Doxycycline with or without famciclovir for infectious ophthalmic and respiratory disease: a prospective, randomized, masked, placebo-controlled trial in 373 kittens.

Autor:	Vernau KM; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA., Kim S; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA., Thomasy SM; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.; Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, CA, USA., Lucyshyn DR; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA., Purpura J; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA., Montgomery E; School of Veterinary Medicine, University of California, Davis, CA, USA., Surmick JD; School of Veterinary Medicine, University of California, Davis, CA, USA., Dubelko AR; School of Veterinary Medicine, University of California, Davis, CA, USA., Moussavi A; Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA., Kass PH; Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA., Maggs DJ; Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of feline medicine and surgery [J Feline Med Surg] 2024 Nov; Vol. 26 (11), pp. 1098612X241278413.
DOI:	10.1177/1098612X241278413
Abstrakt:	Objectives: The aim of this study was to prospectively evaluate in a randomized, triple-masked, placebo-controlled trial, outcomes for kittens with ocular manifestations of infectious upper respiratory disease (IURD) treated with an ophthalmic and oral antibiotic only vs those also treated with famciclovir. Methods: Kittens were stratified into three age (1 to <4, 4 to <8 or 8-12 weeks) and two disease severity ('mild' [total disease score 1-11] or 'severe' [total disease score 12-23]) groups and randomized to receive approximately 5 mg/kg doxycycline either with placebo (group D) or with approximately 90 mg/kg famciclovir (group DF) PO q12h. Caregivers scored clinical signs once daily for 21 days. Ophthalmic examinations and scoring by veterinarians were completed on days 1 and 21. Ophthalmic and clinical resolution were defined as scores of zero for all ocular signs and all ocular and respiratory signs, respectively. Ophthalmic and clinical recovery were defined by absence of active inflammation. Results: For kittens with mild disease, those in group D were slower than those in group DF to achieve clinical recovery ( P  = 0.049) and clinical resolution ( P  = 0.030), but not ophthalmic recovery ( P  = 0.064) or ophthalmic resolution ( P  = 0.089). Kittens with mild disease and receiving famciclovir achieved predicted 75% clinical resolution 4-5 days earlier than kittens with mild disease and receiving doxycycline alone, and kittens with severe disease (regardless of treatment group). Significantly fewer kittens in group DF developed corneal disease than in group D ( P  = 0.016). All five kittens whose clinical signs worsened sufficiently to be removed from the study were in group D. Conclusions and Relevance: The addition of famciclovir to standard antibiotic treatment may reduce corneal disease, length of stay and time to adoption for shelters and rescue groups, thereby increasing capacity for care. Early administration of famciclovir in kittens exhibiting mild ocular manifestations of IURD may be preferable to delaying this treatment until the disease progresses to a severe stage. Competing Interests: Conflict of interestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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