Treatment of Corynebacterium equi pneumonia of foals: a review.

Combined antimicrobial drug treatment was recommended for foals with Corynebacterium equi pneumonia. The preferred combination is orally administered erythromycin estolate (25 mg/kg of body weight, QID) plus rifampin (10 mg/kg, BID). Erythromycin estolate also can be combined for synergistic effect with sodium benzyl penicillin given IV (100,000 IU/kg, QID) or with ampicillin given IV (11 to 15 mg/kg, QID). A third choice is sodium benzyl penicillin IV with gentamicin IM (2.2 mg/kg, TID) or with kanamycin IM (10 mg/kg, QID). Gentamicin should be combined with penicillin G or ampicillin and not used for longer than one week without monitoring for nephrotoxicosis. Rifampin should be used only in combination with erythromycin or penicillin. Erythromycin or rifampin and gentamicin give antagonistic interactions in vitro. Chloramphenicol or trimethoprim-sulfamethoxazole may be effective if given in high doses but are not preferred drugs. Treatment response should be monitored clinically and radiographically and treatment should be continued for 2 weeks after the foal is clinically and radiographically normal.