Einsatz von Fluorchinolonen bei bakteriellen Harnwegsinfektionen der Katze

S. Kramer; M. Kietzmann; W.-R. Pankow

doi:10.1055/s-0038-1623636

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2012; 40(02): 113-121
DOI: 10.1055/s-0038-1623636

Übersichtsartikel

Schattauer GmbH

Einsatz von Fluorchinolonen bei bakteriellen Harnwegsinfektionen der Katze

The use of fluoroquinolones in bacterial urinary tract infections in cats

Authors

S. Kramer

¹Klinik für Kleintiere der Stiftung Tierärztliche Hochschule Hannover
M. Kietzmann

²Institut für Pharmazie, Pharmakologie und Toxikologie2 der Stiftung Tierärztliche Hochschule Hannover
W.-R. Pankow

³Vétoquinol GmbH, Ravensburg

Abstract

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.

Schlüsselwörter

Bakterielle Harnwegsinfektion - Katze - Antibiotika - Pharmakokinetik - Fluorchinolone - Marbofloxacin

Key words

Urinary tract infection - cat - antibiotics - pharmacokinetics - fluoroquinolones - marbofloxacin

Full Text

References

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