Evaluation of the Efficacy and Safety of High Dose Short Duration Enrofloxacin Treatment Regimen for Uncomplicated Urinary Tract Infections in Dogs

Abstract

BackgroundUncomplicated urinary tract infections (UTI) in dogs usually are treated with antimicrobial drugs for 10–14 days. Shorter duration antimicrobial regimens have been evaluated in human patients.HypothesisA high dose short duration (HDSD) enrofloxacin protocol administered to dogs with uncomplicated UTI will not be inferior to a 14-day treatment regimen with amoxicillin-clavulanic acid.AnimalsClient-owned adult, otherwise healthy dogs with aerobic bacterial urine culture yielding ≥103 CFU/mL of bacteria after cystocentesis.MethodsProspective, multicenter, controlled, randomized blinded clinical trial. Enrolled dogs were randomized to group 1 (enrofloxacin 18–20 mg/kg PO q24h for 3 days) or group 2 (amoxicillin-clavulanic acid 13.75–25 mg/kg PO q12h for 14 days). Urine cultures were obtained at days 0, 10, and 21. Microbiologic and clinical cure rates were evaluated 7 days after antimicrobial treatment was discontinued. Lower urinary tract signs and adverse events also were recorded.ResultsThere were 35 dogs in group 1 and 33 in group 2. The microbiologic cure rate was 77.1 and 81.2% for groups 1 and 2, respectively. The clinical cure rate was 88.6 and 87.9% for groups 1 and 2, respectively. Cure rates between groups did not differ according to the selected margin of noninferiority.Conclusions and Clinical ImportanceHDSD enrofloxacin treatment was not inferior to a conventional amoxicillin-clavulanic acid protocol for the treatment of uncomplicated bacterial UTI in dogs. Further research is warranted to determine if this protocol will positively impact owner compliance and decrease the emergence of antimicrobial resistance.

Efficacy of single-dose ceftriaxone versus multiple-dose enrofloxacin in dogs with uncomplicated lower urinary tract infection: a randomised clinical trial

“…In the current study, the data on clinical remission parameters (Table 3) indicate that a single dose of ceftriaxone administration is superior to multiple doses of enrofloxacine for 14 days. Although 91.4% and 93.9% of uropathogens from dogs with uncomplicated urinary tract infections were susceptible to enrofloxacine and amoxicillin, respectively, the rate of clinical cure in response to the administration of these agents was lower than the values from susceptibility test (Westropp et al 2012). In this study, isolated uropathogens were sensitive to both enrofloxacine and ceftriaxone with no significant differences identified between clinical and microbiological cures.…”

“…Dogs with uncomplicated LUTI are usually treated for 10−14 days (Grauer 2009;Weese 2011). However, only a few publications dealing with the efficacy of short term antibiotherapy in dogs with uncomplicated LUTI are available (Westropp et al 2012;Clare 2014). The efficacy of short duration-high dose enrofloxacine treatment was tested in dogs with uncomplicated urinary tract disease (Westropp et al 2012).…”

“…However, only a few publications dealing with the efficacy of short term antibiotherapy in dogs with uncomplicated LUTI are available (Westropp et al 2012;Clare 2014). The efficacy of short duration-high dose enrofloxacine treatment was tested in dogs with uncomplicated urinary tract disease (Westropp et al 2012). In addition, short duration trimethoprim-sulfamethoxazole treatment was compared with long term cephalexine administration in dogs with uncomplicated bacterial cystitis (Clare 2014).…”

Epidemiological analysis, identification and antimicrobial susceptibility profile of dogs with isolated from urinary tract infection

“…As fluorquinolonas são a classe antimicrobiana de maior utilização nas ITUs por seu amplo espectro de atividade contra as altas concentrações de uropatógenos (Westropp et al, 2012). Entretanto, a prevalência de resistência as fluorquinolonas pelos uropatógenos urinários tem aumentado nos Estados Unidos da América (Ball et al, 2008).…”

Preventing canine urinary tract infection (UTI) using an asymptomatic bacteriuria (ASB) Escherichia coli strain

“…Whilst the conventional view has been that the majority of bacterial cystitis episodes resolve with a 7-14 day course of oral antimicrobials, it is now apparent that assumption of microbiologic cure may be ill advised. Two recent studies comparing short-duration treatment with trimethoprim-sulfamethoxazole (Clare et al, 2014) or enrofloxacin (Westropp et al, 2012) with longer duration treatment with beta-lactam antimicrobials revealed that urine of dogs frequently returns to a culture-positive state posttreatment. Persistent or recurrent urinary tract infections can involve refractory bacterial isolates…”