**Author details**

ability to inhibit chitin synthesis, polymerization and deposition. It was supposed that they might interfere with the formation of new chitin in the cell wall, but have no effect on the fungal cell walls that have already formed. Thus, their potential effect may consist in the prevention of a new fungal growth and, thus, reinfection. Lufenuron is an insecticide chitin inhibitor that was evaluated as a treatment for endometrial fungal infections. Preliminary results were promising, and intrauterine lavages, performed with lufenuron suspended in sterile saline solution, were effective in eliminating fungal endometritis in four mares [144]. However, further studies did not confirm the efficacy against *Aspergillus* spp. or *Fusarium* spp. in vitro and indicated that very low concentrations in whole blood of horses were achieved after oral administration [145]. Further investigations about the efficacy of chitin inhibitors are necessary before they can be indicated for the treatment of fungal endometritis in the horse [136].

Another suggested protocol consists in morning lavage with 2% acetic acid solution followed by intrauterine irrigation with the specific antifungal antibiotic in the afternoon. The length of this therapy should be of 7–10 days. If uterine culture and cytology obtained in the first day of the next estrus are negative, the mare is bred with the minimum number of insemination and using sterile techniques and double-guarded pipette, to prevent accidental seeding with

The prognosis for future fertility of mares affected by fungal endometritis is guarded to poor. The success of the therapy relies on the timely identification and treatment of delayed uterine clearance, poor perineal conformation, or fungal colonization of the more distal reproductive tract, the correct length of the treatment period, the appropriate choice and dosage of the antifungal [132]. The uterine biopsy for many of these mares indicates significant fibrosis, probably due to fungal infection, as well as to a previous bacterial infection and age-related changes. Once the fungal infection is resolved, a uterine biopsy may be advised to quantify

Endometritis is the butler of the equine reproduction, and it is the main suspect in all cases of impaired fertility of the mare. Every year the literature is enriched by new interesting reports about this subject, which throw even more light on the knowledge of its pathogenesis. The events occurring during the uterine inflammatory response are complex and intertwined. A thorough understanding of the physiological response to uterine contamination, which is necessarily correlated with the act of the insemination, may allow timely identification of susceptible mares, in which these mechanisms get jammed within the first hours after breeding. Type and dose of treatments, as well as timing of administration, should be correctly targeted towards susceptible and/or affected mares to optimize the results and reduce the cost and the resources used. Continued research is welcome in this area of equine medicine, so that

organisms from reservoir sources [136].

the resulting uterine damage [136].

treatment strategies can be further improved.

**6. Conclusions**

316 Genital Infections and Infertility

Maria Pia Pasolini1 , Chiara Del Prete1 , Silvia Fabbri1 and Luigi Auletta2\*

\*Address all correspondence to: lauletta@sdn-napoli. it

1 Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Napoli, Italy

2 IRCCS SDN, Napoli, Italy
