Comparison of Aerobic Bacterial Culture Among Four Veterinary Microbiology Laboratories from Dogs with Superficial Pyoderma.

Bacterial culture and susceptibility are widely used in veterinary medicine to determine the specific bacteria causing infection as well as aid in appropriate antimicrobial selection. Previous studies have shown variable results with culture and susceptibility depending on the laboratory and methodology used. Samples from dogs with superficial pyoderma were obtained to make a homogeneous solution of bacteria. Sample acquisition from this solution was randomized and submitted to four veterinary laboratories for microbial identification and sensitivity. There was fair agreement among the laboratories in identification of a Staphylococcus spp. as well as fair agreement among the laboratories on the same Staphylococcus sp. Very good agreement was noted on identification of methicillin-resistant Staphylococcus spp. Additionally, good to very good agreement was noted on all antimicrobials that were tested across all four laboratories. A difference in turnaround time for sample processing was observed between the laboratories in the present study. Overall, there was mild variability among the laboratory results in this study.

Staphylococci isolated from cats in Italy with superficial pyoderma and allergic dermatitis: Characterisation of isolates and their resistance to antimicrobials.

BACKGROUND: In cats, superficial pyoderma traditionally is considered rare and few reports are available. There is a particular lack of studies concerning Staphylococcus species associated with pyoderma in subjects affected by allergic skin diseases. HYPOTHESIS/OBJECTIVES: (i) To evaluate the association between Staphylococcus spp. and superficial pyoderma in allergic cats and (ii) to characterise isolated staphylococci and analyse their antimicrobial resistance patterns. ANIMALS: Forty-one cats with allergic dermatitis and superficial pyoderma in Italy. MATERIALS AND METHODS: Skin swabs were cultured for the isolation of Staphylococcus spp. Species identification was performed by matrix-assisted laser desorption/ionisation time of flight mass spectrometry and 16S-rRNA sequencing. Staphylococcus aureus isolates were further characterised by staphylococcal protein A gene-typing. Antimicrobial susceptibility was performed by the disk diffusion method. RESULTS: Staphylococci were isolated from 36/41 cats sampled and 39 different isolates were identified. Uneven distribution of staphylococcal species was observed among different body locations. The 39 isolates were S. aureus (n = 15), S. felis (n = 10), S. pseudintermedius (n = 8) and other staphylococci (n = 6). Eight different S. aureus spa-types associated with human clonal complexes were identified. Antimicrobial resistance was observed to penicillin (56.4%), tetracycline (46.2%), enrofloxacin (33.3%), erythromycin (28.2%), amikacin (25.6%), clindamycin (23.1%), marbofloxacin (15.4%), gentamicin (12.8%), trimethoprim-sulfamethoxazole (10.3%), chloramphenicol (7.7%) and cefoxitin/oxacillin (5.1%). Fifteen isolates (38.4%) were multidrug-resistant while meticillin resistance was associated only with S. pseudintermedius. CONCLUSIONS AND CLINICAL RELEVANCE: These results confirm that S. aureus, S. pseudintermedius, and S. felis are frequently associated with superficial pyoderma in allergic cats. Semi-synthetic penicillins remain a suitable first-line treatment in this study, yet the high prevalence of antimicrobial resistant isolates suggests that antimicrobial susceptibility testing should be performed routinely.

Antibiotic-resistant status and pathogenic clonal complex of canine Streptococcus canis-associated deep pyoderma.

BACKGROUND: Streptococcus canis causes deep pyoderma in canines, which raises concerns about the risk of isolates from lesions acquiring an antibiotic-resistant phenotype. It is necessary to identify effective antibiotics and the characteristics of the pathogenic cluster for S. canis-associated deep pyoderma. RESULTS: The signalment, molecular typing, and antibiotic-resistant status of S. canis isolated from deep pyoderma lesions (27 strains) and oral cavities (26 strains) were analyzed. Older dogs tended to have S. canis-associated deep pyoderma (15 of 27 dogs over 10 years old). Veterinarians chose quinolones for 10/16 cases (63%), even though the rate of quinolone-resistant strains of S. canis is 38-59%. Although 70% of the strains showed resistance to three or more antibiotic classes (37/53), 94% (50/53) strains showed sensitivity for penicillins. We also identified ß-lactamase activity among penicillin-resistant strains of S. canis. Clonal complex 13 (CC13) was detected only in lesions and formed independent clusters in the phylogenetic tree. One strain of CC13 was resistant to the anti-methicillin-resistant Staphylococcus aureus drugs, vancomycin and linezolid. CONCLUSION: Although antibiotic-resistant strains of S. canis are isolated at a high rate, they can currently be treated with ß-lactamase-inhibiting penicillins. CC13 may be a pathogenic cluster with high levels of antibiotics resistance.

