The treatment and prevention of infectious diseases in pigs is an important aspect of swine production worldwide. The prudent use of antimicrobials and other therapeutic drugs is a primary responsibility of swine producers and veterinarians and decisions surrounding the use of drug therapy include considerations such as cost, efficacy, and food safety. The World Health Organization has published numerous reports urging all stakeholders concerned with both food-producing animals and humans to establish recommended steps to enhance the prudent use of antimicrobials (WHO, 2015). Similarly, the Organization for Animal Health has also published recommendations and position statements regarding prudent use and risk management related to antimicrobial use in animals (OIE, 2017).

Antibiotic therapy is used to treat and prevent respiratory diseases in pigs and there are numerous pathogenic organisms involved in all of the predominant swine respiratory diseases (Karriker, et al, 2012). In addition to antibiotics, vaccines targeted towards respiratory pathogens have been used extensively in swine production and are often used in combination with other approaches to reduce the incidence of disease. The usefulness of a vaccine or vaccine program varies from herd to herd and the complex interactions between host, agent and environment in swine production makes the design of a vaccine program challenging for veterinarians. There are many studies that have assessed the efficacy of antibiotics and vaccines for the treatment and prevention Mycoplasma hyopneumonia, for example, however, they often report conflicting results adding to the complexity of the decision-making process (Thacker and Minion, 2012).

Understanding the efficacy of these vaccines products is essential to optimizing their use in order to decrease reliance on antibiotics for both treatment and prevention of swine respiratory disease. Systematic reviews of randomized controlled trials in these areas will yield the highest level of evidence for efficacy of treatment under field conditions (Sargeant and O’Connor, 2014). Although vaccines exist for both viral and bacterial causes of respiratory diseases of swine, and antibiotics often are used in the treatment of both, this review will focus on bacterial causes for logistical reasons.