Subscribe to RSS
DOI: 10.1055/s-0038-1623636
Einsatz von Fluorchinolonen bei bakteriellen Harnwegsinfektionen der Katze
The use of fluoroquinolones in bacterial urinary tract infections in catsPublication History
Eingegangen:
07 April 2011
Akzeptiert nach Revision:
06 October 2011
Publication Date:
06 January 2018 (online)
Zusammenfassung
Ältere Katzen (> 10 Jahre) mit Symptomen der FLUTD (Feline Lower Urinary Tract Disease) sind häufig von Harnwegsinfektionen betroffen. Zusätzlich werden bei diesen Katzen meist Organerkrankungen (z. B. chronische Niereninsuffizienz, Diabetes mellitus) oder iatrogene Ursachen (Immunsuppressiva, Blasenverweilkatheter) festgestellt, die offensichtlich prädisponierend wirken. Aus diagnostischer Sicht zählen Harnanalyse und -kultur zu den wichtigsten Instrumenten, um eine Bakteriurie aufzudecken. Das mikrobiologische Spektrum bei der Katze wird dabei – ähnlich wie beim Hund – von Escherichia (E.) coli dominiert, aber auch Staphylococcus spp. und Enterococcus spp./Streptococcus spp. werden isoliert. Grundlage der antibiotischen Therapie sollten die Ergebnisse eines Antibiogramms sein. Steht diese Information nicht zur Verfügung, muss die Wirkstoffwahl bei unkomplizierten Harnwegsinfektionen auf empirischer Grundlage getroffen werden. Unter Berücksichtigung ihrer Verträglichkeit sind Antibiotika zu bevorzugen, die bei der Katze eine hohe renale Ausscheidung besitzen und somit therapeutisch wirksame Spiegel im Harn garantieren. Unter diesen Aspekten gehören die Fluorchinolone zum Spektrum der geeigneten Harnwegstherapeutika bei der Katze. Die therapeutische Relevanz von im Harn erreichbaren Wirkstoffspiegeln wird am Beispiel des Fluorchinolons Marbofloxacin, ein Fluorchinolon der 3. Generation, diskutiert. Neue pharmakokinetische Untersuchungen zur Substanz zeigen, dass im Urin von gesunden Katzen nach einmaliger Gabe von 2 bzw. 4 mg/kg KM s. c. Wirkstoffkonzentrationen von ≥ 2 μg/ml über 72 bzw. 103 Stunden aufrechterhalten werden.
Summary
Older cats (> 10 years) with FLUTD (Feline Lower Urinary Tract Disease) symptoms are often affected by urinary tract infections. In most of these cats organ diseases (e. g. chronic renal failure, diabetes mellitus) or iatrogenic factors (immunosuppressive drugs, indwelling catheter) are found that clearly predispose cats to this kind of infection. From a diagnostic point of view, urinalysis and urine culture are the most important tools in detecting bacteriuria. The microbiological spectrum is thereby comparable to that found in dogs, revealing Escherichia (E.) coli but also Staphylococcus spp. and Enterococcus spp./Streptococcus spp. Antibiotic therapy should be based on the results of susceptibility testing. If this kind of information is not available, drug selection has to be decided on an empirical basis unless it is a complicated urinary tract infection. Preferred antibiotics should have a high renal excretion rate and thus ensure therapeutically effective drug levels in the urine. In this respect, the fluoroquinolones belong to the group of appropriate drugs to be used in cats. The relevance of therapeutical drug concentrations achievable in the urine is discussed for the example of marbofloxacin, a third-generation fluoroquinolone. New pharmacokinetic data showed that marbofloxacin concentrations of ≥ 2 μg/ml are maintained in the urine of healthy cats for 72 and 103 hours after administration of 2 and 4 mg/kg BW s. c., respectively.
-
Literatur
- 1 Albarellos GA, Montoya L, Landoni MF. Pharmacokinetics of marbofloxacin after single intravenous and repeat oral administration to cats. Vet J 2005; 170: 222-229.
- 2 Alvarez AI, Perez M, Prieto JG, Molina AJ, Real R, Merino G. Fluoroquinolone efflux mediated by ABC transporters. J Pharm Sci 2008; 97: 3483-3493.
