Comparative efficacy of antibiotics used in respiratory tract infections caused by Mannheimia haemolytica and Mycoplasma ovipneumoniae in small ruminants: Systematic review and network meta analysis

The aim of this study is to examine the comparative effectiveness of antibiotics used in naturally occurring respiratory tract infections in small ruminants through network meta analysis. A total of 1,365 documents were retrieved from the Web of Science, Scopus, PubMed, and EBSCOhost databases as of September 13, 2024. Following inclusion and exclusion criteria, 14 documents were included in the analysis. The gemtc, rjags, and netmeta packages were used for the analysis. The analysis was performed using the R programming language and Microsoft Excel 2023. The RoB 2 tool was used to detect bias. The analysis was performed with 100,000 iterations, 30,000 burn-in, 4 chains, and 5 thin. High levels of heterogeneity were detected in both the fixed effect and random effects models (I2>50%). The analysis was performed using both fixed effect and random effects models. In the fixed effect model, the superiority of antibiotics over each other and over the control was detected. In the random effects model, only florfenicol was found to be superior to oxytetracycline (RR=0,11; Crl, 0,01-0,89). No superiority of other antibiotics over each other was determined. No inconsistency was detected in either model (P>0,05). In both models, tulathromycin was found to be the antibiotic with the highest probability of being the best treatment in terms of clinical efficacy and the highest SUCRA value. It was determined that the control group had the highest probability of being ranked last in terms of clinical efficacy and the SUCRA value was the lowest. Egger's regression test and funnel plot were used to detect publication bias. No publication bias was detected in either model (P>0,05). The results obtained from this study may provide important information for the selection of antibiotics used in naturally occurring respiratory tract infections in small ruminants.