Abstract：
Pyometra is a bacterial uterine infection that frequently affects intact older bitches. The treatment of choice is ovariohysterectomy, often associated with perioperative antimicrobial therapy. The aim of this retrospective investigation was to evaluate the antibiotic choice at different administration times (pre-surgery, at surgery/during hospitalization, and post-surgery) against complications and outcomes, considering the susceptibility profile of bacteria. The medical records of 51 bitches referred to the Veterinary Teaching Hospital of the University of Turin (January 2021-November 2023) and subjected to ovariohysterectomy and bacteriological examination (bacterial culture and susceptibility tests) of the uterine exudate, were analysed. All animals had a positive outcome without surgical site infections, with a longer hospitalization time in case of peritonitis or sepsis; antimicrobials were administered for an average of 7 days. Comparing the susceptibility of the isolated bacteria towards the antimicrobials administered before, during and after surgery, complete efficacy was observed in 42 %, 46 % and 50 % of cases, respectively. In addition, 5/16 peritonitis cases were treated with an in vitro ineffective antimicrobial, and 30 % of the bitches never received a fully effective antibiotic, according to susceptibility tests using the minimum inhibitory concentration method (MIC). Cephazolin resulted the best option for Escherichia coli, the most frequently isolated bacterium. Our study confirms that pyometra has a good prognosis following ovariohysterectomy and antibiotic administration. Monitoring the clinical evolution without changing the antibiotic according to bacterial susceptibility could represent the right choice in uncomplicated cases. Evaluation of outcomes without postoperative antibacterial treatment or with a shorter course would be another topic worth investigating, with the aim to judiciously reduce the use of antibiotics.
摘要：
Pyometra是一种细菌性子宫感染，经常影响完整的老年母犬。选择的治疗方法是卵巢子宫切除术，常与围手术期抗菌治疗相关。这项回顾性调查的目的是评估不同给药时间的抗生素选择（手术前，在手术/住院期间，和手术后）针对并发症和结果，考虑到细菌的敏感性。51只母犬的医疗记录转诊到都灵大学兽医教学医院（2021年1月至2023年11月），并接受卵巢子宫切除术和子宫渗出物的细菌学检查（细菌培养和药敏试验），进行了分析。所有动物都有积极的结果，没有手术部位感染，在腹膜炎或败血症的情况下，住院时间更长；平均服用抗生素7天。比较分离的细菌对之前施用的抗微生物剂的敏感性，手术期间和之后,在42%中观察到完全疗效，46%和50%的病例，分别。此外,5/16例腹膜炎病例采用体外无效抗菌药物治疗，30%的母狗从未接受过完全有效的抗生素，根据药敏试验采用最小抑制浓度法(MIC)。头孢唑林是大肠杆菌的最佳选择，最常见的细菌。我们的研究证实卵巢子宫切除术和抗生素给药后子宫积脓具有良好的预后。在不复杂的病例中，监测临床演变而不根据细菌敏感性改变抗生素可能是正确的选择。在没有术后抗菌治疗或病程较短的情况下评估结果将是另一个值得研究的主题，目的是明智地减少抗生素的使用。
