title: Prophylactic trimethoprim-sulfadiazine during chemotherapy in dogs with lymphoma and osteosarcoma: a double-blind, placebo-controlled study.
abstract: BACKGROUND
  The administration of chemotherapy is associated with risk for morbidity. Management of chemotherapy-related morbidity in veterinary oncology has been primarily supportive.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effect of prophylactic antimicrobial use on chemotherapy-associated morbidity in dogs with lymphoma or osteosarcoma.
  
  
  METHODS
  Dogs presenting with histologically confirmed osteosarcoma or lymphoma were eligible.
  
  
  METHODS
  Patients were randomized to receive placebo or trimethoprim-sulfadiazine for 14 days after their first doxorubicin chemotherapy. Both owner and clinician were blinded with respect to treatment. Patient assessment included CBC, physical examination and performance, and toxicosis grading on days 7 and 14. Investigated outcomes were hospitalization, suspicion of infection, gastrointestinal toxicity, neutropenia, nonhematologic toxicity, and quality of life.
  
  
  RESULTS
  Seventy-three dogs were enrolled; 34 had osteosarcoma, and 39 had lymphoma. Dogs receiving trimethoprim-sulfadiazine (n = 36) had a significantly reduced hospitalization rate (P = .03), nonhematologic toxicity (P = 0.039), grade 2-4 nonhematologic toxicity (P < .0001), grade 2-4 gastrointestinal toxicity (P = .007). and altered performance (P = .015). By group, dogs with osteosarcoma (n = 34) that received the antimicrobial experienced fewer occurrences of nonhematologic toxicity (P = .02) and less severe nonhematologic toxicity (P = .038). Dogs with lymphoma (n = 39) had significant reductions in the occurrence of hospitalization (P = .035), severity of nonhematologic toxicity (P = .036), and alterations of performance (P = .015).
  
  
  CONCLUSIONS
  The use of prophylactic trimethoprim-sulfadiazine has benefit in reducing morbidity in dogs with osteosarcoma or lymphoma during the first 14 days after treatment with doxorubicin.
authors.affiliation: Harrington Oncology Program, Tufts University, North Grafton, MA, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Chretin
authors.forename: K M
authors.initials: KM
authors.lastname: Rassnick
authors.forename: N A
authors.initials: NA
authors.lastname: Shaw
authors.forename: K A
authors.initials: KA
authors.lastname: Hahn
authors.forename: G K
authors.initials: GK
authors.lastname: Ogilvie
authors.forename: O
authors.initials: O
authors.lastname: Kristal
authors.forename: N C
authors.initials: NC
authors.lastname: Northrup
authors.forename: A S
authors.initials: AS
authors.lastname: Moore
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000517:prevention & control*; D004283:Dog Diseases / Q000517:prevention & control*; D004285:Dogs; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D008223:Lymphoma / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D012516:Osteosarcoma / Q000188:drug therapy / Q000662:veterinary*; D010919:Placebos; D013413:Sulfadoxine / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D004338:Drug Combinations; D010919:Placebos; C000301:trimethoprim, sulfadoxine drug combination; D013413:Sulfadoxine; D014295:Trimethoprim