Bacterial Cystitis: The Short & Long

In this trial, 38 dogs with uncomplicated bacterial cystitis were treated with either cephalexin 20 mg/kg PO q12h for 10 days (n = 18) or trimethoprim sulfamethoxazole (TMP-SMX) 15 mg/kg PO q12h for 3 days (n = 20), followed by a placebo for the remaining 7 days. Dogs were reevaluated for clinical and microbiological outcomes on days 7, 14 (short-duration), and 42 (long-duration). Improvement or resolution of clinical signs on day 3 did not differ between the 2 groups. In addition, there was no difference between clinical or microbial cure rates in the short-term or the long-term groups.

Global Commentary

The advantages of short-duration antimicrobial treatment of suspected uncomplicated bacterial cystitis include lower cost and potentially better client compliance with fewer adverse effects and lower antimicrobial resistance. This is the second prospective clinical trial to demonstrate similar clinical and microbiologic cure rates when comparing short and longer duration empiric antimicrobial treatment for uncomplicated UTI without adverse effects.¹ These 2 short-duration protocols are exciting and promising; however, further studies are needed to compare the efficacy of short-duration treatment with high-dose enrofloxacin versus TMP-SMX and to examine the impact these treatment regimens may have on the selection of resistant bacteria.—Gregory F. Grauer, DVM, MS, DACVIM

This capsule is part of the Global Edition of Clinician's Brief