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

• Published in: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Tex. : 2000), 2013-09, Vol.23 (5), p.551-556
• Main Authors: Abelson, Amanda L., Buckley, Gareth J., Rozanski, Elizabeth A.
• Format: Article
• Language: English
• Subjects: Animals; Anti-Bacterial Agents - therapeutic use; Antimicrobials; Antimicrobials, Pharmacology; Case-Control Studies; Clinical Protocols; Dog Diseases - drug therapy; Dogs; Emergency Service, Hospital - standards; Female; Gastroenterology; Peritonitis; Peritonitis - drug therapy; Peritonitis - veterinary; Peritonitis, Gastroenterology; Pharmacology; Retrospective Studies; Sepsis; Sepsis - drug therapy; Sepsis - veterinary; Treatment Outcome
• ISSN: 1479-3261; 1476-4431
• DOI: 10.1111/vec.12092

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.