Rifampicin treatment of canine multidrug-resistant meticillin-resistant staphylococcal pyoderma: A retrospective study of 51 cases.

BACKGROUND: Rifampicin (RFP) is a potential treatment for canine multidrug-resistant (MDR) meticillin-resistant staphylococci (MRS), yet the use of lower doses based on recent MIC data has not been evaluated in vivo. HYPOTHESIS/OBJECTIVES: To provide information on the efficacy and safety of low-dose range RFP (≤6 mg/kg/day) for the treatment of canine MDR MRS pyoderma. ANIMALS: Fifty-one client-owned dogs. MATERIALS AND METHODS: Retrospective review of dogs medical records. Dogs were from 11 US dermatology referral practices and had oral RFP at ≤6 mg/kg/day. Data evaluated included response to treatment, adverse events, and serum changes in alanine aminotransferase (ALT) and alkaline phosphatase (ALP). RESULTS: Complete resolution of pyoderma occurred in 39 of 51 dogs (76.5%). Topical antimicrobials were used concurrently in most cases (47 of 51; 92.2%). ALP elevation >1.5-fold of baseline or the high end of the reference range occurred in nine of 37 (24.3%) dogs, while ALT elevation above baseline and the high end of the reference range occurred in two of 36 (5.6%). Only six of 51 (11.8%) had clinical adverse events during treatment; five of six (83.3%) were mild reactions consisting of lethargy and gastrointestinal signs, while one dog had a possible cutaneous adverse drug reaction. Of those that experienced clinical adverse events, four of six (66.7%) did not have concurrent increased liver enzyme activity, while two of six (33.3%) had elevations in ALP alone. CONCLUSIONS AND CLINICAL RELEVANCE: Low-dose RFP (≤6 mg/kg/day) appears to be a relatively safe and effective single-agent systemic antibiotic in combination with topical antimicrobials for canine MDR MRS pyoderma.

CONTEXTE: La rifampicine (RFP) est un traitement potentiel des staphylocoques canins multirésistants (MDR) résistants à la méticilline (MRS), mais l'utilisation de doses plus faibles sur la base de données récentes sur la CMI n'a pas été évaluée in vivo. Hypothèse/Objectifs : Fournir des informations sur l'efficacité et l'innocuité des RFP à faible dose (≤ 6 mg/kg/jour) pour le traitement de la pyodermite MDR-MR canine. Animaux : Cinquante et un chiens de propriétaires. Matériels et méthodes : Revue rétrospective de chiens ayant reçu RFP par voie orale à des doses ≤ 6 mg/kg/jour provenant des dossiers médicaux de 11 centres de référés en dermatologie aux États-Unis. Les données évaluées comprenaient la réponse au traitement, les événements indésirables et les modifications sériques de l'alanine aminotransférase (ALT) et de la phosphatase alcaline (ALP). Résultats : Une résolution complète de la pyodermite s'est produite chez 39 des 51 chiens (76,5 %). Des antimicrobiens topiques ont été utilisés simultanément dans la plupart des cas (47 sur 51 ; 92,2 %). Une élévation de l'ALP> 1,5 fois la ligne de base ou l'extrémité supérieure de la plage de référence s'est produite chez neuf des 37 (24,3%) chiens, tandis qu'une élévation de l'ALT au-dessus de la ligne de base et de l'extrémité supérieure de la plage de référence s'est produite chez deux des 36 (5,6%). Seuls six sur 51 (11,8 %) ont eu des événements indésirables cliniques pendant le traitement ; cinq des six (83,3 %) étaient des réactions bénignes consistant en une léthargie et des signes gastro-intestinaux, tandis qu'un chien a eu un possible effet indésirable cutané au médicament. Parmi ceux qui ont subi des événements indésirables cliniques, quatre sur six (66,7 %) n'ont pas eu d'augmentation simultanée de l'activité des enzymes hépatiques, tandis que deux sur six (33,3 %) ont présenté des élévations de l'ALP seule. Conclusions et pertinence clinique : La RFP à faible dose (≤ 6 mg/kg/jour) semble être un antibiotique systémique à agent unique relativement sûr et efficace en association avec des antimicrobiens topiques pour la pyodermite MDR MRS canine.

