Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea |
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| Authors: | M. Cerquetella G. Rossi J. S. Suchodolski S. Salavati Schmitz K. Allenspach F. Rodríguez-Franco T. Furlanello A. Gavazza A. Marchegiani S. Unterer I. A. Burgener G. Pengo A. E. Jergens |
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| Affiliation: | 1. School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, Matelica, 62024 Italy;2. Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA;3. The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Hospital for Small Animals, The University of Edinburgh, Easter Bush Campus, Midlothian, EH25 9RG UK;4. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50011 USA;5. Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid, 28040 Spain;6. Veterinary Clinic and Laboratory San Marco, Via dell'Industria 3, Veggiano, 35030 Italy;7. Faculty of Veterinary Medicine, Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany;8. Department for Small Animals and Horses, VetMedUni Vienna, Veterinaerplatz 1, Vienna, 1210 Austria;9. St. Antonio Veterinary Clinic, S.S. 415 Paullese 6, Madignano, 26020 Italy |
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| Abstract: | Chronic diarrhoea is a frequent complaint in canine practice and the diagnostic path is often characterised by numerous diagnostic tests and stepwise empirical treatments, often applied before gastrointestinal endoscopy/mucosal biopsies. These include dietary interventions (novel protein, hydrolysed protein diet), parasiticides and still, in many cases, antibacterials. Indiscriminate use of antibacterial drugs risks detrimental consequences for both the individual patient (antimicrobial resistance, long-term disruption of intestinal bacterial populations, potential worsening of gastrointestinal signs) and the general public. For that reason, in this Perspective essay we advocate use of antibacterials only after histopathologic evaluation of gastrointestinal biopsies or, for those cases in which endoscopy is not possible, after other therapeutic trials, such as diet/pre-probiotics or anti-inflammatory drugs have proven unsuccessful. They should be reserved, after appropriate dietary trials, for those canine chronic diarrhoeic patients with signs of true primary infection (i.e. signs of systemic inflammatory response syndrome or evidence of adherent-invasive bacteria) that justify antibacterial use. |
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