Antimicrobial Use in the Veterinary Cancer Patient

Boudreaux, Bonnie

doi:10.1016/j.cvsm.2014.05.004

Cited by 10 publications

(19 citation statements)

References 23 publications

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“…However, several studies have not found any improvement in mortality or overall outcome based on quicker initial administration of antimicrobials and this is currently under review in the human literature . Despite some conflicting evidence on the exact timing of initial administration of antimicrobials, waiting for blood or urinary culture results to inform antimicrobial choice is contraindicated . A rational empirical choice must therefore be made in the first instance …”

Section: Timing and Duration Of Treatmentmentioning

confidence: 99%

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Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations

Bisson

Argyle

2018

Vet Comparative Oncology

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Bacterial infection following cancer chemotherapy-induced neutropenia is a serious cause of morbidity and mortality in human and veterinary patients. Antimicrobial prophylaxis is controversial in the human oncology field, as any decreased incidence in bacterial infections is countered by patient adverse effects and increased antimicrobial resistance. Comprehensive guidelines exist to aid human oncologists in prescribing antimicrobial prophylaxis but similar recommendations are not available in veterinary literature. As the veterinarian's role in antimicrobial stewardship is increasingly emphasized, it is vital that veterinary oncologists implement appropriate antimicrobial use. By considering the available human and veterinary literature we present an overview of current clinical practices and are able to suggest recommendations for prophylactic antimicrobial use in veterinary cancer chemotherapy patients.

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Section: Timing and Duration Of Treatmentmentioning

confidence: 99%

“…In the setting of veterinary cancer chemotherapy antimicrobial prophylaxis is a newer concept, and far fewer resources are available to guide clinicians . Any recommendations are often minimally evidence based and may not be easy to access.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations

Bisson

Argyle

2018

Vet Comparative Oncology

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“…Examples of indications include secondary infections in patients with bladder and urethral carcinomas (Boudreaux 2014, Budreckis and others 2015), and in gross oral tumours.…”

Section: Medical Therapymentioning

confidence: 99%

Palliative care in small animal oncology

Mason¹

2016

In Practice

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Cancer is a common diagnosis in companion animals and, increasingly, clients choose to pursue treatment for their pets. Veterinary oncology is a rapidly growing field and diagnostic and treatment options for animals with cancer are constantly improving and becoming more widely available. Treatment outcomes can be good, but in many cases definitive treatment is not an option and palliative treatment is necessary. This article explores the palliative care of dogs and cats that have been diagnosed with cancer and summarises the various treatment options, with a particular focus on quality of life and the role of communication in the decision-making process.

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“…In veterinary medicine, the neutrophil nadir is not known for each animal although estimates are made to determine the timing of each CBC. An ANC cutoff of 1.0 × 10 3 /μL has been suggested to trigger the prescription of prophylactic antibiotics in afebrile neutropenic dogs but, as with prechemotherapy ANC values, there is little evidence to support this guideline . Clinicians may be reluctant to use a lower neutrophil cutoff to allow a margin of safety if the nadir neutrophil count was not truly captured, or because they are less tolerant of adverse chemotherapy events in pets than are their counterparts in human medicine.…”

Section: Discussionmentioning

confidence: 99%

“…Published ANC cutoffs in veterinary medicine range from 1.5 × 10 3 /μL to 2.5 × 10 3 /μL with 2.0 × 10 3 /μL being most commonly reported . Management of chemotherapy‐induced neutropenia in dogs is largely based on clinical experience although some standards have been published …”

mentioning

confidence: 99%

Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy

Fournier

Serra

Handel

et al. 2017

Veterinary Internal Medicne

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BackgroundPrechemotherapy absolute neutrophil count (ANC) cutoffs are arbitrary and vary across institutions and clinicians. Similarly, subjective guidelines are utilized for the administration of prophylactic antibiotics in neutropenic dogs.ObjectivesTo evaluate the impact of various ANC cutoffs on chemotherapy administration in dogs with lymphoma treated with CHOP chemotherapy and to determine whether an association between prechemotherapy ANC and subsequent toxicity exists. The secondary objective was to evaluate a currently used ANC cutoff to indicate prescription of prophylactic antibiotics.AnimalsDogs diagnosed with lymphoma treated with CHOP chemotherapy (n = 64).MethodsSix hundred and fifteen ANCs were stratified into 6 classes. The 3 ANC cutoffs 1.5 × 103/μL, 2.0 × 103/μL, and 2.5 × 103/μL were assessed. The presence of an association between prechemotherapy ANC class and toxicity was determined. Afebrile neutropenic dogs with ANC <1.5 × 103/μL but above the criteria for prophylactic antibiotics were evaluated.ResultsChemotherapy was not administered in 7% of visits with an ANC cutoff of 1.5 × 103/μL; chemotherapy would not have been administered in 10% and 16% of visits with an ANC cutoff of 2.0 × 103/μL or 2.5 × 103/μL, respectively. There was no association among the 3 lower prechemotherapy ANC classes and toxicity. All dogs with ANC 0.75–1.5 × 103/μL recovered spontaneously without medical intervention.Conclusion and Clinical ImportanceThe number of dose delays was minimized with a prechemotherapy ANC cutoff of 1.5 × 103/μL, and the prechemotherapy ANC class 1.5–1.99 × 103/μL was not associated with an increased toxicity. Further investigation of an ANC cutoff near 0.75 × 103/μL in which to prescribe prophylactic antibiotics is indicated.

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Antimicrobial Use in the Veterinary Cancer Patient

Cited by 10 publications

References 23 publications

Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations

Antibiotic prophylaxis in veterinary cancer chemotherapy: A review and recommendations

Palliative care in small animal oncology

Impact of Pretreatment Neutrophil Count on Chemotherapy Administration and Toxicity in Dogs with Lymphoma Treated with CHOP Chemotherapy

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