Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Mississauga-Oakville Veterinary Emergency and Specialty Hospital, Oakville, Ontario, Canada.
J Vet Intern Med. 2021 Sep;35(5):2277-2286. doi: 10.1111/jvim.16246. Epub 2021 Aug 16.
Antimicrobials are commonly used to treat urinary tract disease in dogs. Understanding antimicrobial use is a critical component of antimicrobial stewardship efforts.
HYPOTHESIS/OBJECTIVES: To evaluate antimicrobial prescriptions for dogs diagnosed with acute cystitis, recurrent cystitis, and pyelonephritis.
Dogs prescribed antimicrobials for urinary tract disease at veterinary practices in the United States and Canada.
A retrospective review of antimicrobial prescriptions was performed.
The main clinical concerns were sporadic bacterial cystitis (n = 6582), recurrent cystitis (n = 428), and pyelonephritis (n = 326). Amoxicillin/clavulanic acid (2702, 41%), cefpodoxime (1024, 16%), and amoxicillin (874, 13%) were most commonly prescribed for sporadic bacterial cystitis. The median prescribed duration was 12 days (range, 3-60 days; interquartile range [IQR], 4 days). Shorter durations were used in 2018 (median, 10 days; IQR, 4 days) compared to both 2016 and 2017 (both median, 14 days; IQR, 4 days; P ≤ .0002). Amoxicillin/clavulanic acid (146, 33%), marbofloxacin (95, 21%), and cefpodoxime (65, 14%) were most commonly used for recurrent cystitis; median duration of 14 days (range, 3-77 days; IQR, 10.5 days). Amoxicillin/clavulanic acid (86, 26%), marbofloxacin (56, 17%), and enrofloxacin (36, 11%) were most commonly prescribed for pyelonephritis; however, 93 (29%) dogs received drug combinations. The median duration of treatment was 14 days (range, 3-77 days; IQR, 11 days).
Decreases in duration and increased use of recommended first-line antimicrobials were encouraging. Common drug choices and durations should still be targets for antimicrobial stewardship programs that aim to optimize antimicrobial use, concurrently maximizing patient benefits while minimizing antimicrobial use and use of higher tier antimicrobials.
抗生素常用于治疗犬的尿路感染。了解抗生素的使用情况是抗生素管理工作的关键组成部分。
假设/目的：评估诊断为急性膀胱炎、复发性膀胱炎和肾盂肾炎的犬的抗生素处方。
美国和加拿大兽医诊所开具抗生素治疗尿路感染的犬。
对抗生素处方进行了回顾性审查。
主要临床关注点为散发性细菌性膀胱炎（n=6582）、复发性膀胱炎（n=428）和肾盂肾炎（n=326）。最常开的处方是阿莫西林/克拉维酸（2702 例，41%）、头孢泊肟（1024 例，16%）和阿莫西林（874 例，13%）用于散发性细菌性膀胱炎。中位数处方持续时间为 12 天（范围，3-60 天；四分位距[IQR]，4 天）。2018 年的持续时间较短（中位数，10 天；IQR，4 天），与 2016 年和 2017 年相比均有显著差异（中位数，14 天；IQR，4 天；P≤.0002）。阿莫西林/克拉维酸（146 例，33%）、马波沙星（95 例，21%）和头孢泊肟（65 例，14%）是复发性膀胱炎最常用的药物；中位数持续时间为 14 天（范围，3-77 天；IQR，10.5 天）。阿莫西林/克拉维酸（86 例，26%）、马波沙星（56 例，17%）和恩诺沙星（36 例，11%）是肾盂肾炎最常用的药物，但 93 例（29%）狗接受了药物联合治疗。治疗的中位数持续时间为 14 天（范围，3-77 天；IQR，11 天）。
抗生素持续时间缩短和首选抗生素的使用增加令人鼓舞。常见的药物选择和持续时间仍然是旨在优化抗生素使用的抗生素管理计划的目标，同时最大限度地提高患者的受益，同时最大限度地减少抗生素的使用和更高层次抗生素的使用。
