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Antibiotics
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Treatment of Mastitis in Dairy Cattle
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Treatment of Mastitis in Dairy Cattle

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics in Animal Health".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 29025

Special Issue Editor

Prof. Dr. Volker Krömker

E-Mail Website
Guest Editor
Section for Production, Nutrition and Health, University of Copenhagen, Copenhagen, Denmark
Interests: antibiotic treatment of cattle; mastitis treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues，

Bovine mastitis is one of the most costly diseases affecting the dairy industry and is the most common condition affecting dairy cows where antibiotics are used. But in particular, mastitis is a painful disease that affects animal welfare. Over recent decades, the aims of mastitis treatment have been focused on maximizing cure rates, which has led to relatively simple treatment criteria resulting in predominantly blanket antimicrobial treatment. Not only uncritical substances are used. Only through careful and systematic scientific work can the therapy of mastitis be more targeted, so that comparable or even better cure rates can be achieved with fewer antibiotic doses. Our times require us to better balance cure rates, antibiotic selection and consumption, resistance avoidance and animal welfare.  This special issue seeks manuscripts that will help in the development of an evidence-based  targeted antibiotic therapy for mastitis in cattle. This includes not only manuscripts on clinical and pharmacological issues, but also those on decision-making tools, antimicrobial resistance, knowledge transfer in practice, economics of evidence-based therapies and animal welfare aspects.

Prof. Dr. Volker Krömker
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • mastitis therapy
  • antimicrobial resistance
  • evidence based antibiotic treatment
  • bacteriological cure
  • animal welfare
  • treatment decision making
  • transfer to practice

Published Papers (10 papers)

