Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection : An Observational Study in Danish Small Animal Practices. / Sørensen, T M; Bjørnvad, C R; Cordoba, G; Damborg, P; Guardabassi, L; Siersma, V; Bjerrum, L; Jessen, L R.

In: Journal of Veterinary Internal Medicine, Vol. 32, No. 2, 2018, p. 743-751.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Sørensen, TM, Bjørnvad, CR, Cordoba, G, Damborg, P, Guardabassi, L, Siersma, V, Bjerrum, L & Jessen, LR 2018, 'Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices', Journal of Veterinary Internal Medicine, vol. 32, no. 2, pp. 743-751. https://doi.org/10.1111/jvim.15048

APA

Sørensen, T. M., Bjørnvad, C. R., Cordoba, G., Damborg, P., Guardabassi, L., Siersma, V., ... Jessen, L. R. (2018). Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices. Journal of Veterinary Internal Medicine, 32(2), 743-751. https://doi.org/10.1111/jvim.15048

Vancouver

Sørensen TM, Bjørnvad CR, Cordoba G, Damborg P, Guardabassi L, Siersma V et al. Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices. Journal of Veterinary Internal Medicine. 2018;32(2):743-751. https://doi.org/10.1111/jvim.15048

Author

Sørensen, T M ; Bjørnvad, C R ; Cordoba, G ; Damborg, P ; Guardabassi, L ; Siersma, V ; Bjerrum, L ; Jessen, L R. / Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection : An Observational Study in Danish Small Animal Practices. In: Journal of Veterinary Internal Medicine. 2018 ; Vol. 32, No. 2. pp. 743-751.

Bibtex

@article{95d32db37bae41e9aabcf220c4851a2b,
title = "Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection: An Observational Study in Danish Small Animal Practices",
abstract = "BACKGROUND: Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics.HYPOTHESIS/OBJECTIVES: To describe and evaluate the impact of diagnostic work-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease.ANIMALS: One hundred and fifty-one dogs presenting to 52 Danish veterinary practices.METHODS: Prospective, observational study. Clinical signs, diagnostic work-up, and prescriptions were recorded. Urine samples were submitted to a reference laboratory for quantitative bacterial culture (QBC) and susceptibility testing. The laboratory results were used as reference for assessing the appropriateness of DTT and COT.RESULTS: In the majority of dogs, veterinarians performed dipstick (99{\%}), microscopic examination of urine (80{\%}) and bacterial culture (56{\%}). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62{\%} of the dogs, while 36{\%} were over-prescribed and 2{\%} under-prescribed. Inappropriate use of second-line agents was found in 57{\%} of the UTI cases. Performing microscopy-but not culture-significantly impacted DTT (P = 0.039) while no difference was seen in COT (P = 0.67). The accuracy of in-house microscopy and culture were 64.5 and 77{\%}, respectively.CONCLUSIONS AND CLINICAL IMPORTANCE: Over-prescription of antibiotics was common among dogs with suspected UTI, regardless of the diagnostic work-up performed. Test inaccuracy under practice conditions and incoherence between diagnostic test results and decision-making both explained inappropriate and unnecessary use of antibiotics.",
author = "S{\o}rensen, {T M} and Bj{\o}rnvad, {C R} and G Cordoba and P Damborg and L Guardabassi and V Siersma and L Bjerrum and Jessen, {L R}",
note = "{\circledC} 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.",
year = "2018",
doi = "10.1111/jvim.15048",
language = "English",
volume = "32",
pages = "743--751",
journal = "Journal of Veterinary Internal Medicine",
issn = "0891-6640",
publisher = "Wiley-Blackwell",
number = "2",

}

RIS

TY - JOUR

T1 - Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection

T2 - An Observational Study in Danish Small Animal Practices

AU - Sørensen, T M

AU - Bjørnvad, C R

AU - Cordoba, G

AU - Damborg, P

AU - Guardabassi, L

AU - Siersma, V

AU - Bjerrum, L

AU - Jessen, L R

N1 - © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics.HYPOTHESIS/OBJECTIVES: To describe and evaluate the impact of diagnostic work-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease.ANIMALS: One hundred and fifty-one dogs presenting to 52 Danish veterinary practices.METHODS: Prospective, observational study. Clinical signs, diagnostic work-up, and prescriptions were recorded. Urine samples were submitted to a reference laboratory for quantitative bacterial culture (QBC) and susceptibility testing. The laboratory results were used as reference for assessing the appropriateness of DTT and COT.RESULTS: In the majority of dogs, veterinarians performed dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over-prescribed and 2% under-prescribed. Inappropriate use of second-line agents was found in 57% of the UTI cases. Performing microscopy-but not culture-significantly impacted DTT (P = 0.039) while no difference was seen in COT (P = 0.67). The accuracy of in-house microscopy and culture were 64.5 and 77%, respectively.CONCLUSIONS AND CLINICAL IMPORTANCE: Over-prescription of antibiotics was common among dogs with suspected UTI, regardless of the diagnostic work-up performed. Test inaccuracy under practice conditions and incoherence between diagnostic test results and decision-making both explained inappropriate and unnecessary use of antibiotics.

AB - BACKGROUND: Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics.HYPOTHESIS/OBJECTIVES: To describe and evaluate the impact of diagnostic work-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease.ANIMALS: One hundred and fifty-one dogs presenting to 52 Danish veterinary practices.METHODS: Prospective, observational study. Clinical signs, diagnostic work-up, and prescriptions were recorded. Urine samples were submitted to a reference laboratory for quantitative bacterial culture (QBC) and susceptibility testing. The laboratory results were used as reference for assessing the appropriateness of DTT and COT.RESULTS: In the majority of dogs, veterinarians performed dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over-prescribed and 2% under-prescribed. Inappropriate use of second-line agents was found in 57% of the UTI cases. Performing microscopy-but not culture-significantly impacted DTT (P = 0.039) while no difference was seen in COT (P = 0.67). The accuracy of in-house microscopy and culture were 64.5 and 77%, respectively.CONCLUSIONS AND CLINICAL IMPORTANCE: Over-prescription of antibiotics was common among dogs with suspected UTI, regardless of the diagnostic work-up performed. Test inaccuracy under practice conditions and incoherence between diagnostic test results and decision-making both explained inappropriate and unnecessary use of antibiotics.

U2 - 10.1111/jvim.15048

DO - 10.1111/jvim.15048

M3 - Journal article

VL - 32

SP - 743

EP - 751

JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

SN - 0891-6640

IS - 2

ER -

ID: 191893436