@article{Rogers-Smith_2021, title={The use of metronidazole in adult dogs with acute onset, uncomplicated, diarrhoea}, volume={6}, url={https://veterinaryevidence.org/index.php/ve/article/view/445}, DOI={10.18849/ve.v6i4.445}, abstractNote={<p><strong>PICO question</strong></p> <p>In adult, non-geriatric, dogs with acute onset (<7 days duration) uncomplicated diarrhoea does the addition of metronidazole to a supportive care protocol such as dietary modification or probiotics (excluding other antimicrobials) reduce the time to resolution of diarrhoea compared to supportive care protocols alone?</p> <p> </p> <p><strong>Clinical bottom line</strong></p> <p><strong>Category of research question</strong></p> <p>Treatment</p> <p><strong>The number and type of study designs reviewed</strong></p> <p>Four studies were included in this appraisal. Two prospective, double blinded, placebo controlled clinical trials, one prospective treatment trial and one retrospective longitudinal observational study</p> <p><strong>Strength of evidence</strong></p> <p>Weak</p> <p><strong>Outcomes reported</strong></p> <p>One study found a shortened duration of clinical signs (by 1.5 days; p = 0.04) in the metronidazole treated group compared to control. However, a separate study found no significant difference between control and metronidazole groups in the regards to resolution of clinical signs.</p> <p>One study demonstrated a long standing (>28 day) negative impact of metronidazole treatment on gut microbiome with no difference in time to resolution of clinical signs when compared with faecal matter transplant</p> <p><strong>Conclusion</strong></p> <p>The current evidence for the superiority of metronidazole compared to supportive treatment alone is weak and at this time there is no evidence-based rationale for its use in cases of uncomplicated, acute, canine diarrhoea. Furthermore, the negative implications of metronidazole on the intestinal microbiome have been found to be long standing (>28 days as a minimum) and should not be discounted by the prescribing clinician</p> <p> </p> <p><span style="color: #0000ff;"><a style="color: #0000ff;" href="https://learn.rcvsknowledge.org/mod/book/view.php?id=50" target="_blank" rel="noopener">How to apply this evidence in practice</a></span></p> <p>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.</p> <p>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.</p> <p> </p> <p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access"> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed"></p>}, number={4}, journal={Veterinary Evidence}, author={Rogers-Smith, Emma}, year={2021}, month={Dec.} }