Efficacy of antimicrobial and nutraceutical treatment for canine acute diarrhoea: A systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines

Scahill, K.; Jessen, L.R.; Prior, C.; Singleton, D.; Foroutan, F.; Ferran, A.A.; Arenas, C.; Bjørnvad, C.R.; Lavy, E.; Allerton, F.; Weese, J.S.; Allenspach, K.; Guardabassi, L.; Unterer, S.; Bodnárová, T.; Windahl, U.; Brennan, M.L.; Werner, M.

Abstract

Systemic antimicrobial treatments are commonly prescribed to dogs with acute diarrhoea, while nutraceuticals (prebiotics, probiotics, and synbiotics) are frequently administered as an alternative treatment. The aim of this systematic review and meta-analysis was to assess the effectiveness of antimicrobials and nutraceutical preparations for treatment of canine acute diarrhoea (CAD). The results of this study will be used to create evidence-based treatment guidelines. PICOs (population, intervention, comparator, and outcome) were generated by a multidisciplinary expert panel taking into account opinions from stakeholders (general practitioners and dog owners). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the certainty of the evidence. The systematic search yielded six randomised controlled trials (RCT) for antimicrobial treatment and six RCTs for nutraceutical treatment meeting the eligibility criteria. Categories of disease severity (mild, moderate, and severe) were created based on the presence of systemic signs and response to fluid therapy. Outcomes included duration of diarrhoea, duration of hospitalization, progression of disease, mortality, and adverse effects. High certainty evidence showed that antimicrobial treatment did not have a clinically relevant effect on any outcome in dogs with mild or moderate disease. Certainty of evidence was low for dogs with severe disease. Nutraceutical products did not show a clinically significant effect in shortening the duration of diarrhoea (based on very low to moderate certainty evidence). No adverse effects were reported in any of the studies.

Citation

Scahill, K., Jessen, L., Prior, C., Singleton, D., Foroutan, F., Ferran, A., Arenas, C., Bjørnvad, C., Lavy, E., Allerton, F., Weese, J., Allenspach, K., Guardabassi, L., Unterer, S., Bodnárová, T., Windahl, U., Brennan, M., & Werner, M. (2024). Efficacy of antimicrobial and nutraceutical treatment for canine acute diarrhoea: A systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines. Veterinary Journal, 303, 106054. https://doi.org/10.1016/j.tvjl.2023.106054

• Journal Article Type: Article
• Acceptance Date: Nov 29, 2023
• Online Publication Date: Dec 20, 2023
• Publication Date: 2024-02
• Deposit Date: Feb 9, 2024
• Publicly Available Date: Feb 9, 2024
• Journal: Veterinary Journal
• Print ISSN: 1090-0233
• Electronic ISSN: 1532-2971
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 303
• Article Number: 106054
• Pages: 106054
• DOI: https://doi.org/10.1016/j.tvjl.2023.106054
• Keywords: Amoxicillin-clavulanic acid; Antimicrobial stewardship; Evidence-based; Metronidazole; Probiotics
• Public URL: https://nottingham-repository.worktribe.com/output/28416466
• Additional Information: This article is maintained by: Elsevier; Article Title: Efficacy of antimicrobial and nutraceutical treatment for canine acute diarrhoea: A systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines; Journal Title: The Veterinary Journal; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.tvjl.2023.106054; Content Type: article; Copyright: © 2023 The Author(s). Published by Elsevier Ltd.