{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:26:06Z","timestamp":1787289966477,"version":"build-2736575974"},"reference-count":104,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Rhodococcus equi<\/jats:italic>\n                    is a facultative intracellular pathogen and a major cause of pneumonia in foals worldwide. The standard treatment for affected foals is a combination of a macrolide with rifampicin. The widespread use of this combination has led to the emergence of multidrug\u2010resistant (MDR) strains of\n                    <jats:italic>R. equi<\/jats:italic>\n                    . Consequently, antimicrobial susceptibility testing is essential for guiding treatment of rhodococcal pneumonia. Unfortunately, clinical breakpoints for macrolides and other antimicrobials against\n                    <jats:italic>R. equi<\/jats:italic>\n                    for foals are lacking, thereby complicating clinical interpretation of in vitro results. This review summarises current knowledge of antimicrobial resistance in\n                    <jats:italic>R. equi<\/jats:italic>\n                    , the methods used for susceptibility testing and the challenges of interpreting susceptibility testing for guiding treatment of this intracellular infection. We discuss the limitations of extrapolating breakpoints from other species of bacteria and animals and emphasise the importance of integrating minimum inhibitory concentration data, knowledge of intracellular antimicrobial activity and principles of pharmacokinetics and pharmacodynamics to inform therapeutic decisions. In the absence of standardised interpretive criteria of results of susceptibility testing, we propose evidence\u2010based guidelines to support veterinarians and diagnostic laboratories in managing\n                    <jats:italic>R. equi<\/jats:italic>\n                    infections of foals.\n                  <\/jats:p>","DOI":"10.1002\/evj.70312","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:05:52Z","timestamp":1787288752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenges for interpreting results of antimicrobial susceptibility testing for treating infections of foals with\n                    <scp>\n                      <i>Rhodococcus equi<\/i>\n                    <\/scp>"],"prefix":"10.1002","author":[{"given":"Marlane Geribone","family":"Seeger","sequence":"first","affiliation":[{"name":"Graduate Program in Veterinary Medicine Federal University of Santa Maria  Santa Maria Rio Grande do Sul Brazil"},{"name":"Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine &amp; Biomedical Sciences Texas A&amp;M University  College Station Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia Trevisan","family":"Gressler","sequence":"additional","affiliation":[{"name":"Department Animal Health Farroupilha Federal Institute \u2013 Frederico Westphalen Campus  Frederico Westphalen Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Pathobiology, College of Veterinary Medicine Auburn University  Auburn Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonsiray","family":"Alvarez\u2010Narvaez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, College of Veterinary Medicine University of Georgia  Athens Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3160-3643","authenticated-orcid":false,"given":"Juliana Felipetto","family":"Cargnelutti","sequence":"additional","affiliation":[{"name":"Department of Preventive Veterinary Medicine, Center of Rural Sciences Federal University of Santa Maria  Santa Maria Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7678-3908","authenticated-orcid":false,"given":"Angela Ilha","family":"Bordin","sequence":"additional","affiliation":[{"name":"Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine &amp; Biomedical Sciences Texas A&amp;M University  College Station Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara D.","family":"Lawhon","sequence":"additional","affiliation":[{"name":"Department of Veterinary Pathobiology, College of Veterinary Medicine &amp; Biomedical Sciences Texas A&amp;M University  College Station Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0384-2903","authenticated-orcid":false,"given":"Noah D.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine &amp; Biomedical Sciences Texas A&amp;M University  College Station Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1128\/CMR.4.1.20","article-title":"Rhodococcus equi: an animal and human pathogen","volume":"4","author":"Prescott JF","year":"1991","journal-title":"Clin Microbiol Rev"},{"issue":"5","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1128\/microbiolspec.ARBA-0004-2016","article-title":"Antimicrobial resistance in Rhodococcus equi","volume":"5","author":"Gigu\u00e8re S","year":"2017","journal-title":"Microbiol Spectr"},{"issue":"7","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2460\/javma.235.7.855","article-title":"Extrapulmonary disorders associated with Rhodococcus equi infection in foals: 150 cases (1987\u20132007)","volume":"235","author":"Reuss SM","year":"2009","journal-title":"J Am Vet Med Assoc"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1294\/jes.11.7","article-title":"Some epidemiological aspects of Rhodococcus equi infection in foals in Japan: a review of 108 cases in 1992\u20131998","volume":"11","author":"Takai S","year":"2000","journal-title":"J Equine Sci"},{"issue":"2","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0192655","article-title":"Development of septic polysynovitis and uveitis in foals experimentally infected with Rhodococcus equi","volume":"13","author":"Huber L","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2460\/javma.237.1.74","article-title":"Determination of the prevalence of antimicrobial resistance to macrolide antimicrobials or rifampin in Rhodococcus equi isolates and treatment outcome in foals infected with antimicrobial\u2010resistant isolates of R equi","volume":"237","author":"Gigu\u00e8re S","year":"2010","journal-title":"J Am Vet Med Assoc"},{"issue":"2","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.1128\/MMBR.00011-21","article-title":"Epidemiology and molecular basis of multidrug resistance in Rhodococcus equi","volume":"85","author":"\u00c1lvarez\u2010Narv\u00e1ez S","year":"2021","journal-title":"Microbiol Mol Biol Rev"},{"issue":"2","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3201\/eid2702.203030","article-title":"Spread of multidrug\u2010resistant Rhodococcus equi, United States","volume":"27","author":"\u00c1lvarez\u2010Narv\u00e1ez S","year":"2021","journal-title":"Emerg Infect Dis"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jevs.2023.104845","article-title":"Rhodococcus Equi: challenges to treat infections and to mitigate antimicrobial resistance","volume":"127","author":"Higgins C","year":"2023","journal-title":"J Equine Vet Sci"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.01714-18","article-title":"Emergence of resistance to macrolides and rifampin in clinical isolates of Rhodococcus equi from foals in central Kentucky, 1995 to 2017","volume":"63","author":"Huber L","year":"2019","journal-title":"Antimicrob Agents Chemother"},{"issue":"6","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.1002\/vetr.4071","article-title":"Update on emerging multidrug\u2010resistant Rhodococcus equi","volume":"194","author":"V\u00e1zquez\u2010Boland J","year":"2024","journal-title":"Vet Rec"},{"issue":"5","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/jvp.70007","article-title":"Is rifampin (rifampicin) essential for the treatment of Rhodococcus equi infections in foals? 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