Table 7.
Diagnostic work-up and antibiotic prescriptions in 274 dogs with respiratory tract infections presented to university hospitals or private practices
| Parameter | University hospital | Private practice | P value* |
| Number of cases | 108 | 166 | |
| Duration of clinical signs, n (%) | |||
| <7 days | 49 (45) | 49 (30) | 0.03 |
| >7 days | 34 (31) | 15 (9) | |
| Unknown | 25 (23) | 102 (61) | |
| Minimal work-up, n (%)† | |||
| Yes | 75 (69) | 1 (0.6) | <0.001 |
| Broncho-alveolar lavage and culture, n (%) | |||
| Yes | 8 (7) | 2 (1) | 0.007 |
| Cases judged severe, n (%)‡ | |||
| Yes | 25 (24) | 1 (0.6) | 0.7 |
| No | 3 (3) | 0 (0) | |
| Impossible to judge | 80 (73) | 165 (99.4) | |
| Diagnosis based on clinical signs in addition to, n (%) | |||
| Clinical examination alone | 15 (14) | 145 (87) | <0.001 |
| Clinical examination and radiographs | 72 (66) | 16 (10) | <0.001 |
| Clinical examination, radiographs (optional) and bronchoscopy | 12 (11) | 6 (4) | 0.014 |
| Clinical examination, radiographs (optional), bronchoscopy and BAL | 8 (7) | 2 (1) | 0.007 |
| Hospitalisation, n (%) | |||
| Yes | 69 (54) | 1 (0.6) | <0.001 |
| No | 39 (36) | 165 (99.4) | |
| Pretreated, n (%) | |||
| Yes | 41 (37) | 7 (4) | <0.001 |
| No | 66 (62) | 158 (95.4) | |
| Unknown | 1 (1) | 1 (0.6) | |
| Antibiotic therapy, n (%) | |||
| Yes | 82 (76) | 89 (49) | <0.001 |
| No | 26 (24) | 77 (51) | |
| Antibiotic classes, n (%) | |||
| Potentiated aminopenicillins | 59 (71) | 58 (65) | 0.3 |
| Tetracyclines | 12 (15) | 26 (29) | 0.03 |
| Non-potentiated aminopenicillins | 2 (2) | 33 (37) | <0.001 |
| Fluoroquinolones | 23 (28) | 4 (4) | <0.001 |
| First-generation cephalosporins | 4 (5) | 0 (0) | <0.001 |
| Third-generation cephalosporins | 1 (1) | 3 (3) | 0.4 |
| Combination therapy, n (%) | |||
| Yes | 18 (22) | 4 (5) | <0.001 |
| No | 64 (88) | 85 (95) | |
| HPCIA§ | |||
| Yes | 25 (30) | 7 (8) | <0.001 |
| No | 57 (70) | 82 (92) | |
| Duration of therapy (days) | |||
| Median (IQR) | 12.7 (3–20) | 6.3 (0–10) | <0.001 |
| Justification score, n (%) | |||
| 1 | 68 (63) | 64 (39) | <0.001 |
| 2 | 1 (1) | 3 (2) | 0.6 |
| 3 | 15 (14) | 11 (7) | 0.04 |
| 4 | 19 (18) | 45 (27) | 0.06 |
| Judgement not possible | 5 (5) | 43 (26) | <0.001 |
*Statistically significant P values after Bonferroni correction are written in bold characters.
†Minimal work-up consist of a thoracic radiograph and CBC.
‡Cases were judged as severe if there was a reduced general state+signs of SIRS (systemic inflammatory response syndrome)/sepis/left-shift+pulmonary involvement (radiographs or auscultation).
§HPCIA: highest priority critically important antimicrobials include third-generation or higher generation cephalosporins, quinolones, macrolides, ketolides, glycopeptides and polymyxins.
BAL, broncho-alveolar lavage; CBC, complete blood count.