Medical honey for canine nasal intertrigo: A randomized, blinded, placebo-controlled, adaptive clinical trial to support antimicrobial stewardship in veterinary dermatology
| Autor: | Jérôme R. E. del Castillo, Nadia Pagé, Caroline de Jaham, Gabrielle Brosseau |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Antibiotics Social Sciences Pathology and Laboratory Medicine law.invention 0403 veterinary science Placebos Randomized controlled trial law Animal Products Medicine and Health Sciences Psychology Dog Diseases Materials Nose Mammals 0303 health sciences Multidisciplinary Antimicrobials Eukaryota Drugs Pseudomonas Aeruginosa Agriculture Hydrogels 04 agricultural and veterinary sciences Honey Bacterial Pathogens medicine.anatomical_structure Intertrigo Medical Microbiology Vertebrates Physical Sciences Medicine Sensory Perception Female medicine.symptom Pathogens Research Article medicine.medical_specialty 040301 veterinary sciences medicine.drug_class Apitherapy Science Amorphous Solids Materials Science Placebo Microbiology Manuka Honey 03 medical and health sciences Dogs Signs and Symptoms Double-Blind Method Internal medicine Microbial Control Pseudomonas medicine Animals Adverse effect Microbial Pathogens 030304 developmental biology Nutrition Pharmacology Bacteria business.industry Pruritus Organisms Cognitive Psychology Biology and Life Sciences Interim analysis Diet Food Mixtures Amniotes Lesions Cognitive Science Perception Clinical Medicine business Zoology Gels Neuroscience |
| Zdroj: | PLoS ONE PLoS ONE, Vol 15, Iss 8, p e0235689 (2020) |
| ISSN: | 1932-6203 |
| Popis: | Intertrigo is a skin fold dermatitis often requiring recurrent treatment with topical antiseptics or antibiotics, which can select antimicrobial resistance. To minimize this risk, we tested the effectiveness of medical-grade Manuka honey at treating intertrigo as compared to a placebo hydrogel. We additionally characterized the culturable microbial flora of intertrigo and recorded any adverse effect with either treatment. During this randomized, placebo-controlled, double-blinded, adaptive group-sequential trial, the owners washed the affected sites on their dog with water, dried and applied a thin film of either the honey or the placebo product once daily for 21 days. Cytological and lesional composite scores, owner-assessed pruritus, and microbial cultures were assessed prior to treatment and on Day-22. The fixed effects of time, treatment, and animal-related variables on the pruritus and on each composite score, accounting for random dog effect, were estimated separately with generalized linear mixed models for repeated count outcomes (α = 0.05). The null hypothesis of equal treatment effects was rejected at the first interim analysis. The placebo (n = 16 dogs) outperformed the medical honey (n = 13 dogs) at improving both the cytological score (Treatment×Time = -0.35±0.17; P = 0.04) and clinical score (Treatment×Time = -0.28±0.13; P = 0.04). A microbial burden score higher than 4 increased the severity of the cytological score (dichotomous score: 0.29±0.11; P = 0.01), which in turn increased the severity of the clinical score and pruritus score. For every unit increase in cytological score, the linear predictor of clinical score increased by 0.042±0.019 (P = 0.03), and the one of pruritus score increased by 0.12±0.05 (P = 0.01). However, medical honey outperformed the placebo at alleviating the dog's owner-assessed pruritus after statistically controlling for masking effects (Time = -0.94±0.24; P = 0.002; and Treatment×Time = 0.80±0.36; P = 0.04). Unilateral tests of the least-square mean estimates revealed that honey only significantly improved the pruritus (Hommel-adjusted P = 0.003), while the placebo only improved the cytological and clinical scores (Hommel-adjusted P = 0.01 and 0.002, respectively). Taken together, these results question the value of Manuka honey at treating nasal intertrigo in dogs. |
| Databáze: | OpenAIRE |
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