Infectious bovine keratoconjunctivitis (IBK) is a common and important disease of calves. Without effective vaccines, antibiotic therapy is often implemented to minimize the impact of IBK. This review updates a previously published systematic review regarding comparative efficacy for antibiotic treatments of IBK. Available years of Centre for Biosciences and Agriculture International and MEDLINE databases were searched, including non-English results. Also searched were the American Association of Bovine Practitioners and World Buiatrics Congress conference proceedings from 1996 to 2016, reviews since 2013, reference lists from relevant trials, and U.S. Food and Drug Administration New Animal Drug Application summaries. Eligible studies assessed antibiotic treatment of naturally-occurring IBK in calves randomly allocated to group at the individual level. Outcomes of interest were clinical score, healing time, unhealed ulcer risk, and ulcer surface area. A mixed-effects model comparing active drug with placebo was employed for all outcomes. Heterogeneity was assessed visually and using Cochran's Q-test. Thirteen trials assessing nine treatments were included. Compared with placebo, most antibiotic treatments were effective. There was evidence that the treatment effect differed by day of outcome measurement. Visually, the largest differences were observed 7–14 days post-treatment. These results indicate improved IBK healing with many antibiotics and suggest the need for randomized trials comparing different antibiotic treatments.

The objective of the study was to evaluate treatments for infectious bovine keratoconjunctivitis (IBK), based on a systematic review of the published literature. A search was conducted to identify all manuscripts relating to antibiotic treatment of cattle with IBK. Relevant studies involved naturally occurring IBK and reported the resolution of lesions as a study outcome. Studies which failed to use methods such as blinding, blocking or randomization to minimize bias were excluded from the review. The initial search yielded 196 manuscripts, of which nine described high-quality, randomized clinical trials. These manuscripts reported antibiotic treatment of IBK with florfenicol, ceftiofur, oxytetracycline, procaine penicillin G, procaine penicillin G and dexamethasone, tilmicosin, or benzathine cloxacillin compared to either a placebo control or a non-medicated control. Overall, the studies suggest that antibiotic treatment is successful in reducing healing times of IBK-associated corneal lesions. Very few manuscripts reported a direct comparison of different antibiotic classes, so it was not possible to make comparative evaluations of efficacy. This review demonstrates the need for further randomized controlled trials that evaluate the efficacy of antibiotic treatment for IBK, including direct comparisons of two or more antibiotics.