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Research

13 pages, 262 KiB  
Article
Different European Perspectives on the Treatment of Clinical Mastitis in Lactation
by Franziska Preine, Demetrio Herrera, Christian Scherpenzeel, Piret Kalmus, Finola McCoy, Sebastian Smulski, Päivi Rajala-Schultz, Anne Schmenger, Paolo Moroni and Volker Krömker
Antibiotics 2022, 11(8), 1107; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11081107 - 16 Aug 2022
Cited by 5 | Viewed by 2683
Abstract
As part of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT), a webinar on the topic “Mastitis Treatment in Lactation” was held, in which eight mastitis experts from different European countries (Spain, The Netherlands, Estonia, Ireland, Poland, Finland, Germany, and Italy) [...] Read more.
As part of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT), a webinar on the topic “Mastitis Treatment in Lactation” was held, in which eight mastitis experts from different European countries (Spain, The Netherlands, Estonia, Ireland, Poland, Finland, Germany, and Italy) presented their treatment approaches for clinical mastitis in lactation. The aim of this study was to compare the therapeutic approaches to identify commonalities and differences. In all eight participating countries, the decision to start treatment is usually made by the veterinarians, while the farm personnel are responsible for treatment administration. Antibiotic treatment is then typically administered intramammarily. The treatment duration often depends on the label instructions and is frequently extended if Staphylococcus aureus or Streptococcus uberis is involved. Administering supportive therapy, especially non-steroidal anti-inflammatory drugs (NSAIDs) is an established practice in all countries. Penicillin is the first-choice drug for the treatment of mastitis in an increasing number of countries. The use of critically important antimicrobials (CIAs) such as quinolones and third- and fourth-generation cephalosporins is at a low level in Finland and The Netherlands. In Estonia, Germany, Italy, and Spain, the use of CIAs is declining and is only allowed if milk samples are analyzed in advance following the legal framework. Systems for monitoring antibiotic use are being introduced in more and more countries. This exchange of different views will help the European countries to move towards a common high standard of antimicrobial stewardship in veterinary medicine. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
16 pages, 1513 KiB  
Article
Synergistic Antibacterial and Anti-inflammatory Activities of Ocimum tenuiflorum Ethanolic Extract against Major Bacterial Mastitis Pathogens
by Janejira Srichok, Natthika Yingbun, Teerada Kowawisetsut, Sudsaijai Kornmatitsuk, Uthaiwan Suttisansanee, Piya Temviriyanukul and Boonrat Chantong
Antibiotics 2022, 11(4), 510; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11040510 - 12 Apr 2022
Cited by 8 | Viewed by 2912
Abstract
Mastitis is the most prevalent global illness affecting dairy cows. This bacterial infection damages and inflames the udder tissues. Several plant extracts have demonstrated synergistic antibacterial activities with standard drugs in mastitis treatment. Scant information exists on Ocimum tenuiflorum L. This study evaluated [...] Read more.
Mastitis is the most prevalent global illness affecting dairy cows. This bacterial infection damages and inflames the udder tissues. Several plant extracts have demonstrated synergistic antibacterial activities with standard drugs in mastitis treatment. Scant information exists on Ocimum tenuiflorum L. This study evaluated the antibacterial activity of O. tenuiflorum extract and its interaction with antibacterial drugs against common mastitis pathogens including Staphylococcus aureus, coagulase-negative Staphylococci (CNS), Streptococcus agalactiae, and Escherichia coli. Anti-inflammatory activities in LPS-stimulated RAW264.7 macrophage cells were also studied. The O. tenuiflorum extract exhibited antibacterial activities against S. aureus, CNS, and S. agalactiae with minimum inhibitory concentration (MIC) ranging from 3.9 to 31.2 µg/mL and minimum bactericidal concentration (MBC) ranging from 15.6 to 500 µg/mL. Combinations of O. tenuiflorum with penicillin or amoxicillin-clavulanic acid showed synergistic effects against all tested strains but an additive effect with cefazolin and gentamicin. Pretreatment of the extract significantly decreased the expression of inflammatory molecules (IL-6, TNF-α, IL-1β, iNOS, COX-2, and PGE2) generated by LPS in macrophages. Results suggested O. tenuiflorum effectiveness against various Gram-positive mastitis bacteria, with the potential to reduce antibacterial doses and combat inflammation. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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9 pages, 451 KiB  
Article
Comparison of Immediate Blanket Treatment versus a Delayed Pathogen-Based Treatment Protocol for Clinical Mastitis Using an On-Farm Culture Test at a Commercial German Dairy Farm
by Stefan Borchardt and Wolfgang Heuwieser
Antibiotics 2022, 11(3), 368; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11030368 - 09 Mar 2022
Cited by 4 | Viewed by 2366
Abstract
The objective of this study was to compare immediate intramammary antimicrobial treatment of mild and moderate cases of clinical mastitis (CM) with a selective treatment protocol based on on-farm culture results using Accumast®. The study was conducted at a 2600 cow [...] Read more.
