Comparative efficacy of antimicrobials for treatment of clinical mastitis in lactating dairy cattle: a systematic review and network meta-analysis

Winder, C. B. and Sargeant, J. M. and Hu, D. and Wang, C. and Kelton, D. F. and Godkin, M. A. and Churchill, K. J. and O’Connor, A. M.

Anim Health Res Rev (2019) 20: 229–246

DOI: 10.1017/s1466252319000318

Abstract

A systematic review and network meta-analysis were conducted to assess the relative efficacy of antimicrobial therapy for clinical mastitis in lactating dairy cattle. Controlled trials in lactating dairy cattle with natural disease exposure were eligible if they compared an antimicrobial treatment to a non-treated control, placebo, or a different antimicrobial, for the treatment of clinical mastitis, and assessed clinical or bacteriologic cure. Potential for bias was assessed using a modified Cochrane Risk of Bias 2.0 tool. From 14775 initially identified records, 54 trials were assessed as eligible. Networks were established for bacteriologic cure by bacterial species group, and clinical cure. Disparate networks among bacteriologic cures precluded meta-analysis. Network meta-analysis was conducted for trials assessing clinical cure, but lack of precision of point estimates resulted in wide credibility intervals for all treatments, with no definitive conclusions regarding relative efficacy. Consideration of network geometry can inform future research to increase the utility of current and previous work. Replication of intervention arms and consideration of connection to existing networks would improve the future ability to determine relative efficacy. Challenges in the evaluation of bias in primary research stemmed from a lack of reporting. Consideration of reporting guidelines would also improve the utility of future research.

Citation

Winder, C. B., Sargeant, J. M., Hu, D., Wang, C., Kelton, D. F., Godkin, M. A., Churchill, K. J., & O’Connor, A. M. (2019). Comparative efficacy of antimicrobials for treatment of clinical mastitis in lactating dairy cattle: a systematic review and network meta-analysis. Anim Health Res Rev, 20(2), 229–246. https://doi.org/10.1017/s1466252319000318 Animals, Female, Cattle, Anti-Bacterial Agents/*therapeutic use, *Lactation, *Network Meta-Analysis, *mixed treatment comparison, *Dairy cow, *udder health, Mastitis, Bovine/*drug therapy

Keywords

• Animals
• Female
• Cattle
• Anti-Bacterial Agents/*therapeutic use
• *Lactation
• *Network Meta-Analysis
• *mixed treatment comparison
• *Dairy cow
• *udder health
• Mastitis
• Bovine/*drug therapy