Introducción- la rifampicina (RFP) es un tratamiento potencial para los estafilococos resistentes a múltiples fármacos (MDR) y meticilina (MRS), sin embargo, el uso de dosis más bajas basado en datos recientes de MIC no se ha evaluado in vivo. Hipótesis/Objetivos- Proporcionar información sobre la eficacia y seguridad de RFP en el rango de dosis bajas (≤6 mg/kg/día) para el tratamiento de la pioderma canina MDR MRS. Animales- Cincuenta y un perros propietarios particulares. Materiales y métodos- revisión retrospectiva de perros que recibieron RFP oral a dosis ≤6 mg/kg/día obtenida de historiales clínicos de 11 prácticas de referencia de dermatología de los Estados Unidos. Los datos evaluados incluyeron la respuesta al tratamiento, los eventos adversos y los cambios séricos en la alanina aminotransferasa (ALT) y la fosfatasa alcalina (ALP). Resultados- una resolución completa de la pioderma ocurrió en 39 de 51 perros (76,5 %). Antimicrobianos tópicos se usaron al mismo tiempo en la mayoría de los casos (47 de 51; 92,2%). En nueve de 37 (24,3 %) perros se produjo una elevación de ALP >1,5 veces respecto al valor inicial o el extremo superior del rango de referencia, mientras que en dos de 36 (5,6 %) se produjo una elevación de ALT por encima del valor inicial y en el límite superior del rango de referencia. Solo seis de 51 (11,8%) tuvieron eventos adversos clínicos durante el tratamiento; cinco de seis (83,3 %) fueron reacciones leves que consistieron en letargo y signos gastrointestinales, mientras que un perro tuvo una posible reacción cutánea adversa al medicamento. De los que experimentaron eventos adversos clínicos, cuatro de seis (66,7 %) no tuvieron un aumento simultáneo de la actividad de las enzimas hepáticas, mientras que dos de seis (33,3 %) tuvieron elevaciones en la ALP por sí sola. Conclusiones y relevancia clínica- la dosis baja de RFP (≤6 mg/kg/día) parece ser un antibiótico sistémico de uso único relativamente seguro y efectivo en combinación con antimicrobianos tópicos para la pioderma canina MDR MRS.

Contexto - A rifampicina (RFP) é um tratamento potencial para estafilococos resistentes à meticilina (MRS) multirresistentes (MDR) e a utilização de doses mais baixas baseado em dados recentes de MIC não foi avaliada in vivo. Hipótese/Objetivos: Fornecer informações sobre a eficácia e segurança de RFP em menor dosagem (≤6 mg/kg/dia) para o tratamento de piodermite canina por MRS MDR. Animais: Cinquenta e um cães de clientes. Materiais e métodos: Uma revisão retrospectiva dos prontuários de cães que receberam RFP oral na dose de ≤6 mg/kg/dia em 11 clínicas dermatológicas nos Estados Unidos. Os dados avaliados incluíram resposta ao tratamento, eventos adversos, alterações séricas de alanina aminotransferase (ALT) e fosfatase alcalina (FA). Resultados: Resolução completa da piodermite ocorreu em 39 de 51 dos cães (76,5%). Antimicrobianos tópicos foram utilizados concomitantemente na maioria dos casos (47 de 51; 92,2%). Elevação de mais de 1,5 vezes na FA ou para o limite superior do intervalo de referência ocorreu em nove de 37 cães (24,3%), enquanto a elevação de ALT acima do valor inicial e o limite superior do valor de referência ocorreu em dois de 36 (5,6%). Apenas cinco de 51 (11,8%) apresentaram efeitos adversos durante o tratamento; cinco de seis (83,3%) tiveram reações leves caracterizadas por letargia e sinais gastrointestinais, enquanto um cão apresentou uma possível farmacodermia. Dos que apresentaram eventos adversos, quatro de seis (66,7%) não apresentaram aumento concomitante de enzimas hepáticas, enquanto dois de seis (33,3%) tiveram aumento de FA isoladamente. Conclusões e relevância clínica - RFP em baixa dosagem (≤6 mg/kg/dia) aparenta ser relativamente segura e eficaz em monoterapia no tratamento da piodermite canina por MRS MDR por via sistêmica, associada a antimicrobianos tópicos.

Efficacy of olanexidine gluconate in canine superficial pyoderma: a randomised, single-blinded controlled trial.