The objective of this study was to compare immediate intramammary antimicrobial treatment of mild and moderate cases of clinical mastitis (CM) with a selective treatment protocol based on on-farm culture results using Accumast®. The study was conducted at a 2600 cow commercial farm in Northeast Germany. Using a randomized design, mild and moderate clinical mastitis cases were assigned to either the blanket therapy (BT) or pathogen-based therapy (SELECT) group. Overall, 468 cases were used for final analyses (BT = 236; SELECT = 232). The percentage of cases assigned to the blanket and pathogen-based groups that received intramammary therapy were 100 and 69.9%, respectively. Implementation of a pathogen-based treatment protocol for mild and moderate CM cases resulted in no significant difference in post-event milk production, somatic cell count, survival to 30 d, and days spent in the hospital compared with a blanket therapy protocol. Cows in the SELECT group had reduced odds of being culled within 60 d post CM (odds ratio = 0.54; 95% CI = 0.31–0.93; p = 0.027). The use of a pathogen-based treatment protocol using an on-farm culture system has the potential to efficiently reduce antimicrobial use without negative effects on health. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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10 pages, 243 KiB  
Article
Microbiological Diagnoses on Clinical Mastitis—Comparison between Diagnoses Made in Veterinary Clinics versus in Laboratory Applying MALDI-TOF MS
by Lærke Boye Astrup, Karl Pedersen and Michael Farre
Antibiotics 2022, 11(2), 271; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11020271 - 19 Feb 2022
Cited by 12 | Viewed by 1664
Abstract
The present study compares the diagnoses on clinical bovine mastitis made in veterinary clinics using conventional diagnostic methods with diagnoses on the same samples made by a veterinary reference laboratory using MALDI-TOF MS as diagnostics. The study enables targeted and evidence-based consulting on [...] Read more.
The present study compares the diagnoses on clinical bovine mastitis made in veterinary clinics using conventional diagnostic methods with diagnoses on the same samples made by a veterinary reference laboratory using MALDI-TOF MS as diagnostics. The study enables targeted and evidence-based consulting on prudent mastitis diagnostics and related antibiotic usage. In total, 492 samples from clinical mastitis were included. When applying MALDI-TOF MS as gold standard, only 90 out of 492 diagnoses made in veterinary clinics, equal to 18%, were correct. Four main findings were important: (1) the veterinary clinics overlooked contamination in mastitis samples; (2) the veterinary clinics only assigned 2 fully correct diagnoses out of 119 samples with mixed growth cultures; (3) the veterinary clinics made close to half of their diagnoses on pure culture erroneously; (4) the veterinary clinics applied a limited number of the relevant pathogen identifications on pure culture samples. Altogether, the present study shows that a large part of Danish clinical mastitis cases are misdiagnosed. Lack of correct diagnoses and diagnostic quality control may lead to the choice of wrong treatment and thus hamper prudent use of antibiotics. Hence, the present study warns a risk of overuse of antibiotics in Denmark. Consequently, the present study calls for training of veterinary clinics in diagnostics of mastitis pathogens and national guidelines on quality assurance of mastitis diagnostics. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
11 pages, 855 KiB  
Article
Cell Differentiation of Bovine Milk Control Samples to Improve Prognosis of Mastitis Cure
by Anne Bunge, Sonja Dreyer, Jan-Hendrik Paduch, Doris Klocke, Stefanie Leimbach, Nicole Wente, Julia Nitz and Volker Krömker
Antibiotics 2022, 11(2), 259; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11020259 - 17 Feb 2022
Viewed by 1622
Abstract
To optimise udder health at the herd level, identifying incurable mastitis cases as well as providing an adequate therapy and culling strategy are necessary. Cows with clinical mastitis should be administered antibiotic medication if it is most likely to improve mammary cure. The [...] Read more.
To optimise udder health at the herd level, identifying incurable mastitis cases as well as providing an adequate therapy and culling strategy are necessary. Cows with clinical mastitis should be administered antibiotic medication if it is most likely to improve mammary cure. The somatic cell count (SCC) in milk of the monthly implemented Dairy Herd Improvement (DHI) test represents the most important tool to decide whether a cow has a promising mammary cure rate. Differential cell count (DCC) facilitates the specification of the immunological ability of defence, for example by characterising leukocyte subpopulations or cell viability. The aim of this study was to assess the DCC and cell viability in DHI milk samples regarding the cytological (CC) and bacteriological cure (BC) of the udder within a longitudinal study, thereby gaining a predictive evaluation of whether a clinical mastitis benefits from an antibiotic treatment or not. The cows enrolled in this study had an SCC above 200,000 cells/mL in the previous DHI test. Study 1 assessed the CC by reference to the SCC of two consecutive DHI tests and included 1010 milk samples: 28.4% of the mammary glands were classified as cytologically cured and 71.6% as uncured. The final mixed logistic regression model identified the total number of non-vital cells as a significant factor associated with CC. An increasing amount of non-vital cells was related to a lower individual ability for CC. Cows which were in the first or second lactation possessed a higher probability of CC than cows having a lactation number above two. If animals developed a clinical mastitis after flow cytometric investigation, the BC was examined in study 2 by analysing quarter foremilk samples microbiologically. Taking 48 milk samples, 81.3% of the mammary glands were classified as bacteriologically cured and 18.7% as uncured. The percentage of total non-vital cells tended to be lower for cows which were cured, but no significance could be observed. This study revealed that the investigation of the proportion of non-vital cells in DHI milk samples can enhance the prognosis of whether an antibiotic treatment of clinical mastitis might be promising or not. Prospectively, this tool may be integrated in the DHI tests to facilitate the decision between therapy or culling. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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13 pages, 1293 KiB  
