Alternative approaches for bovine mastitis treatment: A critical review of emerging strategies, their effectiveness and limitations

Background: This review examined alternative treatments for bovine mastitis, driven by the rising issue of antibiotic resistance that limits the effectiveness of antibiotic therapies. As few new antibiotics are being developed, exploring non-antibiotic options is essential. Method: Data were gathered by searching five databases, including PubMed, Scopus, Google Scholar, NCBI, and CABI, for articles on alternative treatments for bovine mastitis. Full texts of relevant studies published from 2013 onwards, both in vitro and in vivo, were screened and retrieved. A deductive approach was used to identify key themes from the review. Data were presented using tables and graphs created with R software for visualisation. Results: Eligible studies included 69 articles tapered from an initial search of 1696 after removing duplicates and irrelevant records. Phytotherapy was found to be the most extensively researched approach, demonstrating significant effectiveness against mastitis pathogens, including multidrug-resistant Staphylococcus aureus, coagulase-negative S. aureus (CoNS), Escherichia coli, different species of Streptococci, though concerns about the degradation of active compounds in milk and variability in natural product composition exist. Bacteriophage therapy also showed promise, with studies indicating its effectiveness and low risk of inducing bacterial resistance. Treatments such as Trisodium citrate, pheromonicin-NM, and lactoferrin therapy exhibited statistically significant results, particularly against biofilm formation, a major challenge in mastitis management. Many of these treatments lacked extensive in vivo validation. The review highlights the geographic concentration of research, predominantly in countries like China and India, and emphasises the need for more standardised protocols to improve comparison across studies. Conclusion: The review highlighted phytotherapy, followed by bacteriophage therapy, as the next most researched alternative treatment for mastitis, effective against various pathogens despite concerns about compound degradation. Future research should prioritise the long-term effects of these therapies and their real-world effectiveness in enhancing dairy cow welfare and improving productivity in dairy operations.