DOI
https://doi.org/10.18849/ve.v7i2.393Abstract
There is an erratum to this paper published in Veterinary Evidence Vol 7, Issue 2 (2022): 10.18849/VE.V7I2.626
PICO question
In dogs with acute gastroenteritis, is metronidazole faster, slower, or comparable in resolving clinical signs when compared to probiotic administration?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Five studies total, all were blinded, randomised controlled trials
Strength of evidence
Moderate
Outcomes reported
The use of probiotics as a treatment for acute, uncomplicated diarrhoea in dogs may improve clinical signs faster when compared to a placebo, but showed no difference when compared directly to metronidazole. Metronidazole, when compared to a placebo, produced mixed results with one study finding that treatment with metronidazole did significantly reduce the time to resolution of diarrhoea, while another study found the difference with placebo was not significant
Conclusion
Based on the evidence evaluated, the use of oral metronidazole will not decrease time to resolution of clinical signs in cases of acute, uncomplicated diarrhoea in dogs when compared to probiotic administration and thus should not be a first-line treatment in such cases
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Butel, M. J. (2014). Probiotics, gut microbiota and health. Médecine et Maladies Infectieuses. 44(1), 1–8. DOI: https://doi.org/10.1016/j.medmal.2013.10.002
Herstad, H. K., Nesheim, B. B., L'Abée-Lund, T., Larsen, S. & Skancke, E. (2010). Effects of a probiotic intervention in acute canine gastroenteritis – a controlled clinical trial. Journal of Small Animal Practice. 51(1), 34–3 DOI: https://doi.org/10.1111/j.1748-5827.2009.00853.x
Igarashi, H., Maeda, S., Ohno, K., Horigome, A., Odamaki, T. & Tsujimoto, H. (2014). Effect of Oral Administration of Metronidazole or Prednisolone on Fecal Microbiota in Dogs. PLoS One. 9(9). DOI: https://doi.org/10.1371/journal.pone.0107909
Kelley, R. L., Minikhiem, D., Kiely, B., O'Mahony, L., O'Sullivan, D., Boileau, T. & Park, J. S. (2009). Clinical benefits of probiotic canine-derived Bifidobacterium animalis strain AHC7 in dogs with acute idiopathic diarrhea. Veterinary Therapeutics. 10(3), 121–130.
Langlois, D. K., Koenigshof, A. M. & Mani, R. (2020). Metronidazole treatment of acute diarrhea in dogs: A randomized double blinded placebo-controlled clinical trial. Journal of Veterinary Internal Medicine. 34(1), 98–104. DOI: https://doi.org/10.1111/jvim.15664
Lloyd, D. H. & Page, S. W. (2018). Antimicrobial Stewardship in Veterinary Medicine. Microbiology Spectrum. 6(3). DOI: https://doi.org/10.1128/microbiolspec.ARBA-0023-2017
Nixon, S. L., Rose, L. & Muller, A. T. (2019). Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo-controlled, double-blinded clinical study. Journal of Veterinary Internal Medicine. 33(3), 1286–1294. DOI: https://doi.org/10.1111/jvim.15481
Nogueira, J. P. S., He, F., Mangian, H. F., Oba, P. M. & De Godoy, M. R. C. (2019). Dietary supplementation of a fiber-prebiotic and saccharin-eugenol blend in extruded diets fed to dogs. Journal of Animal Science. 97(11), 4519–4531. DOI: https://doi.org/10.1093/jas/skz293
Pilla, R., Gaschen, F.P., Barr, J. W., Olson, E, Honneffer, J., Guard, B. C., Blake, A. M., Villanueva, D., Khattab, M. R., AlShawaqfeh, M. K., Lidbury, J. A., Steiner, J. M. & Suchodolski, J. S. (2020). Effects of metronidazole on the fecal microbiome and metabolome in healthy dogs. Journal of Veterinary Internal Medicine. 34(5), 1853–1866. DOI: https://doi.org/10.1111/jvim.15871
Prescott, J. F. (2019). Veterinary antimicrobial stewardship in North America. Australian Veterinary Journal. 97(7), 243–248. DOI: https://doi.org/doi:10.1111/avj.12811
Shmalberg, J., Montalbano, C., Morelli G. & Buckley, G. J. (2019). A Randomized Double Blinded Placebo-Controlled Clinical Trial of a Probiotic or Metronidazole for Acute Canine Diarrhea. Frontiers in Veterinary Science. 6(163), 1– DOI: https://doi.org/10.3389/fvets.2019.00163
Singleton, D. A., Noble, P. J. M., Sánchez-Vizcaíno, F., Dawson, S., Pinchbeck, G. L., Williams, N. J., Radford, A. D. & Jones, P. H. (2019). Pharmaceutical Prescription in Canine Acute Diarrhoea: A Longitudinal Electronic Health Record Analysis of First Opinion Veterinary Practices. Frontiers in Veterinary Science. 6(218), 1–14. DOI: https://doi.org/doi:10.3389/fvets.2019.00218
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