Effective antifungal treatments for Malassezia skin infection in dogs

Abstract

AbstractThe aim of this systematic review was to evaluate the efficacy of antifungal treatments forMalasseziadermatitis in dogs and, when possible, to propose recommendation for or against their use.Electronic searches were carried out using PubMed MEDLINE®, CABDirect and CONSULTANT database. The volumes ofAdvances in Veterinary Dermatology, the proceedings of ESVD/ECVD and AAVD/ACVD congresses were hand‐searched for studies relevant to this review. All articles and book chapters discussing treatment ofMalasseziadermatitis were scanned for additional citations. Lastly, a request was sent to the Vetderm Listserv to share recent clinical trials. The analysis evaluated study design, methodology quality, subject enrolment quality, type of interventions and outcome measures.The searches identified 35 articles, and 14 trials that fulfilled the following selection criteria: (i)in vivoclinical trials, (ii) dogs showing clinical lesions ofMalasseziadermatitis and (iii) enrolment of at least five dogs. Among these, only eight studies fulfilled the following additional criterion: (iv) prospectivein vivoclinical trials reporting clinical and mycological outcome measures. A total number of 14 different treatment protocols included four blinded, randomized and controlled trials (quality of evidence grade A), four controlled studies lacking blinding and/or randomization (grade B), five open uncontrolled trials (grade C) and one descriptive study (grade D).This systematic review allowed us to recommend, with good evidence, the use of only one topical treatment ofMalasseziadermatitis (2% miconazole nitrate +2% chlorhexidine, twice a week for 3 weeks) and with fair evidence the use of two systemic treatments with azole derivatives (ketoconazole, 10 mg kg−1 day−1and itraconazole, 5 mg kg−1 day−1for 3 weeks).