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Treatment of Meticillin-Resistant Staphylococcus Pyoderma With Rifampicin in 104 Dogs: Clinical Outcomes, Adverse
Tian Chee Lu1, David Robson1, Greg Burton1
1Animal Skin and Ear Specialists, Melbourne Veterinary Specialist Centre, Melbourne, Victoria, Australia.
Background:
Meticillin-resistant Staphylococcus pseudintermedius (MRSP) is often resistant to multiple antibiotics. Rifampicin is effective against most MRSP isolates, yet the potential for the development of rapid resistance raises questions regarding its suitability as an antibiotic monotherapy for MRSP pyoderma.
Objectives:
To describe the: (i) clinical outcome of rifampicin antibiotic monotherapy in MRSP pyoderma; (ii) frequency of adverse effects; and (iii) development of rifampicin resistance among dogs considered nonresponders to therapy.
Materials And Methods:
A retrospective study of medical records from 1/1/2013 to 1/12/2022 of client-owned dogs with MRSP pyoderma treated with oral rifampicin as a systemic antibiotic monotherapy for 21 days.
Results:
104 dogs were included; 77 cases of superficial pyoderma (74%) and 27 cases of deep pyoderma (26%). The mean daily rifampicin dose was 6 mg/kg. Rifampicin was clinically effective in 86 cases (82.7%). Eleven of 18 nonresponding dogs demonstrated rapidly acquired rifampicin resistance (10.6%). Eighty-two (78.8%), 17 (16.3%), two (1.9%) and three (2.9%) dogs experienced zero, mild, moderate and severe adverse effects, respectively.
Conclusions And Clinical Relevance:
Rifampicin at 6 mg/kg is an effective and mostly well-tolerated monotherapy for treating MRSP pyoderma. However, in this study, it was associated with rapid development of resistance in ≥ 10% of treated dogs. Inadequate clinical response occurred without demonstrable resistance in 6.7% of cases. Concurrent use of ciclosporin or fluconazole with rifampicin increased the odds of severe adverse reactions.
Insights
Rifampicin effectively treated MRSP pyoderma in most dogs, but over 10% developed rapid resistance. Careful monitoring is advised due to potential adverse effects, especially with concurrent medications.
Area of Science:
- Veterinary Dermatology
- Antimicrobial Resistance
- Pharmacology
Background:
- Meticillin-resistant Staphylococcus pseudintermedius (MRSP) poses treatment challenges due to multidrug resistance.
- Rifampicin shows efficacy against MRSP, but rapid resistance development is a concern for monotherapy.
Purpose of the Study:
- Evaluate the clinical effectiveness of rifampicin monotherapy for MRSP pyoderma in dogs.
- Assess adverse effects and the incidence of rifampicin resistance in non-responding dogs.
Main Methods:
- Retrospective analysis of medical records (2013-2022) for dogs with MRSP pyoderma treated with oral rifampicin.
- Dosage: 6 mg/kg daily for 21 days.
Main Results:
- Rifampicin was clinically effective in 82.7% of 104 dogs.
- Rapid rifampicin resistance developed in 10.6% of non-responding dogs.
- Adverse effects were mild in 16.3% and severe in 2.9% of dogs.
Conclusions:
- Rifampicin (6 mg/kg) is effective and generally well-tolerated for MRSP pyoderma.
- Rapid resistance development occurred in over 10% of cases.
- Concurrent use of ciclosporin or fluconazole increased severe adverse reactions.
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