Prospective trial of different antimicrobial treatment durations for presumptive canine urinary tract infections – the STOP on SUNDAY trial
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Presentation of lower urinary tract signs (increased frequency of urination and straining to urinate) is a common reason for veterinary consultation in dogs. These signs can be caused by a urinary tract infection (UTI) that can be treated with antimicrobial therapy. In fact the positive predictive value of pollakiuria, dysuria or haematuria in female dogs (6 months to 10 years of age) for presence of a UTI is between 60-80%.
The use of antimicrobials in both human and animal treatment should be carefully considered in order to reduce the risk of developing antimicrobial resistance (AMR). AMR is estimated to cause over 30,000 deaths and almost 900,000 disability-adjusted life-years (DALYs) a year in the EU and EEA alone. It is always important to try to optimise antimicrobial use where possible and guidelines are available to support this decision making in practice (e.g. the PROTECT ME poster from BSAVA and the Small Animal Society). Little is known as to the optimal length of treatment for canine UTIs and course length is typically arbitrary. The latest ISCAID guidelines suggest a 3- 5 day course is sufficient to achieve a clinical cure.
In this study, female dogs that present with lower urinary tract signs (and that don’t have a history of lower urinary tract disease) will be given antibiotic treatments of different durations. All courses will be completed on a Sunday evening, to facilitate prompt follow-up and, where necessary, additional supervision from the case clinician. The response to treatment (presence or absence of lower urinary tract signs) will be assessed 7 days after completion of the course, and recurrence will be monitored in the following 3 weeks. Through comparison of the different antimicrobial treatment durations, we aim to determine the optimal course length.
Further details of the study can be found at: samsoc.org/veterinary-projects/sos-uti-study