Effectiveness of a combined (4% chlorhexidine digluconate shampoo and solution) protocol in MRS and non‐MRS canine superficial pyoderma: a randomized, blinded, antibiotic‐controlled study

Abstract

Background -There is a lack of studies comparing topical antiseptics to systemic antibiotics in the treatment of canine superficial pyoderma.Hypothesis/Objectives -To compare the efficacy of topical chlorhexidine with systemic amoxicillin-clavulanic acid for the treatment of canine superficial pyoderma.Animals -A randomized controlled trial was conducted in dogs with superficial pyoderma. Group T (n = 31) was treated topically with 4% chlorhexidine digluconate shampoo (twice weekly) and solution (once daily) for 4 weeks. Group S (n = 20) was treated orally with amoxicillin-clavulanic acid (25 mg/kg) twice daily for 4 weeks.Methods -Bacterial culture and susceptibility testing were performed on clinical specimens collected before treatment. Severity of lesions and number of intracellular bacteria were evaluated using four-point scales to calculate a total pyoderma score for each dog. Pruritus was assessed by owners using a visual analog scale (range 0-10). Scores were analysed for statistical differences between groups T and S.

Recommendations for approaches to meticillin‐resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures.

“…Likewise, good response to topical therapy alone and no adverse effects were reported in 19 of 28 dogs with MRSP pyoderma and in all 14 dogs with MRSP pyoderma treated topically in other case series . Furthermore, the efficacy of a twice‐weekly chlorhexidine shampoo combined with daily chlorhexidine spray was shown to be comparable to oral amoxicillin‐clavulanate in a four week comparative study in 51 dogs …”

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

“…Topical antimicrobials ultimately might have led to treatment success. Good efficacy of chlorhexidine as sole treatment for superficial pyoderma has been reported in dogs . However, in that study 4% chlorhexidine shampoo and solution were applied regularly on a daily basis for 4 weeks.…”

“…Canine pyoderma caused by meticillin‐resistant staphylococci (MRS) represents a therapeutic challenge as MRS are often multidrug‐resistant and susceptible only to systemic antimicrobials, such as amikacin, chloramphenicol and rifampicin, that are potentially associated with moderate to severe adverse effects . Although topical antimicrobial agents might be effective and should be used preferentially to treat superficial cutaneous infections in dogs, systemic antimicrobials still represent the mainstay of treatment for generalized deep pyoderma and those superficial pyodermas not responsive to topical therapy or that cannot be treated topically due to poor compliance …”

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

“…As evaluation of lesion severity scores and intracellular bacterial scores separately resulted in the same outcome, they were grouped together in a composite total pyoderma score (TPS, ranging from 0 to 24) as reported previously . There was a marked improvement of TPS as early as 1 week after the start of treatment and clinical improvement continued until the end of the study.…”

“…For the treatment of allergic dermatitis, the use of a foam or spray formulation has been demonstrated to be a useful alternative to shampooing . To the best of the authors' knowledge, the use of such formulations in the treatment of canine pyoderma has been limited to one study which demonstrated that the combination of a shampoo and a solution containing 4% chlorhexidine was effective for the treatment of superficial pyoderma . The aim of the clinical trial reported here was to evaluate the effectiveness of a topical spray which contains essential oils and essential fatty acids derived from plant extracts, Manuka oil and N‐acetyl cysteine, as an adjunct treatment for canine superficial pyoderma.…”