{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:32:45Z","timestamp":1793381565745,"version":"4.5.0"},"reference-count":34,"publisher":"CERN","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission","award":["CA18217"],"award-info":[{"award-number":["CA18217"]}],"id":[{"id":"https:\/\/ror.org\/00k4n6c32","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Open Res Europe"],"abstract":"<jats:p>Background\n                    Bovine respiratory disease (BRD) is a major cause of morbidity, mortality, impaired welfare, production loss, and antimicrobial use in cattle. These European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines provide evidence-based recommendations for antimicrobial and non-steroidal anti-inflammatory drug (NSAID) use in cattle with acute, undifferentiated BRD, balancing animal-level outcomes with antimicrobial stewardship.\n                \n                \n                    Methods\n                    Recommendations were developed using the GRADE approach and Evidence-to-Decision frameworks, following ENOVAT procedures and RIGHT reporting guidance. Evidence came from two prespecified systematic reviews and meta-analyses of randomized controlled trials evaluating individual treatment of clinical BRD: one comparing antimicrobial classes head-to-head and one evaluating NSAIDs as adjunctive treatment or monotherapy. Metaphylaxis and prophylaxis were excluded. Certainty of evidence was assessed with GRADE. Panel judgments incorporated stakeholder-derived thresholds for clinically meaningful differences in short-term therapeutic failure, defined as need for antimicrobial re-treatment, and a merged stewardship perspective based on WHO antimicrobial importance and EMA AMEG categories.\n                \n                \n                    Results\n                    Across antimicrobial comparisons, no class showed a clinically meaningful advantage in reducing short-term re-treatment sufficient to override stewardship considerations. The panel conditionally suggests penicillin G, oxytetracycline, or florfenicol as first-line empirical treatment, guided by local susceptibility data, herd treatment history, product authorization, withdrawal periods, and suspicion of \n                        Mycoplasmopsis bovis infection. Macrolides are conditionally suggested as second-line treatment, preferably guided by culture and susceptibility testing or documented treatment failure. Fluoroquinolones are recommended against as primary or secondary treatment, except in exceptional, justified circumstances consistent with regulations. Adding NSAIDs to antimicrobials did not meaningfully reduce antimicrobial re-treatment; the panel recommends against NSAID use for this specific purpose. Evidence was insufficient to recommend for or against NSAIDs for welfare-related outcomes or as antimicrobial substitutes.\n                \n                \n                    Conclusions\n                    These guidelines prioritize effective BRD treatment while reducing unnecessary use of higher-priority antimicrobials. Local adoption or adaptation using GRADE-ADOLOPMENT is recommended.<\/jats:p>","DOI":"10.12688\/openreseurope.24099.1","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:59:06Z","timestamp":1786708746000},"update-policy":"https:\/\/doi.org\/10.68336\/openreseurope.updatepolicy","source":"Crossref","is-referenced-by-count":0,"title":["European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines for antimicrobial and non-steroidal anti-inflammatory drug use in bovine respiratory disease"],"prefix":"10.68336","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8526-3592","authenticated-orcid":true,"given":"Karolina","family":"Scahill","sequence":"first","affiliation":[{"name":"International Veterinary Evidence-based Guidelines Centre, Department of Veterinary Clinical Science, University of Copenhagen, Frederiksberg C, Denmark"},{"name":"Infectious disease, The University of Edinburgh College of Medicine and Veterinary Medicine,, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Buczinski","sequence":"additional","affiliation":[{"name":"D\u00e9partement des sciences cliniques, Facult\u00e9 de m\u00e9decine v\u00e9t\u00e9rinaire, Universit\u00e9 de Montr\u00e9al, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-7786","authenticated-orcid":true,"given":"Clair L.","family":"Firth","sequence":"additional","affiliation":[{"name":"Centre for Veterinary Public Health & One Health, Clinical Department for Farm Animals and Food System Transformation, University of Veterinary Medicine Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Pardon","sequence":"additional","affiliation":[{"name":"U Gent Calf Health, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8869-2029","authenticated-orcid":true,"given":"Maria","family":"Stokstad","sequence":"additional","affiliation":[{"name":"Department of Production Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, \u00c5s, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia R.","family":"Woolums","sequence":"additional","affiliation":[{"name":"Department of Pathobiology and Population Medicine, Mississippi State University, Mississippi, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramazan","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Veterinary Medicine,, Mehmet Akif Ersoy University, Burdur, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise Marie","family":"\u00c5nestad","sequence":"additional","affiliation":[{"name":"Norwegian Veterinary Institute, \u00c5s, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7490-7903","authenticated-orcid":true,"given":"Mickael","family":"Cargnel","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases in Animals, Sciensano, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7367-5178","authenticated-orcid":true,"given":"Luis Pedro","family":"Carmo","sequence":"additional","affiliation":[{"name":"Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Louis","family":"Toutain","sequence":"additional","affiliation":[{"name":"Comparative Biomedical