Amoxycillin and clavulanic acid combination in the treatment of experimentally induced bacterial cystitis in cats.

Clavulanic acid (CA) competitively inhibits beta-lactamase hydrolysis of penicillins in vitro. Treatment with amoxycillin combined with clavulanic acid (A-CA) was compared with placebo in a blind study in cats with experimental cystitis caused by Escherichia coli demonstrating in vitro resistance to amoxycillin. Bacterial cystitis was induced in 20 cats by bladder infusion of 5 ml of 0.05 per cent alcoholic salicylic acid followed after 24 hours by a brain-heart infusion broth of E coli (10(8) colony forming units ml-1) previously found to be resistant to amoxycillin in vitro (minimum inhibitory concentration over 512 micrograms ml-1). Four days after infection, cats were randomly divided into two groups of 10 and treated with amoxycillin combined with clavulanic acid or placebo for 10 days. When compared to the placebo-treated group, the A-CA treated group showed: reduced quantitative bacterial counts in urine on days 7 (P less than 0.001) and 14 (P less than 0.02); reduced culture positive urine on days 7 (P less than 0.001) and 14 (P less than 0.001); and less severe inflammation on histological examination of the bladder and urethra (P less than 0.01). It was concluded that A-CA was effective in reducing the bacterial count and reducing the histopathological changes in the bladder and urethra in an experimental model of acute bacterial cystitis in cats infected with an E coli demonstrating in vitro resistance to amoxycillin.