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J Vet Emerg Crit Care (San Antonio). 2013 Sep-Oct;23(5):551-6. doi: 10.1111/vec.12092. Epub 2013 Sep 9.

Positive impact of an emergency department protocol on time to antimicrobial administration in dogs with septic peritonitis.

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  • 1Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Abstract

OBJECTIVE:

To determine whether the development of a specific antimicrobial protocol for the treatment of canine intra-abdominal sepsis would improve time to appropriate antimicrobial administration following diagnosis of bacterial peritonitis.

DESIGN:

Case controlled observational study.

SETTING:

A tertiary referral small animal teaching hospital.

ANIMALS:

Twenty dogs undergoing surgery for septic peritonitis prior to the deployment of the abdominal sepsis protocol served as a case control population and 40 dogs identified as having septic peritonitis after deployment of the protocol served as the study population.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Median time from diagnosis of septic peritonitis to antimicrobial administration was 6 hours (range 1-10 h) in the preprotocol group (PRE), and 1 hour (range 1-2 h) in the postprotocol group (POST) (P = 0.001). Five of 20 (25%) culture and sensitivity results yielded negative cultures in the PRE versus 6 of 34 (17.6%) in the POST. Inappropriate empirical antimicrobials were selected 3 of 20 times (15%) in the PRE and 3 of 34 times (8.8%) in the POST. The overall survival to discharge was 60% in the PRE and 70% in the POST (P = 0.425).

CONCLUSIONS:

The development of an emergency department antimicrobial protocol significantly decreased time to antimicrobial administration following identification of septic peritonitis in dogs.

© Veterinary Emergency and Critical Care Society 2013.

KEYWORDS:

Antimicrobials, Pharmacology; Peritonitis, Gastroenterology; Sepsis

PMID:
24016280
[PubMed - indexed for MEDLINE]
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