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

• Published in: The veterinary journal (1997) Vol. 303; p. 106054
• Main Authors: 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.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-02-2024; Elsevier
• Subjects: Amoxicillin-clavulanic acid; Antimicrobial stewardship; Evidence-based; Life Sciences; Metronidazole; Probiotics; Probiotics; Antimicrobial stewardship; Evidence-based; Metronidazole; Amoxicillin-clavulanic acid
• ISSN: 1090-0233; 1532-2971; 1532-2971
• DOI: 10.1016/j.tvjl.2023.106054

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.
•Systematic review of antimicrobial and nutraceutical use in canine acute diarrhoea.•Meta-analyses of available data were performed.•Antimicrobials did not have a clinical effect on canine acute diarrhoea.•Nutraceuticals did not have a clinical effect on canine acute diarrhoea.•High certainty evidence was found for dogs with mild and moderate diarrhoea.