Article
Therapy of Subclinical Mastitis during Lactation
by Scott McDougall, Laura M. Clausen, Hassan M. Hussein and Chris W. R. Compton
Antibiotics 2022, 11(2), 209; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11020209 - 07 Feb 2022
Cited by 11 | Viewed by 3461
Abstract
This study tested the hypothesis that increasing the duration and/or frequency of antimicrobial treatment of subclinical mastitis would result in a higher bacteriological cure rate. Glands with a positive California mastitis test (CMT) from cows with an elevated somatic cell count (>500,000 cells/mL) [...] Read more.
This study tested the hypothesis that increasing the duration and/or frequency of antimicrobial treatment of subclinical mastitis would result in a higher bacteriological cure rate. Glands with a positive California mastitis test (CMT) from cows with an elevated somatic cell count (>500,000 cells/mL) that had an intramammary infection were randomly assigned at cow level to no treatment (Control; n = 80 glands), intramammary infusion of 200 mg cloxacillin sodium on three occasions at 48 h intervals (3 × 48 h; n = 273 glands), five occasions at 24 h intervals (5 × 24 h; n = 279 glands), or on five occasions at 48 h intervals (5 × 48 h; n = 72 glands). Glands were resampled at 21 (±3) and 28 (±3) days after initiation of treatment. The gland-level cure rate for any pathogen was 5/80 (6.2%), 139/173 (49.8%), 172/297 (61.6%) and 58/72 (80.6%) for Control, 3 × 48 h, 5 × 24 h and 5 × 48 h, respectively. The cure rate for major pathogens (defined as Staphylococcus aureus or Streptococcus spp.) was 4/52 (7.7%), 84/197 (42.6%), 96/183 (52.5%) and 36/48 (75%) for Control, 3 × 48 h, 5 × 24 h and 5 × 48 h, respectively. We conclude that treatment was superior to no treatment, and bacteriological cure rate was higher with the 5 × 24 h protocol than for the 3 × 48 h protocol and was higher with the 5 × 48 h than the 5 × 24 h protocol. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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12 pages, 295 KiB  
Article
Etiology of Mastitis and Antimicrobial Resistance in Dairy Cattle Farms in the Western Part of Romania
by Corina Pascu, Viorel Herman, Ionica Iancu and Luminita Costinar
Antibiotics 2022, 11(1), 57; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11010057 - 03 Jan 2022
Cited by 30 | Viewed by 3350
Abstract
The present study aimed to determine the bacteria isolated from bovine mastitis and their antimicrobial resistance in the western part of Romania. Clinical mastitis was diagnosed based on local inflammation in the udder, changes in milk, and when present, generalized symptoms. Subclinical mastitis [...] Read more.
The present study aimed to determine the bacteria isolated from bovine mastitis and their antimicrobial resistance in the western part of Romania. Clinical mastitis was diagnosed based on local inflammation in the udder, changes in milk, and when present, generalized symptoms. Subclinical mastitis was assessed using a rapid test—the California Mastitis Test. The identification of bacterial strains was performed based on biochemical profiles using API system tests (API 20 E, API Staph, API 20 Strep, API Coryne, API 20 NE (bioMerieux, Marcy l’Etoile, France), and MALDI-TOF mass spectrometry (MS). The prevalent isolated bacteria were Staphylococcus spp. (50/116; 43.19%), followed by Streptococcus spp. (26/116; 22.41%), E. coli (16/116; 13.79%), Corynebacterium spp. (9/116; 7.75%), Enterococcus spp. (10/116; 8.62%), and Enterobacter spp. (5/116; 4.31%). Phenotype antimicrobial resistance profiling was performed used the disc diffusion method. Generally, Gram-positive bacteria showed low susceptibility to most of the antimicrobials tested, except cephalothin. Susceptibilities to penicillins and quinolones were fairly high in Gram-negative bacteria, whereas resistance was observed to macrolides, aminoglycosides, and tetracyclines. The highest number of isolates were multidrug resistant (MDR), the resistance pathotypes identified including the most frequently antimicrobials used in cow mastitis treatment in Romania. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
11 pages, 959 KiB  
Article
Antimicrobial Selection for the Treatment of Clinical Mastitis and the Efficacy of Penicillin Treatment Protocols in Large Estonian Dairy Herds
by Anri Timonen, Marju Sammul, Suvi Taponen, Tanel Kaart, Kerli Mõtus and Piret Kalmus
Antibiotics 2022, 11(1), 44; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics11010044 - 30 Dec 2021
Cited by 2 | Viewed by 2100
Abstract
Clinical mastitis (CM) is the most common microbial disease treated in dairy cows. We analyzed the antimicrobial usage in cows with CM (n = 11,420) in large dairy herds (n = 43) in Estonia. CM treatment data were collected during a [...] Read more.