Sciences, The Royal Veterinary College, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2389-5084","authenticated-orcid":true,"given":"Luca","family":"Guardabassi","sequence":"additional","affiliation":[{"name":"Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"13904","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"118226","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2024.1416436"},{"key":"118227","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2016"},{"key":"118228","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9040337"},{"key":"118229","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-04273"},{"key":"118230","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0294733"},{"key":"118231","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0146488"},{"key":"118232","doi-asserted-by":"publisher","DOI":"10.7326\/M16-1561"},{"key":"118233","unstructured":"European Medicines Agency: Categorisation of antibiotics in the European Union. Amsterdam: EMA;2025. [Accessed: 2026-05-21]. Reference Source (https:\/\/www.ema.europa.eu\/en\/documents\/report\/categorisation-antibiotics-european-union-answer-request-european-commission-updating-scientific-advice-impact-public-health-animal-health-use-antibiotics-animals_en.pdf)"},{"key":"118234","doi-asserted-by":"publisher","DOI":"10.2460\/javma.23.06.0361"},{"key":"118235","doi-asserted-by":"publisher","DOI":"10.1136\/vr.156.25.809"},{"key":"118236","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec"},{"key":"118237","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec"},{"key":"118238","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-081903"},{"key":"118239","doi-asserted-by":"publisher","DOI":"10.1002\/gin2.70057"},{"key":"118240","unstructured":"Kilgore WR, Spensley MS, Sun F, et al.: Therapeutic efficacy of tulathromycin, a novel triamilide antimicrobial, against bovine respiratory disease in feeder calves. Vet. Ther. 2005; 6(2): 143\u2013153."},{"key":"118241","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2024.111494"},{"key":"118242","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa104"},{"key":"118243","doi-asserted-by":"publisher","DOI":"10.1136\/vr.104057"},{"key":"118244","doi-asserted-by":"publisher","DOI":"10.1136\/vetreco-2020-000415"},{"key":"118245","unstructured":"Neumann I, Akl E, Meerpohl J, et al.: GRADE recommendations. GRADE Book;2026. [Accessed: 2026-05-21] Reference Source (https:\/\/book.gradepro.org\/guideline\/grade-recommendations)"},{"key":"118246","doi-asserted-by":"publisher","DOI":"10.1111\/jvim.12547"},{"key":"118247","unstructured":"Nutsch RG, Skogerboe TL, Rooney KA, et al.: Comparative efficacy of tulathromycin, tilmicosin, and florfenicol in the treatment of bovine respiratory disease in stocker cattle. Vet. Ther. 2005; 6(2): 167\u2013179. https:\/\/pubmed.ncbi.nlm.nih.gov\/16094564"},{"key":"118248","doi-asserted-by":"publisher","DOI":"10.3390\/vetsci12080778"},{"key":"118249","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr570"},{"key":"118250","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-04761"},{"key":"118251","doi-asserted-by":"publisher","DOI":"10.12688\/openreseurope.21879.2"},{"key":"118252","doi-asserted-by":"publisher","DOI":"10.12688\/openreseurope.23174.2"},{"key":"118253","doi-asserted-by":"publisher","DOI":"10.17605\/OSF.IO\/3NVHY"},{"key":"118254","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.09.009"},{"key":"118255","unstructured":"Skogerboe TL, Rooney KA, Nutsch RG, et al.: Comparative efficacy of tulathromycin versus florfenicol and tilmicosin against undifferentiated bovine respiratory disease in feedlot cattle. Vet. Ther. 2005; 6(2): 180\u2013196. https:\/\/pubmed.ncbi.nlm.nih.gov\/16094565"},{"key":"118256","doi-asserted-by":"publisher","DOI":"10.21423\/bovine-vol47no2p152-158"},{"key":"118257","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2885.2007.00846.x"},{"key":"118258","unstructured":"World Health Organization: WHO\u2019s list of medically important antimicrobials: a risk management tool for mitigating antimicrobial resistance due to non-human use. Geneva: World Health Organization;2024. [Accessed: 2026-05-21]. Reference Source (https:\/\/cdn.who.int\/media\/docs\/default-source\/gcp\/who-mia-list-2024-lv.pdf)"},{"key":"118259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.06.017"}],"container-title":["Open Research Europe"],"original-title":[],"link":[{"URL":"https:\/\/open-research-europe.ec.europa.eu\/articles\/6-296\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/1491\/version\/2459\/4915","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/1491\/version\/2459\/4916","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/1491\/version\/2459\/4915","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:11:10Z","timestamp":1793380270000},"score":1,"resource":{"primary":{"URL":"https:\/\/ore.eu\/ore\/article\/view\/1491\/version\/2459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":34,"URL":"https:\/\/doi.org\/10.12688\/openreseurope.24099.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/openreseurope.26088.r79328","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/openreseurope.26088.r80057","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/openreseurope.26088.r80054","asserted-by":"object"}]},"ISSN":["2732-5121"],"issn-type":[{"value":"2732-5121","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"2026-08-14","name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"This work was funded by the European Union\u2019s Framework Programme for Research &amp; Innovation via COST Action CA18217 (ENOVAT), supported by the COST Association (European Cooperation in Science and Technology). The funders had no role in study design, evidence synthesis, recommendation development, decision to publish, or preparation of the manuscript.\n\n                    The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","name":"funding_statement","label":"Funding Statement","group":{"name":"funding_information","label":"Funding Information"}}],"article-number":"296"}}