Ketoprofen as the sole initial treatment for mild and moderate bovine mastitis: efficacy and antibiotic reduction

A randomized, multi-herd, non-inferiority study was carried out to compare two treatments of non-severe mastitis cases. The animals in the studied group were treated with systemic NSAID (ketoprofen (KE); KE group; n=104), followed by antibiotic treatment only in cases without clinical improvement, while the animals in the reference group (AB group) received an intramammary antibiotic (n=118) (Figure 1). The study included 222 cases of non-severe clinical mastitis on three conventional dairy farms in Northern Germany between November 2022 and November 2023. Study outcomes were clinical cure at day 5, bacteriological cure, CM recurrence in a period of 60 days and new infection risk. Mixed logistic regression was used to analyze the effect of treatment on outcomes. The non-inferiority assumption was checked with the confidence interval of the treatment difference for clinical cure at day 5, calculating using the least square means and their standard deviations.

Treatment of mild and moderate mastitis with ketoprofen represents an alternative that promoted the deliberate and selective use of antibiotics. Furthermore, as ketoprofen has no withdrawal period for milk, less milk was discarded in the ketoprofen group than in the antibiotic group. However, some limitations with regard to treatment efficacy in Gram-positive mastitis were observed. A targeted mastitis concept based on the identification of the bacterium involved could help to select cases to be treated with ketoprofen alone and therefore to overcome this limitation.