Antibiotic Use for Diarrhea
Speaker: Fergus Allerton
Reviewed by: Dr Philip Judge
Event Name: WSAVA World Congress 2024
Key Takeaways
Top Tips
Key Takeaways
- Current Practices:
- 50% of dogs with acute diarrhoea are prescribed antibiotics, which may not always be necessary or ideal for antibiotic stewardship.
- Antibiotic Stewardship Resources:
- The “Protect Me” poster provides guidelines on appropriate antibiotic use for dogs and cats.
- The Journal of Small Animal Practice published an open-source article highlighting that antibiotics are a low priority in treating chronic diarrhoea.
- Various veterinary associations also offer guidelines for appropriate antibiotic use in small animals.
- Antibiotic Necessity Based on Diarrhea Severity:
- Mild Diarrhoea: Antibiotics are generally not required. Most dogs recover without them.
- Moderate Diarrhoea: Antibiotics are also not needed in most cases. These patients may need short-term hospitalisation for rehydration etc., but are generally not systemically ill.
- Severe Diarrhoea: Antibiotics may benefit dogs with severe disease, particularly those at risk of sepsis.
- Sepsis and Antibiotic Timing:
- Early administration of antibiotics can lower the mortality rate in dogs progressing to sepsis.
- Client Communication Tool:
- The BSAVA offers a “No Antibiotic Prescription Required” form to help explain to clients why antibiotics are not indicated for their pet’s condition, managing both client expectations and the veterinarian’s perceived need to act.
- Probiotics and Faecal Transplantation:
- Probiotics are still in the early research stage, with limited evidence supporting their effectiveness, especially for systemically ill or septic patients.
- Faecal transplantation is an emerging therapy, and consensus guidelines are available on its appropriate use for dogs.
Top Tips
- Think Before Prescribing Antibiotics: Not all cases of diarrohea require antibiotics. Consider if they’re truly necessary before prescribing.
- Use Resources Like the “Protect Me” Poster: Familiarize yourself with available tools like the “Protect Me” poster and BSAVA guidelines to guide your decision-making and explain your rationale to clients.
- Manage Client Expectations: Use tools like the No Antibiotics Prescription Required sheet to help clients understand why antibiotics may not be needed, easing pressure to prescribe unnecessarily.
- Early Antibiotic Use in Severe Cases: When faced with a severe case with signs of sepsis, start antibiotics early to improve outcomes.
- Consider Alternatives: Stay updated on probiotics and fecal transplantation guidelines, but proceed cautiously, especially with septic patients.