Randomized, Controlled, Crossover trial of Prevention of Clindamycin-Induced Gastrointestinal Signs Using a Synbiotic in Healthy Research Cats

Abstract

Background: Synbiotics often are prescribed to limit antibiotic-associated gastrointestinal signs (AAGS) in cats, but data to support this recommendation are lacking.

Objective: To determine whether synbiotic co-administration mitigates AAGS in healthy research cats treated with clindamycin.

Animals: 16 healthy research cats.

Methods: A randomized, double-blinded, placebo-controlled, 2-way, 2-period, crossover study with a 6-week washout was performed. Each study period consisted of a 1-week baseline and a 3-week treatment period. Cats received 75 mg clindamycin with food once daily for 3 weeks, followed 1 hour later by either 2 capsules of a synbiotic or placebo. Food consumption, vomiting, fecal score, and completion of treatment were compared using repeated measures split plot or crossover designs with covariates, with P < 0.05 considered significant.

Results: Cats that received the synbiotic were more likely to complete treatment in period 1 (100% vs. 50%, P = 0.04). Cats vomited less when receiving the synbiotic but this was not significant, but there were significant period effects (F-value = 11.4, P < 0.01). Cats had higher food intake while receiving the synbiotic (F-value = 31.1, P < 0.01) despite period effects (F-value = 8.6, P < 0.01). There was no significant effect of treatment on fecal scores, which significantly increased over time (F-value = 17.9, P < 0.01).

Conclusions and clinical importance: Administration of a synbiotic 1 hour after clindamycin administration decreased hyporexia and vomiting in healthy cats. Additionally, significant period effects suggest that clinical benefits of synbiotic administration persist for at least 6 weeks after discontinuation, decreasing the severity of AAGS in cats that subsequently received clindamycin with placebo. Unlike in people, synbiotic administration did not decrease antibiotic-associated diarrhea.

Keywords: Antibiotic-associated diarrhea; Antibiotic-associated gastrointestinal signs; Diarrhea and vomiting; Probiotic.

Figure 1

Percentage of 16 healthy cats, 8 per group, that completed treatment with 75 mg clindamycin PO once daily for 21 days, followed 1 hour later by 2 capsules of either placebo or synbiotic PO. Group A: Cats in the column represented by a dashed bar received placebo during period 1 and synbiotic in period 2. Group B: Cats in the column represented by a solid bar received synbiotic during period 1 and plaecbo during period 2.