Clinical mastitis (CM) is the most common microbial disease treated in dairy cows. We analyzed the antimicrobial usage in cows with CM (n = 11,420) in large dairy herds (n = 43) in Estonia. CM treatment data were collected during a 12-month study period. The antimicrobial usage was observed during the 21 days from the initiation of treatment, and the incidence of antimicrobial-treated CM was calculated for each study herd. The effect of intramammary (IMM), systemic, and combined (systemic and IMM) penicillin treatment of CM on the post-treatment somatic cell count (SCC) was analyzed using the treatment records of 2222 cows from 24 herds with a mixed multivariable linear regression model. The median incidence of antimicrobial-treated CM was 35.8 per 100 cow-years. Procaine benzylpenicillin and marbofloxacin were used in 6103 (35.5%, 95% CI 34.8–36.2) and 2839 (16.5%, 95% CI 16.0–17.1) CM treatments, respectively. Post-treatment SCC was higher after IMM penicillin therapy compared to systemic or combination therapy. Treatment of CM usually included first-choice antimicrobials, but different antimicrobial combinations were also widely used. The effect of procaine benzylpenicillin to post-treatment SCC was dependent on the administration route, cow parity, and days in milk. Further studies should evaluate the factors affecting veterinarians’ choice of antimicrobial used in the treatment of CM. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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11 pages, 827 KiB  
Article
Genotyping and Antimicrobial Susceptibility Profiling of Streptococcus uberis Isolated from a Clinical Bovine Mastitis Outbreak in a Dairy Farm
by Valentina Monistero, Antonio Barberio, Paola Cremonesi, Bianca Castiglioni, Stefano Morandi, Desiree C. K. Lassen, Lærke B. Astrup, Clara Locatelli, Renata Piccinini, M. Filippa Addis, Valerio Bronzo and Paolo Moroni
Antibiotics 2021, 10(6), 644; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10060644 - 28 May 2021
Cited by 11 | Viewed by 2950
Abstract
Streptococcus uberis, an environmental pathogen responsible also for contagious transmission, has been increasingly implicated in clinical mastitis (CM) cases in Europe. We described a 4-month epidemiological investigation of Strep. uberis CM cases in an Italian dairy farm. We determined molecular characteristics and [...] Read more.
Streptococcus uberis, an environmental pathogen responsible also for contagious transmission, has been increasingly implicated in clinical mastitis (CM) cases in Europe. We described a 4-month epidemiological investigation of Strep. uberis CM cases in an Italian dairy farm. We determined molecular characteristics and phenotypic antimicrobial resistance of 71 Strep. uberis isolates from dairy cows with CM. Genotypic variability was investigated via multiplex PCR of housekeeping and virulence genes, and by RAPD-PCR typing. Antimicrobial susceptibility was assessed for 14 antimicrobials by MIC assay. All the isolates carried the 11 genes investigated. At 90% similarity, two distinct clusters, grouping 69 of the 71 isolates, were detected in the dendrogram derived from the primer ERIC1. The predominant cluster I could be separated into two subclusters, containing 38 and 14 isolates, respectively. Strep. uberis strains belonging to the same RAPD pattern differed in their resistance profiles. Most (97.2%) of them were resistant to at least one of the drugs tested, but only 25.4% showed a multidrug resistance phenotype. The highest resistance rate was observed for lincomycin (93%), followed by tetracycline (85.9%). This study confirmed a low prevalence of β-lactam resistance in Strep. uberis, with only one isolate showing resistance to six antimicrobial classes, including cephalosporins. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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16 pages, 1700 KiB  
Article
Veterinary Treatment Approach and Antibiotic Usage for Clinical Mastitis in Danish Dairy Herds
by Jensine Wilm, Line Svennesen, Esben Østergaard Eriksen, Tariq Halasa and Volker Krömker
Antibiotics 2021, 10(2), 189; https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020189 - 15 Feb 2021
Cited by 12 | Viewed by 4062
Abstract
Danish veterinarians’ treatment approach and use of antibiotics for clinical mastitis were investigated through a web-based questionnaire. The objective of the study was to describe and evaluate how the clinical mastitis treatment practice in Danish dairy herds corresponds to evidence from the literature [...] Read more.
Danish veterinarians’ treatment approach and use of antibiotics for clinical mastitis were investigated through a web-based questionnaire. The objective of the study was to describe and evaluate how the clinical mastitis treatment practice in Danish dairy herds corresponds to evidence from the literature and legislative requirements, in order to suggest directions for improvements and approaches encouraging the prudent use of antibiotics. In total, 174 veterinarians working with cattle received the questionnaire and 85 (48.9%) completed it. Their answers suggested that the Danish treatment approach for clinical mastitis generally relies on combined systemic and intramammary antibiotic administration (92% would use this often or always) and almost always includes supportive treatment with nonsteroidal anti-inflammatory drugs (99% would use it often or always in combination with antibiotic therapy). While collecting milk samples in order to target treatment towards pathogens is a priority in the legislation and for veterinarians, the direct application seems hindered due to the waiting time with the currently used analysis practice. Consequently, 91% reported that they would start treatment immediately after clinical examination often or always. The results of this investigation show that there is a potential for improvement in targeting treatments towards the causative pathogen by encouraging methods that allow for a more rapid reliable pathogen determination. When this issue has been addressed, the available evidence on the best treatment practice of Gram-negative-caused mastitis cases can be applied properly, reducing the volume of antibiotic treatments with limited expected effect. Additionally, investigating the potential of reducing combined administration to only intramammary treatment in Gram-positive cases could be a further step towards a more prudent antibiotic strategy. Full article
(This article belongs to the Special Issue Treatment of Mastitis in Dairy Cattle)
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