BACKGROUND: Topical treatments can be beneficial for managing canine superficial pyoderma. A novel antiseptic agent, olanexidine gluconate, has become available recently for use in humans, and its efficacy for canine pyoderma as topical therapy is unknown. OBJECTIVE: The antimicrobial effect of olanexidine was evaluated using minimal inhibitory concentration (MIC) towards Staphylococcus pseudintermedius. Furthermore, its clinical efficacy in canine superficial pyoderma was assessed in a randomized, single-blinded study. ANIMALS: Twenty-eight client-owned dogs with atopic dermatitis and superficial pyoderma. METHODS AND MATERIALS: The MIC of olanexidine was determined for S. pseudintermedius isolates (n=73) by serial dilution of 96-well broth microdilution method. Regarding the clinical trial, all recruited dogs were randomized into two groups; one treated with 1.5% olanexidine spray once daily and the other with a 3% chlorhexidine shampoo once a week for 2 times, respectively. Clinical assessment was performed at days 0 and 14 according to the guidelines of the Japanese Society of Antimicrobials for Animals. RESULTS: The MIC values for methicillin-resistant S. pseudintermedius (MRSP) and methicillin-sensitive S. pseudintermedius (MSSP) were 0.23 µg/ml and 0.24 µg/ml (P =0.9), respectively. In clinical trial, olanexidine and chlorhexidine showed substantial improvement in clinical presentation compared to the baseline. CONCLUSIONS AND CLINICAL IMPORTANCE: Olanexidine showed comparable efficacy to chlorhexidine (P=0.73). Moreover, the MIC against S. pseudintermedius indicated high bactericidal activity, which was supported by the topical effectiveness of olanexidine.

Efficacy study of a topical treatment with a plant extract with antibiofilm activities using an in vivo model of canine superficial pyoderma.

BACKGROUND: Canine pyoderma is a common skin infection caused predominantly by staphylococcal bacteria. Because of increasing rates of antimicrobial resistance in bacterial isolates, there is an urgent need for alternative or supplementary treatment options. W16P576, a Water Extract of Complex Mix of Edible Plants (WECMEP), has shown in vitro activity against a variety of bacteria, including Staphylococcus pseudintermedius. A canine model of pyoderma was developed which allows in vivo testing of antimicrobial agents in a controlled environment. OBJECTIVE: To evaluate the antibacterial efficacy of topical application of W16P576 in a model of canine pyoderma. ANIMALS: Nine laboratory housed beagle dogs. METHODS AND MATERIALS: In an evaluator-blinded cross-over study with an eight week washout period, dogs were treated topically twice daily with W16P576 WECMEP or its vehicle, starting three days before bacterial challenge. On the day of challenge, each dog was treated with two concentrations of a clinical S. pseudintermedius strain on opposite sides of the body. Topical treatment was continued for 11 days and lesions of pyoderma were evaluated and scored for 14 days. RESULTS: All dogs developed lesions consistent with bacterial pyoderma. Lesion scores were generally higher on the side inoculated with a higher concentration of bacteria. Treatment with W16P576 significantly reduced lesion development and hastened resolution of lesions, compared to placebo. CONCLUSION: Topical application of W16P576 markedly reduced lesion development in this proof of principle study. Clinical trials are warranted to estimate benefits for dogs with naturally occurring pyoderma under field conditions.

A perplexing case of superficial granulomatous pyoderma with sporotrichoid-like distribution.

Superficial granulomatous pyoderma (SGP) is a rare pyoderma gangrenosum (PG) variant that differs from classic PG in that the ulcers tend to be more superficial, lack a rapidly advancing border, and are not typically associated with an underlying systemic disease. The ulcers are most commonly painless and located on the trunk, with a clean granulating base. They generally do not show undermining but may have a vegetative border. Lesions usually respond well to either topical or intralesional corticosteroids with complete healing. The classic histopathologic finding is a "three-layer granuloma" in the superficial dermis consisting of central neutrophilic inflammation and necrosis, a surrounding layer of histiocytes and multinucleated giant cells, and an outer most layer of plasma cells and eosinophils. Herein, we present a unique case of SGP with sporotrichoid-like distribution on the lower extremity.

Residual antibacterial activity of canine hair treated with five mousse products against Staphylococcus pseudintermedius in vitro.

