Efficacy of Antimicrobial Treatment in Dogs with Atopic Dermatitis: An Observational Study

Abstract

There is a shortage of studies reporting the efficacy of antimicrobial treatment of dogs with atopic dermatitis (AD) and skin infections (SIs). The aim of this study was to evaluate the change in the severity of skin lesions and pruritus, and the overall efficacy of antimicrobial treatment, in dogs with AD and bacterial overgrowth/infection and/or Malassezia dermatitis. A total of 20 dogs with AD and SIs were prospectively enrolled (group A) and they were examined before and after the administration of systemic antimicrobials that resulted in the resolution of SIs. In addition, 19 dogs fulfilling the same inclusion criteria and treated with systemic, with or without topical antimicrobials, were included retrospectively (group B). Since there were no major differences between the groups, their results were combined. The severity of skin lesions decreased significantly, by 30% based on Canine Atopic Dermatitis Extent and Severity Index-4 (CADESI-4), by 28.1% based on the erythema domain of CADESI-4 and based on owner’s global assessment of the severity of skin lesions. Pruritus decreased significantly, by 34.7% based on the Pruritus Visual Analogue Scale (PVAS). The efficacy of antimicrobial treatment was assessed as good to excellent by the investigator and the owner in 55% and 60% of the dogs, respectively. Despite the significant improvement, there was high variability in the response to treatment among dogs. Further studies are needed to find factors that determine the response to antimicrobial treatment in dogs with AD and SIs.

Establishment of clinical criteria for the diagnosis of adverse food reactions in dogs with atopic dermatitis

“…In our study, the prevalence of AFR was relatively high (45%), perhaps because their relative contribution to the pathogenesis of AD was intentionally increased by the previous implementation of effective ectoparasite prevention and treatment of infections. 21 However, this result may have been different if the 5 of 34 initially enrolled dogs had not been withdrawn, if all G2-NR dogs had participated in Phase 2, and if the duration of phases 1 and 2 had been longer, which, along with the small number of dogs are the major limitations of our study. Also, the fact that only one of seven G2-NR dogs responded to the home-made EDT and this dog was not finally diagnosed with AFR should be interpreted with caution owing to the small number of dogs.…”

“…Canine AD is a multifactorial syndrome with numerous endogenous (genetic predisposition, aberrant immune responses, inflammatory cytokines/chemokines, impaired skin barrier) and exogenous (e.g., environmental allergens, food allergens, bacteria, yeasts) factors contributing to inflammation and pruritus 22 . Not all of these factors participate in the pathogenesis of AD in every dog, and the relative contribution of those that participate is probably variable, which may explain the inconsistent responses of dogs with AD to various therapeutic interventions 21–24 . Therefore, AFR may be irrelevant for a dog with AD, may have a minor contribution to the clinical signs or may be of major importance, and the aim of our diagnostic investigation was to identify those dogs with clinically meaningful AFR.…”

“…All dogs presented to the authors' clinic during the study period were eligible if they met the following criteria: diagnosis of nonseasonal AD by a boardcertified veterinary dermatologist based on history, clinical signs and exclusion of differentials; fulfilment of at least six of eight set 1 diagnostic criteria proposed by Favrot et al 20 ; no pregnancy, lactation or unrelated cutaneous or systemic diseases; no administration of H1 antihistamines during the previous week, of topical glucocorticoids or tacrolimus and of oral short-acting glucocorticoids, ciclosporin, oclacitinib, pentoxifylline, ketoconazole or essential fatty acids for the previous two weeks, of lokivetmab for the previous six weeks, and of long-acting injectable glucocorticoids for the previous eight weeks; no current interventions to reduce exposure to environmental allergens; no current allergen immunotherapy; regular oral isoxazoline administration for prevention of ectoparasitoses; and no clinical or cytological evidence of skin infections or otitis necessitating treatment. Skin infections were treated before enrolment, 21 and the owners of these dogs were instructed to use a 2% chlorhexidine-2% miconazole shampoo (Malaseb; Dechra) twice weekly for the duration of the study to avoid their relapse. Isoxazoline administration was continued for the duration of the study in all dogs, while no anti-inflammatory and antipruritic drugs were allowed, except for palliative reasons (see Results).…”

Is Vitamin D3 a Worthy Supplement Protecting against Secondary Infections in Dogs with Atopic Dermatitis?

“…Dogs with atopic dermatitis are predisposed to recurrent staphylococcal and Malassezia pachydermatis infections in the skin and ears. Skin infections are considered the most prevalent complications of CAD [ 2 , 35 , 36 , 37 ]. These secondary infections are often associated with poor control of the disease.…”

Efficacy of Chlorhexidine Impregnated Wipes for the Local Dysbiosis in Atopic Dogs: A Multicentric Prospective Study

“…Recognising and managing bacterial and fungal dysbiosis is mandatory early in the management of CAD, not only to restore the skin microbiota but also to limit the development of infections, which may require systemic antimicrobials and increase the risk of the spread of antibiotic resistance [ 5 ].…”