Response to 'reconsidering the link between antimicrobial duration, microbiota, and surgical site infection in ruminants'.

Thank you for the opportunity to respond to the correspondance from Souza and Fonteque encouraging discussion on the potential reasons for the link between prolonged antimicrobial duration and surgical site infection (SSI) identified in the manuscript “Incidence and risk factors of surgical site infection in ruminant species following internal fixation for orthopedic injury: 81 cases (2010-2023)” 1, 2. We agree that the points raised by Souza and Fonteque are all important and as we highlighted in the manuscript it is highly likely that the link between prolonged antimicrobial duration and SSI is due to reverse causation. Cases at risk of developing SSI may be identified early in the postoperative period and so antimicrobial therapy was prolonged. As discussed by Souze and Fonteque, there is some evidence showing the plausibility of bacterial translocation from the gastrointestinal tract, and the potential detrimental consequences of prolonged antimicrobial use are an important area for further research. The authors declare no conflicts of interest related to this report. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.