BACKGROUND: Topical therapy alone can be effective in the treatment of canine pyoderma. Topical products are commercially available as shampoos, sprays, wipes and mousses. To date, no studies have evaluated the efficacy of commercially available mousse products in the treatment of canine pyoderma. OBJECTIVE: To determine the residual antibacterial activity of canine hairs treated with mousse products containing different active ingredients. ANIMALS: Fifteen client-owned dogs with no history of dermatological disease. METHODS AND MATERIALS: Dogs were treated once with five mousse products [(i) 2% chlorhexidine and 1% ketoconazole, (ii) 2% chlorhexidine and 2% miconazole, (iii) 3% chlorhexidine and 0.5% climbazole, (iv) 2% salicylic acid 10% ethyl lactate and (v) phytosphingosine HCl 0.05%; control]. Hair samples were collected from each treatment area before application, one hour after application and on days 2, 4, 7, 10 and 14 post-treatment. Collected hairs were weighed and plated on Mueller-Hinton agar plates streaked with a Staphylococcus pseudintermedius isolate showing no antimicrobial resistance. Plates were incubated for 24 h and bacterial growth inhibition zones around the hairs were measured. RESULTS: Mousses 1, 2 and 3 created significant inhibition zones up to Day 10 when compared to pre-treatment samples. On Day 14, only mousse 3 produced a significant zone of inhibition when compared to the pre-treatment sample. Mousses 4 and 5 showed no statistical difference between any of the samples. CONCLUSIONS AND CLINICAL IMPORTANCE: These results suggest that three of the mousse products had residual activity in inhibiting S. pseudintermedius growth in vitro for at least 10 days.

Blastomycosis-like Pyoderma Arising in Lichen Planus.

Blastomycosis-like pyoderma (BLP) is a rare reactive skin disease that is most commonly caused by bacterial infection. Herein we present a case of BLP arising in lichen planus, a chronic inflammatory disease. We propose Wolf's isotopic response, or the appearance of a new skin disease at the site of an existing and unrelated disease, as the underlying molecular mechanism responsible for this unusual physical presentation. It is important that clinicians recognize atypical morphologies such as BLP, which mimics squamous cell carcinoma both clinically and pathologically. These similarities highlight the need for a tissue diagnosis to identify infectious etiologies and rule out malignancy when BLP is suspected. J Drugs Dermatol. 2018;17(2):233-235.

In vitro efficacy of a honey-based gel against canine clinical isolates of Staphylococcus pseudintermedius and Malassezia pachydermatis.

BACKGROUND: Staphylococcus pseudintermedius and Malassezia pachydermatis are important agents in canine pyoderma and otitis. HYPOTHESIS/OBJECTIVES: Determine the in vitro efficacy of a honey-based gel (HBO) against meticillin-susceptible S. pseudintermedius (MSSP), meticillin-resistant S. pseudintermedius (MRSP) and M. pachydermatis, by minimum bactericidal concentration (MBC), minimum fungicidal concentration (MFC) and time-kill assay (TKA). Efficacy of the product's honey component (HO) also was evaluated. METHODS: Sixty S. pseudintermedius and 10 M. pachydermatis canine isolates were selected. All isolates were tested against serial dilutions of an HBO containing 40% HO (40%, 20%, 10%, 5% and 2.5% w/v) and HO alone (undiluted, 40%, 20%, 10%, 5% and 2.5% w/v). Microbroth assay followed by subculture was used to determine MBC and MFC. The same protocol was applied after product exposure to catalase. A well-diffusion assay for S. pseudintermedius was used to generate inhibition zones. A TKA for 10 isolates of S. pseudintermedius and 10 isolates of M. pachydermatis was performed. RESULTS: MBC was 20% w/v (5-20% w/v) for HBO and HO. HBO had lower MBC values when compared to HO (P = 0.003). No statistical difference was observed between MSSP/MRSP isolates (HBO P = 0.757, HO P = 0.743). Only HO was affected by catalase (P = 0.015). MFC for HBO was 10% w/v (5-10% w/v) and 40% w/v for HO (20-≥40% w/v). All isolates were killed after 4 h of exposure. CONCLUSIONS AND CLINICAL IMPORTANCE: Staphylococcus pseudintermedius and M. pachydermatis are susceptible to the HBO and these results can be used for future clinical trials.

Identification of VIM-2 metallo-ß-lactamase-producing Pseudomonas aeruginosa isolated from dogs with pyoderma and otitis in Korea.

