The evidence – equine surgery

These guidelines are designed to be evidence based and transparent. As such, we’ve provided the evidence behind our recommendations.

A literature search was undertaken in PubMed using the following search terms:

(Dog OR Cat OR Canine OR Feline) AND Surg* AND (Antibiotic OR Antimicrobial OR Infection OR Complication)

Only research papers pertaining to species other than humans, with abstracts, and papers written in English were considered. No time limit was included.

The abstracts for all returned articles were examined. Articles were included if the title or abstract suggested that either surgical site infection or antimicrobial prophylaxis for surgery were discussed in the paper. In addition, articles were excluded if the sample size was insufficient to make appropriate inferences from the study. All study designs were considered as the literature is limited.

Risk of bias was assessed using the ROBINS-I assessment tool14.

Domains Reason for non-inclusion
Confounding Selection bias Classification bias Deviation from intended intervention Missing data Measurement Reporting
Ahern, 201015 +++ + 0 0 Not assessable 0 0 Paper does not describe timing of antimicrobial therapy in relation to surgery
Borg, 20134 0 0 0 NR + + 0
Busk, 20101 +++ + 0 NR Not assessable + 0 Paper does not describe timing of antimicrobial therapy in relation to surgery
Clark, 200816 ++ + 0 N/A Not assessable 0 0 Canadian bacterial isolates unlikely to be relevant to Australia
Dallap Schaer, 20129 ++ + 0 N/A Not assessable 0 0
Durward-Akhurst, 20137 ++ 0 0 + Not assessable 0 0
Freeman, 201217 ++ ++ 0 NR + 0 0 Not significantly powered to detect difference
Isgren, 201718 +++ 0 0 N/A Not assessable + 0 Paper does not describe timing of antimicrobial therapy in relation to surgery
Kilcoyne, 20132 ++ + 0 N/A Not assessable 0 0
Macdonald, 19946 +++ + 0 N/A Not assessable + N/A  Only data on surgical duration used, confounding to significant for other analysis
Mair & Smith, 200519 + ++ 0 NR Not assessable 0 0
Olds, 20065 + ++ 0 NR ++ 0 0
Torfs, 201020 ++ ++ 0 N/A Not assessable 0 0
Weese & Cruz, 20093 + 0 + NR Not assessable 0 0



  1. Busk P, Jacobsen S, Martinussen T. Administration of perioperative penicillin reduces postoperative serum amyloid A response in horses being castrated standing. Vet Surg 2010;39:638-643.
  2. Kilcoyne I, Watson JL, Kass PH, Spier SJ. Incidence, management, and outcome of complications of castration in equids: 324 cases (1998-2008). JAVMA 2013;242:820-825.
  3. Weese JS, Cruz A. Retrospective study of perioperative antimicrobial use practices in horses undergoing elective arthroscopic surgery at a veterinary teaching hospital. Can Vet J 2009;50.
  4. Borg H, Carmalt JL. Postoperative septic arthritis after elective equine arthroscopy without antimicrobial prophylaxis. Vet Surg 2013;42:262-266.
  5. Olds AM, Stewart AA, Freeman DE, Schaeffer DJ. Evaluation of the rate of development of septic arthritis after elective arthroscopy in horses: 7 cases (1994-2003). JAVMA 2006;229:1949-1954.
  6. Macdonald DG, Morley PS, Bailey JV, Barber SM, Fretz PB. An examination of the occurrence of surgical wound infection following equine orthopaedic surgery (1981-1990). Equine Vet J 1994;26:323-326.
  7. Durward-Akhurst SA, Mair TS, Boston R, Dunkel B. Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery. Vet Rec 2013;172:287.
  8. Traub-Dargatz J, George JL, Dargatz DA et al. Survey of complications and antimicrobial use in equine patients at veterinary teaching hospitals that underwent surgery because of colic. JAVMA 2002;220:1359-1365.
  9. Dallap Schaer BL, Linton JK, Aceto H. Antimicrobial use in horses undergoing colic surgery. J Vet Intern Med 2012;26:1449-1456.
  10. Uboh CE, Soma LR, Luo Y et al. Pharmacokinetics of penicillin G procaine versus penicillin G potassium and procaine hydrochloride in horses. Am J Vet Res 2000;61:811-815.
  11. Mayhew PD, Freeman L, Kwan T, Brown DC. Comparison of surgical site infection rates in clean and clean-contaminated wounds in dogs and cats after minimally invasive versus open surgery: 179 cases (2007-2008). JAVMA 2012;240:193-198.
  12. Eugster S, Schawalder P, Gaschen F, Boerlin P. A prospective study of postoperative surgical site infections in dogs and cats. Vet Surg 2004;33:542-550.
  13. Bergstrom A, Dimopoulou M, Eldh M. Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist. Vet Surg 2016;45:571-576.
  14. Sterne JA, Hernan MA, Reeves BC et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016;355:i4919.
  15. Ahern BJ, Richardson DW, Boston RC, Schaer TP. Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006). Vet Surg 2010;39:588-593.
  16. Clark C, Greenwood S, Boison JO, Chirino-Trejo M, Dowling PM. Bacterial isolates from equine infections in western Canada (1998-2003). Can Vet J 2008;49:153-160.
  17. Freeman KD, Southwood LL, Lane J, Lindborg S, Aceto HW. Post operative infection, pyrexia and perioperative antimicrobial drug use in surgical colic patients. Equine Vet J 2012;44:476-481.
  18. Isgren CM, Salem SE, Archer DC, Worsman FC, Townsend NB. Risk factors for surgical site infection following laparotomy: Effect of season and perioperative variables and reporting of bacterial isolates in 287 horses. Equine Vet J 2017;49:39-44.
  19. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short term complications. Equine Vet J 2005;37:303-309.
  20. Torfs S, Levet T, Delesalle C et al. Risk factors for incisional complications after exploratory celiotomy in horses: do skin staples increase the risk? Vet Surg 2010;39:616-620.



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