- 3 Anonym Kinetics in cats (p28); Efficacy indicators (p43). Marbocyl® Reference Book; Vétoquinol SA, Lure (France): 1996
- 4 Bailiff NL, Westropp JL, Nelson RW, Sykes JE, Owens SD, Kass PH. Evaluation of urine specific gravity and urine sediment as risk factors for urinary tract infections in cats. Vet Clin Pathol 2008; 37: 317-322.
- 5 Barber JP, Rawlings JM, Markwell PJ, Elliott J. Incidence and prevalence of bacterial urinary tract infections in cats with chronic renal failure. J Vet Int Med 1999; 13: 251.
- 6 Barsanti JA. Genitourinary infections. In: Infectious Diseases of the Dog and Cat. Greene CE. ed. St. Louis (USA): Saunders Elsevier; 2006: 935-949.
- 7 Barsanti JA. Multidrug-resistant urinary tract infection. In: Kirk’s Current Veterinary Therapy XIV. Bonagura JD, Twedt DC. eds. Philadelphia (USA): Saunders Elsevier; 2009: 921-925.
- 8 Barsanti JA, Bartges JW. Bacterial urinary tract infection in cats. In: Kirk’s Current Veterinary Therapy XIII. Bonagura JD. ed. Philadelphia USA: Saunders Elsevier; 2000: 880-882.
- 9 Bartges JW. Revisting bacterial urinary tract infection. In: Consultations in Feline Internal Medicine. Vol 5. August JR. ed. St. Louis: Elsevier; 2006: 441-446.
- 10 Bartges JW. Diagnosis of urinary tract infections. Vet Clin Small Anim Pract 2004; 34: 923-933.
- 11 Blanco LJ, Bartges JW. Understanding and eradicating bacterial urinary tract infections. Vet Med 2001; 96: 776-789.
- 12 Buffington CA, Chew DJ, Kendall MS, Scrivani PV, Thompson SB, Blaisdell JL, Woodworth BE. Clinical evaluation of cats with non obstructive urinary tract diseases. J Am Vet Med Assoc 1997; 210: 46-50.
- 13 Cester CC, Schneider M, Toutain PL. Comparative kinetics of two orally administered fluoroquinolones in dog: Enrofloxacin versus marbofloxacin. Rev Med Vet 1996; 147: 703-716.
- 14 Chen YM, Wright PJ, Lee CS, Browning GF. Uropathogenic virulence factors in isolates of Escherichia coli from clinical cases of canine pyometra and feces of healthy bitches. Vet Microbiol 2003; 94: 57-69.
- 15 Chew DJ, Dibartola SP, Schenck PA. Canine and Feline Nephrology and Urology. St. Louis (USA): Elsevier Saunders; 2011
- 16 Daube G, Mensinger S, Stephan B. Pharmacokinetics – What you need to know. Proc. 4th International Baytril®; Symposium, Florence (Italy): 18-19. June, 2009. 74-79.
- 17 Demuth D, Althaus FR. Pharmakotherapie. In: Krankheiten der Katze. Horzinek MC, Schmidt V, Lutz H. Hrsg. Stuttgart: Enke; 2003: 763-766.
- 18 van Duijkeren E, van Laar P, Houwers DJ. Cystocentesis is essential for reliable diagnosis of urinary tract infections in cats. Tijdschr Diergeneeskd 2004; 129: 394-396.
- 19 Dunning M, Stonehewer J. Urinary tract infections in small animals: pathophysiology and diagnosis. In Practice 2002; 24: 418-432.
- 20 Dunning M, Stonehewer J. Urinary tract infections in small animals: therapeutic options and management of problem cases. In Practice 2002; 24: 518-527.
- 21 Eggertsdóttir AV, Lund HS, Krontveit R, Sørum H. Bacteriuria in cats with feline lower urinary tract disease: a clinical study of 134 cases in Norway. J Feline Med Surg 2007; 09: 458-465.
- 22 Ford MM, Dubielzig RR, Giuliano EA, Moore CP, Narfström KL. Ocular and systemic manifestations after oral administration of a high dose of enrofloxacin in cats. Am J Vet Res 2007; 68: 190-202.
- 23 Frimodt-Møller N. Correlation between pharmacokinetic/pharmacodynamic parameters and efficacy for antibiotics in the treatment of urinary tract infection. Int J Antimicrob Agents 2002; 19: 546-553.