BACKGROUND: Pseudomonas aeruginosa is a challenging pathogen cultured from cases of acute and chronic canine otitis and sometimes in cases of deep pyoderma. The spread of antimicrobial resistance, especially carbapenem resistance, is a serious therapeutic challenge worldwide. HYPOTHESIS/OBJECTIVES: To investigate the identification and characterization of resistant P. aeruginosa clinical canine isolates. MATERIALS: Clinical isolates (n = 80) were collected from dogs with pyoderma (n = 18) and otitis (n = 62) in Korea. METHODS: Antimicrobial susceptibility was determined using agar dilution and using Clinical and Laboratory Standards Institute guidelines for recording susceptibility for human Pseudomonas isolates; genetic relatedness of isolates was investigated by multilocus sequence typing (MLST) and SpeI macrorestriction analysis. The class 1 integrons were amplified and sequenced using primer walking. RESULTS: Most isolates were susceptible to colistin (97.5%), polymyxin B (96.3%), ciprofloxacin (81.3%) and meropenem (80.0%); whereas resistance to aztreonam (80%), piperacillin (52.5%), piperacillin/tazobactam (41.3%) and cefepime (37.5%) was high; 12 carbapenem-nonsusceptible isolates (15%) were detected. MLST revealed 45 different sequence types (STs) and macrorestriction analysis detected 55 distinct pulsotypes (PTs), which were divided into 25 clonal groups. Among carbapenem-nonsusceptible isolates, 10 (83.3%) were VIM-2-producing strains. Nine VIM-2-producing isolates were identified as ST1047 and harboured the same 2.8 kb class 1 integron. One remaining isolate was ST1203 with 2.1 kb class 1 integron. CONCLUSIONS AND CLINICAL IMPORTANCE: This study demonstrated the diversity of the phenotype and genotype of clinical P. aeruginosa isolates from dogs with pyoderma and otitis. The identification of VIM-2-producing P. aeruginosa in dogs is alarming and warrants further surveillance.

In Vitro ADME Properties of Two Novel Antimicrobial Peptoid-Based Compounds as Potential Agents against Canine Pyoderma.

Antimicrobial peptides (AMPs) hold promise as the next generation of antimicrobial agents, but often suffer from rapid degradation in vivo. Modifying AMPs with non-proteinogenic residues such as peptoids (oligomers of N-alkylglycines) provides the potential to improve stability. We have identified two novel peptoid-based compounds, B1 and D2, which are effective against the canine skin pathogen Staphylococcus pseudintermedius, the main cause of antibiotic use in companion animals. We report on their potential to treat infections topically by characterizing their release from formulation and in vitro ADME properties. In vitro ADME assays included skin penetration profiles, stability to proteases and liver microsomes, and plasma protein binding. Both B1 and D2 were resistant to proteases and >98% bound to plasma proteins. While half-lives in liver microsomes for both were >2 h, peptoid D2 showed higher stability to plasma proteases than the peptide-peptoid hybrid B1 (>2 versus 0.5 h). Both compounds were suitable for administration in an oil-in-water cream formulation (50% release in 8 h), and displayed no skin permeation, in the absence or presence of skin permeability modifiers. Our results indicate that these peptoid-based drugs may be suitable as antimicrobials for local treatment of canine superficial pyoderma and that they can overcome the inherent limitations of stability encountered in peptides.

[Drug therapy of acne inversa]. / Medikamentöse Therapie der Acne inversa.

Acne inversa is a chronic inflammatory destructive skin disease that affects about 1% of the population. The therapy should be personalized and consists of surgical and conservative procedures. Antibiotics are administered either topically or systemically. Combination therapy with clindamycin and rifampicin for 10-12 weeks can be very effective. Furthermore, TNF-α inhibitors show adequate efficacy and can be recommended. Adalimumab is the only approved drug product for systemic treatment of acne inversa. The efficacy of retinoids is controversial. Isotretinoin cannot be recommended for the treatment of acne inversa; however, acitretin has been proven to be more effective. Immune-modulating substances, like dapsone, cyclosporine A, methotrexate, colchicine, or corticosteroids, can be considered; however, the study data are insufficient for recommendation. Hormonal therapies can influence the course of the disease. Antiseptics are applied independent of the stage of disease. Patients should be informed about triggering factors.

Rifampicin treatment of canine pyoderma due to multidrug-resistant meticillin-resistant staphylococci: a retrospective study of 32 cases.

