Efficacy of a surgical scrub including 2% chlorhexidine acetate for canine superficial pyoderma

Abstract

The clinical efficacy of a surgical scrub containing 2% chlorhexidine acetate (2CA; Nolvasan® Surgical Scrub; Fort Dodge Animal Health, USA) was evaluated for the topical management of canine superficial pyoderma. The first study was a randomized, double-blind, controlled trial. The control was a shampoo containing 4% chlorhexidine gluconate (4CG; Skin Clinic Shampoo; CHD MEDICS, Goyang, Korea). Ten dogs with symmetrical lesions of canine superficial pyoderma were allocated to receive either 2CA or the control shampoo applied to either side of the body twice weekly for 1 week. Both the owners and the investigators subjectively scored skin lesions including pruritus, erythema, crusted papules and scales on a scale of 0-3. The 2CA and 4CG resulted in almost the same degree of improvement of skin lesions, and there were no significant differences between the two groups. The second study was an open trial of 2CA monotherapy in eight dogs with cefalexin-resistant Staphylococcus intermedius group-associated superficial pyoderma. The 2CA monotherapy was applied every 2 days for 2 weeks. Five dogs improved with 2CA monotherapy, one partially improved and two did not. No adverse reactions were seen in either trial. This suggests that a 2CA surgical scrub could be a useful and safe topical adjunct therapy for dogs with superficial pyoderma involving cefalexin-resistant Staphylococcus intermedius group.

In Vitro Antiseptic Susceptibilities for Staphylococcus Pseudintermedius Isolated from Canine Superficial Pyoderma in Japan

“…Previous studies have shown that 2-4% chlorhexidine is an effective treatment for superficial pyoderma in some, but not all, dogs. [2][3][4]27 There are a number of possible explanations for discrepancies between in vivo antiseptic efficacy and in vitro susceptibility. Chlorhexidine might not have good penetration into the skin.…”

“…These samples have been used in previous studies. [2][3][4] Pyoderma was confirmed based on clinical signs, cytological findings and bacterial culture. Samples for bacterial culture and susceptibility testing were collected from skin lesions compatible with pyoderma.…”

“…[2][3][4] In those studies, 2-4% chlorhexidine acetate resulted in a positive clinical response in 60-70% of the dogs. [2][3][4] In humans, there are reports of topical treatment with chlorhexidine not being successful in eliminating meticillin-resistant Staphylococcus aureus (MRSA), 5 and a low level of resistance to chlorhexidine is a concern.…”

Dose assessment of 2% chlorhexidine acetate for canine superficial pyoderma

“…Treatments for canine superficial pyoderma are mainly systemic antimicrobials, particularly cephalosporins, 3 although multidrug‐resistant mecA ‐positive Staphylococcus pseudintermedius has been emerging throughout the world 4,5 . The bisbiguanide antiseptic chlorhexidine has been considered an effective agent for treating canine superficial pyoderma, 6 and we have demonstrated the efficacy of 2% chlorhexidine acetate (2CA; Nolvasan ® Surgical Scrub; Fort Dodge Animal Health, Fort Dodge, IA, USA) monotherapy for canine superficial pyoderma associated with cefalexin‐resistant Staphylococcus intermedius 5 . One of the manufacturers of the 2% chlorhexidine product recommends 57 mL/m 2 body surface area; however, there has been no investigation to assess the appropriate dose of 2CA for canine superficial pyoderma.…”

Resisting the resistance. Is there progress in maintaining antimicrobial efficacy?

“…Surface and superficial pyoderma, otitis and skin infections involving MDR staphylococci are the main conditions for which topical treatment is recommended. 28,29 A review published in Veterinary Dermatology in 2012 showed that good-quality studies are sparse and that there is a need for more randomized controlled trials using topical products. 30 However, the review found good evidence for efficacy of 2-4% chlorhexidine and benzoyl peroxide shampoos.…”