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

Authors

  • Amanda L. Abelson DVM, DACVECC,

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
    Search for more papers by this author
  • Gareth J. Buckley MA, VetMB, DACVECC,

    1. Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
    Current affiliation:
    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32605, USA
    Search for more papers by this author
  • Elizabeth A. Rozanski DVM, DACVIM, DACVECC

    Corresponding author
    • Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
    Search for more papers by this author

  • The authors declare no conflict of interest.

Address correspondence and reprint requests to Dr. Elizabeth Rozanski, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA. Email: Elizabeth.Rozanski@tufts.edu

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.

Ancillary