BACKGROUND: Rifampicin has received increased interest in veterinary dermatology because of its activity against multidrug-resistant meticillin-resistant staphylococci (MRS). There is limited knowledge about the efficacy and safety of rifampicin in dogs. HYPOTHESIS/OBJECTIVE: To provide information on response to treatment and adverse effects in dogs treated with rifampicin for multidrug-resistant MRS pyoderma. ANIMALS: Thirty two dogs treated with rifampicin for rifampicin-susceptible multidrug-resistant MRS pyoderma. METHODS: Retrospective review of medical records, including alanine aminotransferase (ALT) and alkaline phosphatase (ALP) serum activity levels and total bilirubin concentrations, obtained before and throughout the treatment, was performed. RESULTS: Oral rifampicin as sole systemic antimicrobial therapy (median dose 5 mg/kg twice daily) was effective in 71.88% of cases. Topical antimicrobials were used in most cases. Median duration of rifampicin treatment was five weeks for superficial pyoderma and four weeks for deep pyoderma. Gastrointestinal signs were reported in 15% of treated dogs. Statistically significant increases of ALT (P = 0.045) and ALP (P = 0.0002) values after 3-4 weeks of treatment was observed. The median increase was equal to 0.3 and ×1.5 the upper limit of the reference ranges for ALT and ALP, respectively. CONCLUSIONS/CLINICAL IMPORTANCE: Oral rifampicin combined with topical antimicrobials can be considered an effective therapeutic option for canine superficial and deep pyoderma caused by rifampicin-susceptible multidrug-resistant MRS. Liver enzyme induction might be the most important cause of ALT and ALP increase associated with rifampicin therapy in dogs.

[AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine]. / AntibioticScout.ch: Eine Entscheidungshilfe für den umsichtigen Einsatz von antimikrobiellen Wirkstoffen: Anwendung in der Kleintiermedizin.

INTRODUCTION: Bacterial resistances to antimicrobial drugs pose serious public health challenges. The observed increase of resistances is attributed to the uncontrolled, massive and often unnecessary administration of antibiotics both in human and veterinary medicine. To support the responsible use of antimicrobials in animals and help veterinarians selecting the most suitable antimicrobial drugs, we developed the AntibioticScout.ch as a comprehensive decision supporting tool providing online access to the current knowledge of rational antibiotic prescription practices. User-friendly search functions allow for the fast and efficient retrieval of information that is structured in this database by animal species, organ systems and therapeutic indications. In addition, an online form allows to report treatment failures in order to identify problematic cases as well as ensuing risks and take appropriate mitigation measures. The present report describes the workflow of this decision support system applied to the prudent use of antimicrobials in companion animal medicine.

INTRODUCTION: Les résistances bactériennes face aux substances antimicrobiennes placent le système de santé face à de grands défis. L'augmentation des résistances est attribuée à une utilisation mal dirigée, massive et souvent inutile d'antibiotiques tant en médecine humaine qu'en médecine vétérinaire. Afin d'encourager une utilisation responsable des substances antimicrobiennes en médecine vétérinaire et pour soutenir les vétérinaires lors du choix de l'antibiotique adapté, on a créé, avec AntibioticScout. ch, une aide à la décision de grande envergure qui permet de recourir à chaque instant aux principes de prescription reconnus de la médecine fondée sur les faits (Evidence Based Medicine). La banque de données est structurée par espèces animales, systèmes d'organes et indications et un moteur de recherche intuitif garantit de trouver rapidement et efficacement les informations. D'autre part un formulaire en ligne pour l'annonce d'une inefficacité est proposé afin de reconnaitre les cas à problèmes et les risques en vue d'améliorer l'aide au diagnostic. La présente contribution pour but de démontrer l'utilisation d'AntibioticScout pour un usage prudent des antibiotiques en médecine des petits animaux.

Influence of long-term oral application of quinolones on the ECG curve in dogs.

The aim of the study was to analyse the influence of enrofloxacin and pradofloxacin administered orally for 14 days on the ECG in dogs. The ECG was performed before and after a 14 day period of quinolone administration. There was an increase in the QTc and the TpTe interval in the group treated with quinolones. QTc was prolonged by 24 ms (p=0.001). The TpTe interval was shortened, on average, by 6.55 ms (p=0.048). In the group treated with enrofloxacin, QTc was prolonged by 16.27 ms (p=0.006) and the TpTe interval was shortened by 9.64 ms (p=0.050), the TpTe/QT index was reduced by 0.034 (p=0.050) on average. In dogs treated with pradofloxacin, QTc was prolonged by 21.55 ms (p=0.012) on average. The results suggest that a prolonged administration of quinolones can increase the risk of arrhythmias. Furthermore, different generations of these drugs increase this risk to various degrees. The study proved that second generation quinolones, such as enrofloxacin, significantly change the phase of depolarization and repolarization of the ventricles, at the same time increasing the risk of ventricular arrythmia. Pradofloxacin does not change the TpTe and TpTe/QT values, so it is safer in use.