- 24 Frimodt-Møller N, Maigaard S, Madsen PO. Effect of urine concentration versus tissue concentration of ampicillin and mecillinam on bacterial adherence in the rat bladder. Invest Urol 1981; 18: 322-325.
- 25 Greene CE, Watson ADJ. Quinolones. In: Infectious Diseases of the Dog and Cat. Greene CE. ed. St. Louis (USA): Saunders Elsevier; 2006: 292-297.
- 26 Griffin DW, Gregory CR. Prevalence of bacterial urinary tract infection after perineal urethrostomy in cats. J Am Vet Med Assoc 1992; 200: 681-684.
- 27 Grobbel M, Lübke-Becker A, Alesik E, Schwarz S, Wallmann J, Werckenthin C, Wieler LH. Antimicrobial susceptibility of Escherichia coli from swine, horses, dogs and cats as determined in the BfT-GermVet monitoring program 2004–2006. Berl Münch Tierärztl Wschr 2007; 120: 391-401.
- 28 Grobbel M, Lübke-Becker A, Alesik E, Schwarz S, Wallmann J, Werckenthin C, Wieler LH. Antimicrobial susceptibility of Klebsiella spp. and Proteus spp. from various organ systems in horses, dogs and cats as determined in the BfT-GermVet monitoring program 2004–2006. Berl Münch Tierärztl Wschr 2007; 120: 402-411.
- 29 Guardabassi L, Houser GA, Frank LA, Papich MG. Guidelines for antimicrobial use in dogs and cats. Urinary tract infections (UTI). In: Guide to Antimicrobial Use in Animals. Guarddabassi L, Jensen LB, Kruse H. eds. Oxford: Blackwell; 2008: 193-196.
- 30 Gyles CL, Fairbrother JM. Escherichia coli. In: Pathogenesis of Bacterial Infections in Animals. Gyles CL, Prescott JF, Songer JG, Thoen CO. eds. Ames, Iowa (USA): Blackwell; 2004: 193-223.
- 31 Hesse A, Neiger R. Harnsteine bei Kleintieren. Stuttgart: Enke; 2008: 126-132.
- 32 Hostutler RA, Chew DJ, DiBartola SP. Recent concepts in feline lower urinary tract disease. Vet Clin North Am Small Anim Pract 2005; 35: 147-170.
- 33 Ihrke PJ, Norton AL, Ling GV, Stannard AA. Urinary tract infection associated with long-term corticosteroid administration in dogs with chronic skin diseases. J Am Vet Med Assoc 1985; 186: 43-46.
- 34 Kietzmann M, Niedorf F, Kramer S, Hoffmann M, Schneider M, Valle M, Pankow R. Plasma and urine concentrations of Marbofloxacin following single subcutaneous administration to cats. Berl Münch Tierärztl Wschr 2011; 124: 83-88.
- 35 Kruger JM, Osborne CA, Goyal SM, Wickstrom SL, Johnston GR, Fletcher TF, Brown PA. Clinical evaluation of cats with lower urinary tract disease. J Am Vet Med Assoc 1991; 199: 211-216.
- 36 Kruger JM, Conway TS, Kaneene JB, Perry RL, Hagenlocker E, Golombek A, Stuhler J. Randomized controlled trial of the efficacy of short-term amitriptyline administration for treatment of acute, non obstructive, idiopathic lower urinary tract disease in cats. J Am Vet Med Assoc 2003; 222: 749-758.
- 37 Kruth S. Urinary tract infections. In: Antimicrobial Therapy in Veterinary Medicine. Giguère S, Prescott JF, Baggot JD, Walker RD, Dowling PM. eds. Ames, Iowa, USA: Blackwell; 2006: 372-379.
- 38 Kruth S. Gram-negative bacterial infections. In: Infectious Diseases of the Dog and Cat. Greene CE. ed. St. Louis (USA): Saunders Elsevier; 2006: 320-330.
- 39 Labato MA. Uncomplicated urinary tract infection. In: Kirk’s Current Veterinary Therapy XIV. Bonagura JD, Twedt DC. eds. St. Louis (USA): Saunders Elsevier; 2009: 918-921.
- 40 Lees GE, Osborne CA. Use and misuse of indwelling urethral catheters. Vet Clin North Am Small Anim Pract 1984; 14: 599-608.
- 41 Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats. J Am Vet Med Assoc 2001; 218: 1429-1435.
