Rhodococcus equi infections

Erythromycin estolate in conjunction with rifampin (both drugs administered orally) can be recommended for the treatment of Rhodococcus equi pneumonia in foals. Early diagnosis of the infection and prompt initiation of therapy considerably increase the effectiveness of treatment. Apart from this specific indication, macrolide antibiotics (including erythromycin) and lincosamides (lincomycin and clindamycin) are contra-indicated in horses. Antimicrobial agents in these classes can cause severe disturbance of the balance between commensal bacterial flora in the colon of the horse. 

Mascellino, M. T., Iona, E., Ponzo, R., Mastroianni, C. M., and Delia, S. (1994). Infections due to Rhodococcus equi in three HIV-infected patients Microbiological findings and antibiotic susceptibility. Int. J. Clin. Pharmacol. Res. 14, 157-163. 

Kwak EJ, Strollo DC, Kulich SM, Kusne S (2003) Cavitary pneumonia due to Rhodococcus equi in a heart transplant recipient. Transplant Infect Dis 5 43-46 Lazem E, Barbir M, Banner N, Ludman P, Mitchell A, Yacoub M (1997) Coronary calcification detected by ultrafast computed tomography is a predictor of cardiac events in heart transplant recipients. Transplant Proc 29 572-575 Leung AN (1999) Invited Commentary Scientific exhibit. RadioGraphics 19(2) 340-341... 

To prevent the rapid development of bacterial resistance. Erythromycin and rifampin are used in combination in the treatment of foals with Rhodococcus (R.) equi infections. Each drug has a completely different mechanism of antimicrobial action their combination reduces the chance of chromosomal mutations conferring bacterial resistance. 

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