Abstract：
Treatment of clinical mastitis (CM) and use of antimicrobials for dry cow therapy are responsible for the majority of animal-defined daily doses of antimicrobial use (AMU) on dairy farms. However, advancements made in the last decade have enabled excluding nonsevere CM cases from antimicrobial treatment that have a high probability of cure without antimicrobials (no bacterial causes or gram-negative, excluding Klebsiella spp.) and cases with a low bacteriological cure rate (chronic cases). These advancements include availability of rapid diagnostic tests and improved udder health management practices, which reduced the incidence and infection pressure of contagious CM pathogens. This review informed an evidence-based protocol for selective CM treatment decisions based on a combination of rapid diagnostic test results, review of somatic cell count and CM records, and elucidated consequences in terms of udder health, AMU, and farm economics. Relatively fast identification of the causative agent is the most important factor in selective CM treatment protocols. Many reported studies did not indicate detrimental udder health consequences (e.g., reduced clinical or bacteriological cures, increased somatic cell count, increased culling rate, or increased recurrence of CM later in lactation) after initiating selective CM treatment protocols using on-farm testing. The magnitude of AMU reduction following a selective CM treatment protocol implementation depended on the causal pathogen distribution and protocol characteristics. Uptake of selective treatment of nonsevere CM cases differs across regions and is dependent on management systems and adoption of udder health programs. No economic losses or animal welfare issues are expected when adopting a selective versus blanket CM treatment protocol. Therefore, selective CM treatment of nonsevere cases can be a practical tool to aid AMU reduction on dairy farms.
摘要：
临床乳腺炎（CM）的治疗和用于干牛治疗的抗微生物剂的使用是奶牛场中大多数动物定义的每日抗微生物剂使用（AMU）的原因。然而,在过去十年中取得的进步使得能够将非严重CM病例从抗菌治疗中排除，这些病例在没有抗菌药物的情况下治愈的可能性很高（没有细菌原因或革兰氏阴性，不包括克雷伯菌属。)和细菌学治愈率低的病例(慢性病例)。这些进步包括快速诊断测试的可用性和改进的乳房健康管理实践，降低了传染性CM病原体的发病率和感染压力。这篇综述为基于快速诊断测试结果的选择性CM治疗决策提供了基于证据的方案。审查体细胞计数和CM记录，并阐明了乳房健康方面的后果，AMU,农业经济。相对快速地识别病原体是选择性CM治疗方案中最重要的因素。许多报告的研究没有表明有害的乳房健康后果(例如，减少临床或细菌学治疗，体细胞计数增加，提高剔除率，或在哺乳期后期增加CM的复发）使用农场测试启动选择性CM治疗方案后。实施选择性CM治疗方案后，AMU减少的幅度取决于病原体的分布和方案特征。非严重CM病例的选择性治疗方法因地区而异，取决于管理系统和乳房健康计划的采用。采用选择性与一揽子CM治疗方案时，预计不会有经济损失或动物福利问题。因此,非严重病例的选择性CM治疗可以成为帮助奶牛场减少AMU的实用工具。
