Evidence map›Paper›PMID 34488771›Full record

ArticleBMC veterinary research2021

Prospective trial of different antimicrobial treatment durations for presumptive canine urinary tract infections.

Fergus Allerton, Koen B Pouwels, Julien Bazelle, Sarah Caddy, Andria Cauvin, Luisa De Risio, James Swann, James Warland, Andrew Kent

Abstract readMulticenter Study
In one paragraph

Article in BMC veterinary research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Fergus AllertonWillows Veterinary Centre and Referral Service; part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, UK. fergus.allerton@willows.uk.net.ORCID http://orcid.org/0000-0003-4856-3307
Koen B PouwelsHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Julien BazelleDavies Veterinary Specialists; part of Linnaeus Veterinary Limited, Manor Farm Business Park, Higham Gobion, Hitchin, UK.
Sarah CaddyCambridge Institute for Therapeutic Immunology and Infectious Disease, Jeffery Cheah Biomedical Centre, Puddicomb Way, Cambridge Biomedical Campus, Cambridge, UK.
Andria CauvinBeechley Farm, Park Hall Road, Gosfield, Essex, UK.
Luisa De RisioLinnaeus Veterinary Limited, Friars gate, Shirley, Solihull, UK.
James SwannColumbia Stem Cell Initiative, Columbia University, 650 West 168th Street, NY, 10032, New York, USA.
James WarlandWellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Puddicombe Way, Cambridge, UK.
Andrew KentWillows Veterinary Centre and Referral Service; part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAvoidance of unnecessary antimicrobial administration is a key tenet of antimicrobial stewardship; knowing the optimal duration of therapy obviates over-treatment. However, little research has been performed to establish course lengths for common canine infections. In clinical practice, antimicrobial therapy is frequently prescribed in dogs presenting lower urinary tract signs (haematuria, pollakiuria and dysuria/stranguria). The proposed length of treatment in International Consensus guidelines has decreased with each iteration, but these recommendations remain arbitrary and largely extrapolated from experience in people.

methodsThe objective of this prospective, multi-centre study is to find the shortest course duration that is non-inferior to the standard duration of 7 days of amoxicillin/clavulanate in terms of clinical outcomes for female dogs with lower urinary tract signs consistent with a urinary tract infection. An electronic data capture platform will be used by participating veterinarians working in clinical practice in the United Kingdom. Eligible dogs must be female, aged between 6 months and 10 years and have lower urinary tract signs of up to seven days' duration. Enrolment will be offered in cases where the case clinician intends to prescribe antimicrobial therapy. Automatic pseudo-randomisation to treatment group will be based on the day of presentation (Monday-Friday); all antimicrobial courses will be completed on the Sunday after presentation generating different treatment durations. Follow-up data will be collected 1, 8 and 22-26 days after completion of the antimicrobial course to ensure effective safety netting, and to monitor short-term outcome and recurrence rates. Informed owner consent will be obtained in all cases. The study is approved by the Ethical Review Board of the University of Nottingham and has an Animal Test Certificate from the Veterinary Medicine's Directorate. DISCUSSION: This study has been designed to mirror current standards of clinical management; conclusions should therefore, be widely applicable and guide practising veterinarians in their antimicrobial decision-making process. A duration-response curve will be created allowing determination of the optimal treatment duration for the management of female dogs with lower urinary tract signs. It is hoped that these results will contribute valuable information to improve future antimicrobial stewardship as part of a wider one-health perspective.

Indexed as

Amoxicillin-Potassium Clavulanate CombinationAnimalsAnti-Bacterial AgentsDog DiseasesDogsDuration of TherapyFemaleProspective StudiesUnited KingdomUrinary Tract InfectionsAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsAntimicrobial resistanceAntimicrobial stewardshipCaninedurationDuration-response curveUrinary tract infection

Identifiers

PMID34488771
PMCPMC8422737

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.