Efficacy of Atovaquone and Azithromycin or Imidocarb Dipropionate in Cats with Acute Cytauxzoonosis
Efficacy of Atovaquone and Azithromycin or Imidocarb Dipropionate in Cats with Acute Cytauxzoonosis
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DOI：
10.1111/j.1939-1676.2010.0646.x
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发表时间：
2011-01-01
影响因子：
2.6
通讯作者：
Craig, A. W.
中科院分区：
文献类型：
--
作者：
Cohn, L. A.;Birkenheuer, A. J.;Craig, A. W.
BackgroundImidocarb or a combination of atovaquone and azithromycin (A&A) has been suggested for treatment of cats with cytauxzoonosis, but neither has been prospectively evaluated for efficacy.Hypothesis/ObjectivesThat survival to hospital discharge is improved by treatment with A&A as compared with imidocarb.AnimalsEighty acutely ill cats with Cytauxzoon felis infection treated at one of 18 veterinary clinics in 5 states.MethodsAn open-label, randomized prospective study compared survival in cats treated with atovaquone (15 mg/kg PO q8h) and azithromycin (10 mg/kg PO q24h) or imidocarb (3.5 mg/kg IM). All received heparin, fluids, and supportive care. Clinical and clinicopathologic data from initial presentation were collated. Parasitemia was quantified (n = 79) and pathogens genotyped (n = 60). Logistic regression was used to determine the impact of treatment group on the primary endpoint, survival to hospital discharge or death. Covariants were analyzed by rank-sum testing.ResultsOf 53 cats treated with A&A, 32 (60%) survived to discharge while only 7 of 27 cats (26%) treated with imidocarb survived (P = .0036; odds ratio 7.2, 95% CI 2.2, 24). Cats with a lower parasitemia were more likely to survive, as were cats with higher white blood cell counts and lower total bilirubin. Unique pathogen genotypes were identified from 15 cats, while genotype isolated from 21 cats had been described previously. There were multiple pathogen genotypes identified in 24 cats.Conclusions and Clinical ImportanceSurvival to discharge was more likely in cats treated with A&A as compared with imidocarb, although case fatality rate remained high.
