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Treatment of uterine infections

Treatment of bovine endometritis aims at the:

Elimination of bacterial infection
Improvement of uterine contractility
Prevention of the recurrent infections during the following luteal phase

Click here to open a decision tree for treatment of endometritis

For a treatment of endometritis flow-chart click on the thumbnail sketch

Elimination of bacterial infection

Antibiotics used in the treatment of uterine infections have to comply with the criteria described in the table below.

Requirements of antibiotics used for the treatment of uterine infections
Criteria	Acute metritis	Clinical and subclinical endometritis
High activity against main pathogens	E.coli A.pyogenes Peptostreptococci	A.pyogenes F.necrophorum Gram negative anaerobes
Recommended formulation and other properties	Injectable: must reach high concentrations in uterine lumen and endometrium Intrauterine: good penetration in the lumen and endometrium, no irritation to endometrium No negative effect on uterine immune cells	Intrauterine: good penetration in the lumen and endometrium, no irritation to endometrium No negative effect on uterine immune cells
Withdrawal time - milk	Short or nil	Nil
Most often used actives	Oxytetracyclines, ceftiofur, cefquinome	Cefapirin (Metricure), oxytetracyclines

Intervet recommends Metricure for the treatment of clinical and subclinical endometritis. For more information about the product see the Metricure slide show

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Improvement of uterine contractility

Evacuation of pathological contents of the uterus
Prostaglandins or estrogens are routinely used. Estrogens should not be used as in many countries the use of oestradiol esters is strictly forbidden in food producing animals.
Elimination of immunosuppresive influence of progesterone

Role of prostaglandins in the therapy of uterine infections (Lewis 2004):

Elimination of corpus luteum:
- improvement of contractility
- elimination of immunosuppressive effect of progesterone
Direct stimulation of the function of immune cells in endometrium

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Preventing recurrent infections during the following luteal phase

If prostaglandins alone are used in the treatment of endometritis, clinical improvement can be achieved, some bacteria may however remain in the endometrial crypts. These bacteria will multiply during the next luteal phase when the immune function of the endometrium is decreased due to the effect of progesterone. This leads to relapses of endometritis.

Combination of proper anti-infective therapy and prostaglandins allows not only elimination of existing bacterial infection but also prevents recurrence of the condition in the following cycle.

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Uterine lavage

Preparing intrauterine antibiotic

Administration of intrauterine antibiotics

Treatment of uterine infections

More information for vets about Metricure.