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Antibiotics in dogs with kennel cough

Clinical Scenario

Mr. Tilly brings in his two-year-old Jack Russell Terrier, “Larry”, with a sudden onset dry, hacking cough.  Several of “Larry’s” canine playmates in the park have been coughing recently and some have seen their vet and been given antibiotics.  Larry is well in himself with no other signs and the only abnormality on clinical examination is the eliciting of the cough on squeezing his trachea.  You suspect “Larry” has infectious tracheobronchitis and have been told at a CPD meeting, that it is not indicated to give antibiotics to uncomplicated cases.  You wonder if giving “Larry” antibiotics will speed cough resolution...

3-Part Question (PICO)

[In dogs with infectious tracheobronchitis that are not systemically ill] does [treatment with oral, systemic antibiotics compared to no antibiotics] reduce [time to cough resolution]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(dog.mp.OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp Dogs/)

AND

(tracheobronchitis.mp. OR bronchitis.mp. OR tracheitis.mp. OR kennel cough.mp. OR infectious respiratory disease complex.mp. OR paramyxoviridae.mp. OR parainfluenza.mp.OR exp Tracheitis/ OR exp Bronchitis/ OR exp Bordetella bronchiseptica/ OR exp Paramyxoviridae/)

AND

(antibacterial.mp. or antibacterials.mp. OR antibiotic.mp. OR antibiotics.mp. OR antimicrobial.mp. OR antimicrobials.mp. OR exp Anti-Bacterial Agents/ OR exp Anti-Infective Agents/)

CAB Abstracts 1910 to Present using the OVID interface

(dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp dogs/)

AND

tracheobronchitis.mp. OR bronchitis.mp. OR tracheitis.mp. OR kennel cough.mp. OR infectious (respiratory disease complex.mp. OR paramyxoviridae.mp. OR parainfluenza.mp. OR exp tracheitis/ OR exp bronchitis/ OR exp Bordetella bronchiseptica/ OR exp Canine parainfluenza virus/ OR exp paramyxoviridae/)

AND

(antibacterial.mp. or antibacterials.mp. OR antibiotic.mp. OR antibiotics.mp. OR antimicrobial.mp. OR antimicrobials.mp. OR exp antibacterial agents/ OR exp antibiotics/ OR exp antiinfective agents/)

Search Outcome

MEDLINE

  • 206 papers found in MEDLINE search
  • 204 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 2 papers excluded as they are review articles/in vitro research/conference proceedings
  • 0 total relevant papers from MEDLINE

CAB Abstracts

  • 266 papers found in CAB search
  • 258 papers excluded as they don't meet the PICO question
  • 2 papers excluded as they are in a foreign language
  • 5 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Thrusfield et al., 1991, UK

Title:

A field investigation of kennel cough: efficacy of different treatments.

Patient group:

Coughing dogs attending a random sample of veterinary practices in summer 1986/87, (N=551)

Study Type:

Cohort study

Outcomes:
  • Duration of coughing post treatment
Key Results:
  • Cough lasted from 0-29 days for treated dogs and 0-30 days for non-treated dogs (no p-value given). N.B. Numbers taken from figures, no absolute numbers given.
  • Median duration of cough 7 days in dogs treated with antibiotics compared to 10 days for untreated dogs.
  • Treatment with Trimethoprim potentiated sulphonamide (TMPS) or ampicillin/amoxicillin resulted in a statistically significant reduction in duration of cough when compared to untreated controls (95% confidence intervals: TMPS 2, 7 days; amp/amox 1, 7 days).
  • Other antibiotics resulted in no significant difference when compared to no treatment.
Study Weaknesses:
  • No data on demographics of population, so not sure if representative of a practice caseload.
  • Study inclusion criteria not clear, so do not know if treated and non-treated groups equivalent.
  • Small control group of untreated dogs (n=29), so likely to be an underpowered study.
  • Not specified if dogs in both groups were systemically ill or not.
  • No defined study time.
  • Dosages and length of treatment not specified (so not sure if data sheet levels used).
  • Results, including figures and basic data, poorly reported in places, so difficult to interpret.
  • No ethical approval reported.

 

Attachment:
No attachments.

Comments

There is only one relevant paper, which is a retrospective cohort study.  As it is not a randomised controlled trial, it is not strong evidence for treatment efficacy.  Although the results show some statistical significance, the small differences between the groups may not be biologically significant. This, combined with the influence of the small control group, means there may be no clinically significant effect of using antibiotics.

Several pharmaceutical companies were involved in funding the study, although their interest is not stated.

Bottom line

There is currently insufficient evidence to indicate that the use of antibiotics in dogs with kennel cough will lead to a clinically significant reduction in the duration of coughing.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Thrusfield MV, Aitken CGG, Muirhead RH (1991). A field investigation of kennel cough: efficacy of different treatments.  Journal of Small Animal Practice 32(9): 455-9.

About this BET

First author:
Richard Ewers
Second author:
Rachel Dean
Institution:

University of Nottingham

Search last performed:
2016-10-28 12:49:03
Original publication date:
2014-06-27 12:49:03
Last updated:
2016-10-28 12:49:03
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