Treatment options for dogs diagnosed with sinonasal aspergillosis

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PICO question In dogs diagnosed with SNA, does inclusion of debridement in the treatment protocol improve clinical outcomes compared to dogs treated without debridement? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed No papers that directly addressed the PICO were reviewed. Four retrospective case series which partially addressed the PICO question were discussed in the appraisal. Strength of evidence Zero. Outcomes reported None. Conclusion No conclusions can be made based on the current level of evidence, however the studies discussed in the appraisal suggest that there may be an association between the inclusion of debridement in the treatment protocol for SNA and an improved clinical outcome. Undertaking further higher-level studies (comparative, blind, prospective, randomised) would be required to confirm this. Ethical implications would not preclude such studies, for there is evidence that treatment protocols including topical deposition of antifungal agents alone are efficacious. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.