Antibiotikaeinsatz beim akuten Durchfall des Hundes – Übersicht potenzieller Risiken, Indikationen und Alternativen

Zusammenfassung

Antibiotika werden bei Hunden mit Magen-Darm-Problemen wie akutem Durchfall (AD) in Deutschland häufig eingesetzt. In Einklang mit den weltweiten Bemühungen, den Antibiotikaeinsatz einzuschränken, soll diese Literaturübersicht einen Überblick über den rationalen und sinnvollen Einsatz von Antibiotika beim AD liefern. Antibiotika können zu gastrointestinalen Nebenwirkungen, negativen Auswirkungen auf die intestinale Mikrobiota und zur Entstehung von Resistenzen führen. Es gibt auch Hinweise darauf, dass chronische immunologische Erkrankungen durch die Verabreichung von Antibiotika ausgelöst werden können. Daher sollten sie bei unkompliziertem AD ohne Anzeichen einer Sepsis oder einer systemischen Entzündungsreaktion nicht verabreicht werden. Darüber hinaus spielen enteropathogene Bakterien bei der Ätiologie akuter Durchfälle beim Hund kaum eine Rolle. Bei bestimmten Krankheitsbildern, wie dem akuten hämorrhagischen Durchfallsyndrom, wird eine Antibiotikatherapie nur dann empfohlen, wenn Hinweise auf eine bakterielle Translokation mit nachfolgender Sepsis vorliegen. Dagegen ist die Gabe von Antibiotika bei der Parvovirose aufgrund der immunologischen Inkompetenz des Hundes, die durch die hochgradige Neutropenie verursacht wird, unumgänglich.

Abstract

In Germany, antibiotics are frequently used in dogs with gastrointestinal disorders such as acute diarrhea. In line with global efforts to limit antibiotic use, this literature review aims to provide a guideline for the rational and judicious use of antibiotics in acute canine diarrhea. Antibiotics can lead to gastrointestinal side effects and may exert a negative influence on the intestinal microbiota in addition to increasing the occurrence of resistant bacteria. There is also evidence that chronic immunological diseases may be triggered by the administration of antibiotics. Therefore, these should not be administered in uncomplicated acute diarrhea without signs of sepsis or systemic inflammatory reaction. In addition, enteropathogenic bacteria usually do not play a role in the etiology of acute diarrhea. For select clinical entities such as acute hemorrhagic diarrhea syndrome, antibiotic therapy should only be recommended in cases displaying signs of bacterial translocation with subsequent sepsis. In the case of parvovirosis, on the other hand, the administration of antibiotics is unavoidable due to the immunological incompetence of the dog caused by the accompanying severe neutropenia.

Schlüsselwörter

Kanin - Gastroenteritis - Metronidazol - Mikrobiom - Mikrobiota

Key words

Canine - gastroenteritis - metronidazole - microbiome - microbiota

Publikationsverlauf

Eingereicht: 31. Dezember 2020

Angenommen: 09. Februar 2021

Artikel online veröffentlicht:
26. April 2021

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