Retrospective Analysis of Antibiotic Use in Dogs with Chronic Inflammatory Enteropathy Prior to Referral: 144 Cases...

Chronic inflammatory enteropathy (CIE) has historically been divided into food-responsive chronic inflammatory enteropathy (CIE-FR), immunosuppressant-responsive chronic inflammatory enteropathy (CIE-IR), non-responsive chronic inflammatory enteropathy (CIE-NR) and antibiotic-responsive chronic inflammatory enteropathy (CIE-AR). Given the rising concern for antimicrobial resistance (AMR) and the effects of antibiotics on the microbiome, replacement of CIE-AR with microbiota-modulation-responsive enteropathy (MrMRE) has been suggested, and antibiotic use questioned. The objective of this study was to assess the prescribing habits of antibiotics for dogs with CIE prior to referral. This was a single-centre retrospective study of cases between 2020 and 2024 assessing antibiotic prescription for CIE in the six months prior to referral. Data including signalment, clinical signs, diagnosis, antibiotic administration and the antibiotics used were recorded. A total of 144 dogs with chronic inflammatory enteropathy were included, of which 128 had CIE without protein-losing enteropathy (PLE) and 16 had PLE. Overall, 57.6% of dogs with CIE referred for investigation were prescribed antibiotics in the six months prior to referral. Of the dogs prescribed antibiotics, metronidazole was the most prescribed (74.7%), followed by amoxicillin-clavulanate (36.1%). Dogs with diarrhoea were more likely to be prescribed antibiotics overall and were also more likely to receive metronidazole. Antibiotic use differed across the years, with the lowest rate prescribed in 2024 (26/46 [56.5%] in 2020/2021, 24/33 [72.7%] in 2022, 22/35 [62.9%] in 2023, and 11/30 [36.7%] in 2024; p = 0.031). Further work is required to understand continued antibiotic use in CIE and inform antimicrobial stewardship strategies.