Outpatient Clinical Trial in Dogs With Leptospirosis Treated With Enrofloxacin Hydrochloride-Dihydrate (ENRO-C)

Abstract

Pharmacokinetics of enrofloxacin HCl-2H2O (enro-C) in dogs and Monte-Carlo simulations against Leptospira spp. prompted a clinical study to treat the clinically apparent phase of this disease. Leptospirosis was diagnosed by real-time PCR from blood, micro-agglutination titers (MAT), clinical signs and blood parameters of the liver and kidney. In order to determine the clinical ability of the participants to diagnose leptospirosis on the first exam and establish an early treatment to avoid excessive organ damage, patients were clinically classified as: high-risk or medium-risk. Forty-five dogs were included in this trial (from 2017 to early 2019). The treatment consisted of IM injections of a 5% aqueous enro-C suspension (10 mg/kg/day) for 10 days, and subsequently enro-C was administered orally for another 7 days in gelatin capsules. Thirty-four high-risk and 11 medium-risk dogs were treated, including 6 puppies (4 high-risk with ages between 6 to 10 months and 2 medium-risk dogs with an average age of 6 and 7 months). Other ages ranged from 1 to 5 years. Fifteen cases had a history of having received prior treatment with other antibiotics, including all puppies. The clinical diagnostic error was 13.5% (7/52 cases), and only one of the misdiagnosed dogs had been classified as a high-risk patient. Three to 5 days after finishing treatment with enro-C, 82.2% of the dogs were negative to real-time PCR from urine samples and 100% negativity was observed on day 30 after treatment, when antibody titrations dropped to 1:100–1:200. Based on the absence of clinical signs, real-time PCR, and MAT titers, all treated dogs were considered as successful treatments. Within 6–24 months of clinical follow-up, no relapses were recorded. Adverse effects were inconsequential. This study represents the first report of a successful treatment of canine leptospirosis using a fluoroquinolone, and due to its efficacy, it is suggested that enro-C be considered as a viable option for the treatment of this disease.

Treatment of Bovine Leptospirosis with Enrofloxacin HCl 2H2O (Enro-C): A Clinical Trial

“…Indeed, achieving therapeutic concentrations of enrofloxacin in the renal and reproductive tract when using enro-C requires confirmation, but the cure rates observed in this trial suggest it is possible. The decrease in the antibody titers observed after treatment with 15 mg/kg of enro-C follows the patterns reported by Gerritsen and colleagues [ 10 ] after administering a dose of 25 mg/kg/day of streptomycin and complies well with the previously reported efficacy of enro-C to treat dogs [ 21 ]. Hence, it is safe to assume that this trend toward reduction in antibody titers is associated with a decrease in or absence of bacteria, as Carrascosa et al [ 36 ] demonstrated in the hamster leptospirosis model.…”

“…In comparison, enro-C is highly effective against Leptospira spp. in the hamster model [ 36 ] and clinical cases in dogs [ 21 ]. However, neither enro-C nor other fluoroquinolones were tested in cattle.…”

“…As compared to standard enrofloxacin, enro-C was shown to exhibit superior key pharmacokinetics parameters. Hence, favorable Monte Carlo simulations and clinical outcomes were obtained in dogs [ 20 , 21 ]. In cows, the maximum serum concentration/minimum inhibitory concentrations (C MAX /MIC) and area under the curve in 24 h/MIC (AUC 0-24 /MIC) ratios, as well as the Monte Carlo simulations, strongly suggest that enro-C may be useful in the treatment of bovine leptospirosis [ 22 ].…”

Evaluation by polymerase chain reaction assay of persistent shedding of pathogenic leptospires in the urine of dogs with leptospirosis

“…Fluoroquinolones were routinely unsuccessful in this group of dogs, in contrast to the results of a recent study. 25 It is possible that geographical variables in the strains of Leptospira spp. contribute to this finding.…”

Faktor Risiko Potensial terhadap Canine Leptospirosis di Ragunan Animal Hospital Jakarta, Indonesia

“…Ketepatan diagnosa dari infeksi ini sangat penting dalam manajemen kasus kaitannya dengan pilihan antibiotik saat pengobatan. Diagnosis dini leptospirosis pada anjing harus dilakukan karena sifat zoonosisnya dari penyakit dan kebutuhan untuk memulai intervensi dalam langkah awal pelaksanaan terapi pada anjing yang terinfeksi secara tepat (Gutierrez 2019). Diferensial diagnosa canine leptospirosis diantaranya penyakit cacing jantung (heartworm disease), autoimmune he mo lytic anemia, bacteremia, infectious canine hepatitis virus, hepatic neoplasia, trauma, lupus, Rocky Mountain spotted fever, Ehrlichiosis, toxoplasmosis, renal neoplasia, dan renal calculi (Nilufer 2004).…”