- 42 Litster AL, Moss S, Platell J, Trott D. Occult bacterial lower urinary tract infections in cats – urinanalysis and culture findings. Vet Microbiol 2009; 136: 130-134.
- 43 Litster A, Thompson M, Moss S, Trott D. Feline bacterial urinary tract infections: An update on an evolving clinical problem. Vet J 2011; 187: 18-22.
- 44 Mayer-Roenne B, Goldstein RE, Erb HN. Urinary tract infections in cats with hyperthyroidism, diabetes mellitus and chronic kidney disease. J Feline Med Surg 2007; 09: 124-132.
- 45 Mehlhorn AJ, Brown DA. Safety concerns with fluoroquinolones. Ann Pharmacother 2007; 41: 1859-1866.
- 46 Meier C. Beitrag zur Bedeutung von bakteriellen Infektionserregern bei Hund und Katze – Eine Auswertung der bakteriologischen Unterschungsbefunde des Instituts für Veterinärbakteriologie. Inaugural-Dissertation; Vetsuisse-Fakultät Universität Zürich: 2004
- 47 Mulvey MA, Schilling JD, Hultgren SJ. Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection. Infect Immun 2001; 69: 4572-4579.
- 48 Osborne CA, Caywood DD, Johnston GR, Polzin DJ, Lulich JP, Kruger JM, Ulrich LK. Feline perineal urethrostomy: a potential cause of feline lower urinary tract disease. Vet Clin North Am Small Anim Pract 1996; 26: 535-49.
- 49 Osborne CA, Stevens JB. Urinalysis: A Clinical Guide to Compassionate Patient Care. Veterinary Learning Systems; USA: 1999
- 50 Ramirez CJ, Minch JD, Gay JM, Lahmers SM, Guerra DJ, Haldorson GJ, Schneider T, Mealey KL. Molecular genetic basis for fluoroquinolone-induced retinal degeneration in cats. Pharmacogenet Genomics 2011; 21: 66-75.
- 51 Ristic J, Skeldon N. Companion animal practice: Urinalysis in practice – an update. In Practice 2011; 33: 12-19.
- 52 Ross DL, Riley CM. Dissociation and complexation of the fluoroquinolone antimicrobials – an update. J Pharm Biomed Anal 1994; 12: 1325-1331.
- 53 Scheer M. Concentrations of active ingredient in the serum and in tissues after oral and parenteral administration of Baytril®. Vet Med Res 1987; 02: 104-118.
- 54 Seguin MA, Papich MG, Sigle KJ, Gibson NM, Levy JK. Pharmacokinetics of enrofloxacin in neonatal kittens. Am J Vet Res 2004; 65: 350-356.
- 55 Senior DF. Management of urinary tract infections. In: Manual of Canine and Feline Nephrology and Urology. Elliott E, Grauer GF. eds. Quedgeley (UK): BSAVA; 2007: 282-289.
- 56 Spreng M, Delforge J, Thomas V, Boisramé B, Drugeon H. Antibacterial activity of marbofloxacin. A new fluoroquinolone for veterinary use against canine and feline isolates. J Vet Pharmacol Ther 1995; 18: 284-289.
- 57 Syme HM. Feline UTIs: Are they common?. Proc. BSAVA Congress; Birmingham: 7-10. April, 2005. 264-266.
- 58 Vallé M. et al. Epidemiosurveillance Study Vétoquinol; Enterobacteriaceae, Ps. aeruginosa, Staphylococcus spp. and Pasteurella multocida isolated from dogs and cats with urinary tract infections. 1994-2007. unpublished.
- 59 Wamsley H, Alleman R. Complete urinalysis. In: Manual of Canine and Feline Nephrology and Urology. Elliott E, Grauer GF. eds. Quedgeley (UK): BSAVA; 2007: 87-116.
- 60 Werckenthin C, Alesik E, Grobbel M, Lübke-Becker A, Schwarz S, Wieler JLH Wallmann. Antimicrobial susceptibility of Pseudomonas aeruginosa from dogs and cats as well as Arcanobacterium pyogenes from cattle and swine as determined in the BfT-GermVet monitoring program 2004–2006. Berl Münch Tierärztl Wschr 2007; 120: 412-422.
- 61 Wiebe V, Hamilton P. Fluoroquinolone-induced retinal degeneration in cats. J Am Vet Med Assoc 2002; 221: 1568-1571.