LAUSR

BACKGROUND Commonly, cheek tooth extraction performed in standing horses using perioperative prophylactic antibiotics, results in low post-operative complication rates. However, no studies have documented the relevance of perioperative antibiotics to the risk of post-operative complications. OBJECTIVES To examine the association between perioperative antibiotics and post-operative complications after standing cheek tooth extraction. STUDY DESIGN Retrospective cohort study. METHODS Information from clinical records and follow-up questionnaires relating to horses subjected to cheek tooth extractions between September 2016 and May 2020 was obtained. Post-operative complications and associations with perioperative antibiotics, age, sex, breed, diagnosis, tooth position, and extraction method were analysed using multivariate logistic regression. RESULTS 305 horses were included, and of these 71 (23.3%) received perioperative antibiotics. Antibiotics were not associated with the risk of complications in 264 horses that underwent standard oral extraction; 9/49 (18.4%) that received antibiotics and 35/215 (16.3%) that did not receive antibiotics experienced postoperative complications (P=1, RR=0.89, OR=1, OR CI=[0.41;2.46]). Of 41 horses that had cheek tooth extraction through minimally invasive transbuccal cheek tooth extraction (MTE), 5/22 (22.7%) that received antibiotics and 10/19 (52.6%) that did not receive antibiotics, experienced postoperative complications. Although not statistically significant when adjusting for multiple comparisons (naïve P = 0.04, adjusted P=0.26, RR=2.32, OR=4.48, OR CI=[1.05;19.11]), this finding is clinically relevant. Younger age was also significantly associated with development of complications (P=0.02, OR=0.92 per year, OR CI=[0.87;1.36]). MAIN LIMITATIONS The retrospective nature of the study leads to uncontrollable potential confounders and there is a relatively low number of MTE cases. CONCLUSION Perioperative antibiotics were not associated with a lower complication rate in horses subjected to standard standing cheek tooth extraction. Use of perioperative antibiotics in conjunction with MTE may be merited, although further investigations are needed. This article is protected by copyright. All rights reserved.