title: Effectiveness of a combined (4% chlorhexidine digluconate shampoo and solution) protocol in MRS and non-MRS canine superficial pyoderma: a randomized, blinded, antibiotic-controlled study.
abstract: BACKGROUND
  There is a lack of studies comparing topical antiseptics to systemic antibiotics in the treatment of canine superficial pyoderma.
  
  
  OBJECTIVE
  To compare the efficacy of topical chlorhexidine with systemic amoxicillin-clavulanic acid for the treatment of canine superficial pyoderma.
  
  
  METHODS
  A randomized controlled trial was conducted in dogs with superficial pyoderma. Group T (n = 31) was treated topically with 4% chlorhexidine digluconate shampoo (twice weekly) and solution (once daily) for 4 weeks. Group S (n = 20) was treated orally with amoxicillin-clavulanic acid (25 mg/kg) twice daily for 4 weeks.
  
  
  METHODS
  Bacterial culture and susceptibility testing were performed on clinical specimens collected before treatment. Severity of lesions and number of intracellular bacteria were evaluated using four-point scales to calculate a total pyoderma score for each dog. Pruritus was assessed by owners using a visual analog scale (range 0-10). Scores were analysed for statistical differences between groups T and S.
  
  
  RESULTS
  Staphylococcus pseudintermedius was isolated from 48 dogs, including eight meticillin-resistant strains (MRSP). Although the number of dogs was small, no significant differences in pyoderma and pruritus scores were observed between groups throughout the study except for day 1, when group S had a significantly higher total score than group T (P = 0.03). Treatment with chlorhexidine products resulted in resolution of clinical signs in all dogs including those infected with MRSP.
  
  
  CONCLUSIONS
  Topical therapy with chlorhexidine digluconate products may be as effective as systemic therapy with amoxicillin-clavulanic acid. This finding supports the current recommendations to use topical antiseptics alone for the management of superficial pyoderma.
authors.affiliation: Servizi Dermatologici Veterinari, 12 via Italia, I-10099, San Mauro Torinese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Borio
authors.affiliation: Servizi Dermatologici Veterinari, 24 via Felice Musazzi, I-20025, Legnano, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Colombo
authors.affiliation: Veterinary Science, University of Torino, 44 via Leonardo Da Vinci, I-10095, Grugliasco, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Rosa
authors.affiliation: Clinica Veterinaria Privata San Marco, 114⁄C via Sorio, I-35141, Padova, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: De Lucia
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 15, DK-1870, Frederiksberg C, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damborg
authors.affiliation: Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 15, DK-1870, Frederiksberg C, Denmark.
authors.forename: Luca
authors.initials: L
authors.lastname: Guardabassi
mesh_terms: D000287:Administration, Topical; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy* / Q000382:microbiology; D004285:Dogs; D004359:Drug Therapy, Combination / Q000662:veterinary; D005260:Female; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D011711:Pyoderma / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary*; D016037:Single-Blind Method; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D019980:Amoxicillin-Potassium Clavulanate Combination; C010882:chlorhexidine gluconate; D002710:Chlorhexidine