A split-body, randomized, blinded study to evaluate the efficacy of a topical spray composed of essential oils and essential fatty acids from plant extracts with antimicrobial properties.

BACKGROUND: Bacterial pyoderma is a frequent presentation in dogs. Despite the widespread availability of effective systemic and topical antimicrobial products, good clinical practice currently recommends avoidance of long-term use to mitigate the development of bacterial resistance. HYPOTHESIS/OBJECTIVES: To evaluate the speed of resolution of clinical signs of bacterial pyoderma in dogs treated with a systemic antimicrobial agent with or without the use of an adjunctive spray with antimicrobial properties. ANIMALS: Twelve dogs with superficial bacterial pyoderma. METHODS: In this controlled and blinded study, all dogs were treated with oral cefalexin and a topical spray (PYOClean Spray) for 4 weeks. The spray was applied to one half of each dog's body, whereas a placebo spray was applied to the other half. RESULTS: Twelve dogs completed the study. Mean clinical scores were significantly reduced on spray-treated sites, for test product and placebo (respectively), by 47% and 34% at Week 1, 83% and 60% at Week 2, 95% and 82% at Week 3, and 100% and 96% at Week 4. Fifty percent of treated sites were considered clinically and cytologically cured at Week 2, 83% at Week 3, and 100% at Week 4 compared to 8%, 50% and 83% for the placebo sites, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: These results demonstrate that use of a topical spray which contains plant-derived essential oils and fatty acids, and compounds with antimicrobial properties (Manuka oil and N-acetyl cysteine) may help to speed resolution of pyoderma and may allow for shorter antimicrobial treatment time.

Prior antibacterial drug exposure in dogs with meticillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma.

BACKGROUND: The emergence of meticillin-resistant Staphylococcus pseudintermedius (MRSP) has become a significant animal health problem. Recent studies have indicated that previous antibacterial drug exposure is a factor in acquisition of meticillin-resistant strains of staphylococci. HYPOTHESIS/OBJECTIVES: The purpose of this study was to identify factors associated with prior antimicrobial drug use and MRSP pyoderma in dogs presented to a veterinary teaching hospital. ANIMALS: Dogs diagnosed with pyoderma associated with MRSP (n = 53) or meticillin-sensitive S. pseudintermedius (MSSP; n = 45). METHODS: The medical records of dogs diagnosed with pyoderma associated with isolation of S. pseudintermedius between January 2006 and November 2012 were reviewed. All cases with a complete twelve month to 3 yr drug history prior to the diagnosis were included. RESULTS: Fifty two of 53 (98%) MRSP cases and 42 of 45 (93%) MSSP cases had received at least one course of antibacterial drug prior to diagnosis. The total number of antibacterial drug prescriptions provided to pet owners and the variety of antibacterial drug classes represented were higher for cases with MRSP than for cases with MSSP (P < 0.0001 and P = 0.009, respectively). More cases with MRSP (98%) received beta-lactam drugs than those with MSSP (82%; P = 0.007) and the proportion of MRSP cases that had received concurrent immunomodulatory therapy was higher (62% versus 42%; P = 0.048). CONCLUSIONS AND CLINICAL IMPORTANCE: These results suggest that the total number of antibacterial drug prescriptions, exposure to multiple drug classes (beta-lactams in particular) and concurrent immunomodulatory therapy may be associated with increased risk for acquisition of MRSP.

Pyodermatitis vegetans of the vulva.

Pyodermatitis vegetans (PV) is a rare inflammatory dermatosis of unknown etiology and difficult diagnosis characterized by vesiculopustular, exudative, and vegetating plaques usually localized in the axillary, genital, and oral region. It bears similarities to pemphigus vegetans but clinical history, histology, and immunofluorescence help confirm the diagnosis. Pyodermatitis vegetans is often associated with an underlying gastrointestinal disorder, especially ulcerative colitis. No standardized treatment plan is available for PV. Its evolution tends to follow the progression of the underlying disorder. We report a patient with vulvar PV with good response to systemic antibiotics and corticosteroids.