How Equine Medicine Is Reinventing the Fight Against Bacteria
Antibiotics built modern veterinary medicine. Penicillin changed the game in the early 20th century, and for decades these drugs have saved countless equine lives. But in 2026, veterinary professionals are facing a hard truth. Antibiotics are no longer a limitless resource, and their downsides are becoming impossible to ignore.
Dean Hendrickson, DVM, MS, Dipl. ACVS, professor of equine surgery at Colorado State University, puts it plainly. Antibiotics are lifesaving, but they also fuel antimicrobial resistance and disrupt the microbiome in ways that can slow healing and complicate recovery. That combination has pushed researchers to ask a bold question. What if the future of infection control in horses blends ancient remedies with cutting-edge technology? Welcome to the new era of equine antimicrobials, where honey, garlic, light therapy, and phages are all on the table.
Antimicrobial resistance is not just a human health crisis. It is a daily reality in equine hospitals, breeding farms, and ambulatory practice. Yosra Helmy, PhD, DVM, MVSc, associate professor at the University of Kentucky’s Gluck Equine Research Center, warns that without serious investment in alternatives, treatment failures and biosecurity risks will continue to rise. For millennial veterinarians who already juggle client expectations, hospital protocols, and One Health responsibilities, the pressure is real. Using antibiotics wisely is no longer optional. It is part of professional survival.
If there is a bright spot, it is wounds. They are accessible, visible, and ideal for testing alternatives to systemic antibiotics. Hendrickson’s research highlights a practical approach many clinicians already recognize. Mechanical debridement followed by topical antiseptics such as polyhexamethylene biguanide and acetic acid can significantly reduce bacterial load. These methods support healing without contributing to resistance.
Honey is also having a moment. Raw and medical-grade honeys have shown impressive antibacterial activity in laboratory studies of equine wounds. The enzymes in honey naturally attack bacteria, creating an environment that pathogens struggle to survive in. Hendrickson cautions, however, that raw honey must be used carefully to avoid ingestion and the rare risk of botulism. Medical-grade products remain the safer choice when available.
Plant-based antimicrobials are gaining attention far beyond North America. Eyob Hirpa Tola, DVM, MSc, associate professor at Addis Ababa University, has demonstrated strong antibacterial effects from garlic against drug-resistant Staphylococcus aureus in equine wounds. The effect was even stronger when garlic was combined with ginger or leaves from Croton macrostachyus, a native African tree. These findings matter because accessibility matters. Not every region has easy access to advanced pharmaceuticals, but many have medicinal plants with real antimicrobial potential. For a generation of veterinarians interested in sustainable and globally relevant medicine, this research hits home.
Some of the most exciting innovations sound like science fiction. Andrea Marchegiani, DVM, PhD, at the University of Camerino in Italy, found that vitamin B2 combined with short bursts of ultraviolet-A light outperformed standard antibiotics in treating equine corneal ulcers. Meanwhile, researchers at the University of Illinois are exploring hydrogen peroxide, platelet-poor plasma, and platelet-rich plasma as potential treatments for bacteria associated with endometritis in mares. These approaches have only been tested in the lab so far, but the early results are promising.
Topical solutions are one thing. Internal infections are another challenge entirely. As Hendrickson notes, enzymes that work beautifully on a wound do not survive digestion or reach systemic targets. This is where Helmy’s work on Rhodococcus equi stands out. Her lab has identified small molecules and probiotic strains that prevent this pathogen from surviving inside foal lung cells in laboratory models. The goal is not just to kill bacteria, but to disarm them.
Antivirulence drugs, next-generation probiotics, postbiotics, and bacteriophages are all part of the strategy. Paired with smart delivery systems for lungs, uterus, eyes, intestines, and skin, these tools could redefine how equine practitioners approach infectious disease.
Another shift in thinking focuses less on the pathogen and more on the host. Eveline Ibeagha-Awemu, PhD, with Agriculture and Agri-Food Canada, emphasizes immune support as a critical piece of the puzzle. Fermented brewer’s yeast, for example, may help stabilize the equine gut microbiome during stress, potentially improving resistance to infection. Vaccines remain one of the most effective tools available, while probiotics, phages, immunotherapies, herbs, essential oils, acidifiers, and enzymes show promise in enhancing immune function. Most still need stronger evidence before routine clinical use, but the direction is clear.
Reducing antibiotic use in horses does more than protect equine patients. It supports the One Health framework connecting animal, human, and environmental health. Horses live at the crossroads of companionship and agriculture. They interact closely with people, other animals, and shared environments. Helmy points out that this makes them potential reservoirs for pathogens such as Salmonella, Clostridioides difficile, and MRSA. Antibiotics that pass through the horse and into manure can influence environmental microbiomes, spreading resistance into soil and water. Thoughtful antimicrobial stewardship in equine practice has ripple effects far beyond the barn.
Antibiotics are not the villain. Indiscriminate use is. The future of equine medicine lies in replacing routine antibiotic use with evidence-based alternatives, reserving antibiotics for when they are truly needed. Honey, garlic, light therapy, probiotics, and phages may sound unconventional, but they reflect a serious shift in how the profession approaches infection control. For millennial veterinarians who value innovation, sustainability, and One Health, this is not fringe science. It is the next chapter of equine care. As Helmy puts it, antibiotic resistance is a solvable biology and engineering problem. The goal is not to abandon antibiotics, but to protect them by building smarter, safer ways to keep horses healthy.
