UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Veterinary Science Building, Level 2, Room 235, Gatton, Queensland, 4343, Australia.
Faculty of Health, Engineering and Sciences, School of Sciences, University of Southern Queensland, Toowoomba, QLD, Australia.
BMC Vet Res. 2022 Apr 27;18(1):151. doi: 10.1186/s12917-022-03255-y.
Canine allergic dermatitis is a common diagnosis in veterinary practices which can lead to secondary infections requiring treatment with antimicrobials. A previous study suggested that dogs treated with oclacitinib in an Australian referral hospital required fewer courses of antimicrobial therapy compared to dogs receiving other anti-pruritic treatments. This study aimed to quantify the effect of oclacitinib treatment on the use of antimicrobials and other therapies in general practice veterinary clinics across Australia. A retrospective case-controlled review of patient records was designed to investigate the number of courses of antimicrobials and other therapies in dogs that received oclacitinib (Apoquel®), compared with those who received an anti-pruritic treatment that was not oclacitinib.
The target population included canine patients with a presumptive diagnosis of allergic dermatitis presenting between 2008 and 2018 to general practices contributing to the VetCompass Australia database. Patient records of interest were identified using search terms relating to allergic dermatitis, resulting in over 700,000 observations. Multivariable logistic regression models were developed to determine whether cases were prescribed fewer antimicrobial courses than controls, after adjusting for the presence of concurrent skin infections or infectious agents in ears. Our results indicate that fewer antimicrobial courses were prescribed in the cases compared to the controls. After adjusting for the concurrent skin infections, there was a significant reduction in the use of cefovecin [OR:0.62(0.39-0.98), P = 0.043], chlorhexidine [OR:0.57(0.42-0.77), P < 0.001], neomycin [OR:0.4(0.28-0.56), P < 0.001] and amoxycillin clavulanic acid (AMC) [OR: 0.55(0.39-0.78), P = 0.001] in cases compared to controls.
This study demonstrates a potential sparing effect of oclacitinib on the prescription of antimicrobials for the treatment of allergic skin diseases in dogs. This information may assist in the planning of treatment for canine allergic dermatitis, with consideration for antimicrobial stewardship.
犬过敏性皮炎是兽医实践中的常见诊断，可能导致需要使用抗生素治疗的继发感染。先前的一项研究表明，在澳大利亚转诊医院接受奥克利替尼治疗的狗与接受其他止痒治疗的狗相比，需要接受的抗生素治疗疗程更少。本研究旨在量化奥克利替尼治疗对澳大利亚一般实践兽医诊所中抗生素和其他治疗方法的使用效果。设计了一项回顾性病例对照研究，以调查接受奥克利替尼（Apoquel®）治疗的狗与接受非奥克利替尼止痒治疗的狗相比，接受抗生素和其他治疗的疗程数。
目标人群包括 2008 年至 2018 年期间向参与澳大利亚 VetCompass 数据库的一般实践就诊的疑似过敏性皮炎犬患者。使用与过敏性皮炎相关的搜索词来确定感兴趣的患者记录，结果产生了超过 70 万次观察。建立多变量逻辑回归模型，以确定在调整同时存在的皮肤感染或耳部感染因子后，病例是否比对照处方的抗生素疗程更少。我们的结果表明，与对照相比，病例中开具的抗生素疗程更少。在调整同时存在的皮肤感染后，头孢噻肟（OR：0.62（0.39-0.98），P=0.043）、洗必泰（OR：0.57（0.42-0.77），P<0.001）、新霉素（OR：0.4（0.28-0.56），P<0.001）和阿莫西林克拉维酸（AMC）（OR：0.55（0.39-0.78），P=0.001）的使用显著减少。
本研究表明奥克利替尼治疗犬过敏性皮肤病可能具有抗生素节约作用。这些信息可能有助于规划犬过敏性皮炎的治疗，同时考虑抗生素管理。
