human health. Few focused on severe cases caused by gram-positive bacteria or on the relative use of non-antibiotic treatment. In general, only a small number of statistically significant differences were found in trials comparing different treatment protocols, with no obvious trends across trials. Our findings emphasize the need for more research into the treatment efficacy of antibiotic and non-antibiotic options for clinically severe mastitis. Furthermore, consideration of how trial conditions relate to the practical circumstances in a field setting could improve the applicability of reported results. This could help to provide practitioners with the information needed to make evidence-based treatment decisions in cases of clinically severe mastitis.
