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Treatment of refractory sino‐nasal aspergillosis with posaconazole and terbinafine in 10 dogs
Author(s) -
Stewart J.,
Bianco D.
Publication year - 2017
Publication title -
journal of small animal practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 67
eISSN - 1748-5827
pISSN - 0022-4510
DOI - 10.1111/jsap.12686
Subject(s) - medicine , posaconazole , refractory (planetary science) , aspergillosis , terbinafine , adverse effect , surgery , combination therapy , doxycycline , gastroenterology , anesthesia , dermatology , amphotericin b , antibiotics , antifungal , itraconazole , immunology , physics , astrobiology , microbiology and biotechnology , biology
Objectives To determine the safety and efficacy of posaconazole and terbinafine for the treatment of naturally occurring sino‐nasal aspergillosis in dogs refractory to conventional topical and systemic treatment. Materials and Methods Ten client‐owned dogs with sino‐nasal aspergillosis and not responsive to conventional treatments were prospectively enrolled to receive a dose of 5 mg/kg posaconazole orally every 12 hours for six months. All dogs were concurrently treated with doses of 30 mg/kg terbinafine orally every 12 hours and 5 mg/kg doxycycline orally every 12 hours for 6 to 18 months. Results All 10 enrolled dogs completed the study. The treatment response was defined as complete clinical remission (n=7) or partial clinical remission (n=3). Two dogs relapsed after cessation of combination therapy. All dogs lived more than one year after starting combination therapy and eight dogs are alive at the time of writing. No clinically relevant adverse reactions or increases in hepatic enzyme activity occurred during the combination therapy. Clinical Significance The results of this study suggest that this combination therapy appears safe and well‐tolerated for the treatment of refractory sino‐nasal aspergillosis in dogs. Long‐term survival is possible with prolonged treatment, but relapse is possible. Larger prospective studies are warranted to further evaluate these preliminary findings.