Possible association of short-term complications and antimicrobial use in standing equine cheek tooth extractions 2018-2022.

Background: Despite growing concerns about antimicrobial resistance, prophylactic antimicrobials continue to be routinely administered in many procedures, including dental extractions. Further evidence-based research is needed on whether their use influences post-operative complication rates.

Objectives: To identify risk factors for short-term complications, associations between complications and antimicrobial use as well as factors leading to antimicrobial use in equine (standing) cheek tooth extractions.

Study Design: Retrospective analysis of clinical records.

Methods: Data were extracted from records of horses undergoing cheek tooth extractions (2018-2022). Multi-variable logistic regression models examined associations between clinical variables and the occurrence of complications and antimicrobial use.

Results: Three hundred and five cases undergoing 447 dental extractions were included. Of these, 197 cases (64.6%) received antimicrobials. Complications occurred in 56 cases (18.4%); these were considered mild and transient in 39 cases (12.7%) and severe, requiring veterinary treatment, in 18 cases (5.6%). Occurrence of complications demonstrated an association with increased antimicrobial use (OR 2.69; CI 1.20-6.04; p = 0.02), presence of concurrent diseases (OR 4.32, CI 1.89-9.84; p = 0.001), extraction of mandibular teeth compared to maxillary teeth (OR 2.20; CI 1.14-4.23; p = 0.018), warmer seasons (OR 1.97; CI 1.03-3.76; p = 0.04) and the reason for extraction being either dental infection (OR 6.37; CI 2.39-16.97; p < 0.001) or dental fracture (OR 3.90; CI 1.53-9.91; p = 0.004) versus periodontal diseases. Antimicrobials were more frequently used when more than 2 teeth were extracted (OR 5.96; CI 2.26-15.70; p < 0.001), when dental infection was the reason for extraction (OR 3.75; CI 1.76-8.02; p = 0.001) or when the extraction was performed in warmer seasons (OR 1.96; CI 1.17-3.29; p = 0.01).

Conclusions: Complication rates were comparable to previous studies and in large numbers of horses antimicrobials were not administered, which did not result in higher complication rates. Antimicrobials might be justified in horses suffering from concurrent diseases.