AB in Companion Animals Flashcards by Benedicte Mæhlum

Do you need systemic treatment in surface pyoderma?

no, local

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Do you need systemic treatment in superficial pyoderma?

topical as a start, usually need systemic also

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Pathogenic bacteria in pyoderma:

Staphylococcus pseudointermedius 
S.aureus + streptococcus cani 
S.pseudomedius 
E.coli
P.aeruginosa

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1st choice treatment of pyoderm caused by P.pseudointermedius :

Cephalosporin, cephalexin.

Amox + clav can also be.

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Why don’t we use penicillinase stable AB inpyoderm caused by P.pseudointermedius :

not good orally

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Drug for pyoderma that can be used against MRSA, MRSP:

Mupirocin - local

Fusidic acid when mupirocin is not available

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what are the AB that can be used emperically in pyoderma: (1st line)

1st gen cephalosporins - cephalexin
Amox+clav
3rd cephalosporins - cefovecin (CIA..) 
Lincosamides - clindamycin
PotSA  - Sulfamethoxazol + TMP

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2nd line drugs of pyoderma (only after susceptibility test):

Fluoroquinolones:
2nd gen : Enro, Marbo, Cipro - best

4th gen : Pradofloxacin - Last choice!

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Which bacteria is ciprofloxacin very good against (pyoderma):

against strept, staphylococcus, pseudomonas, e.coli

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Local drugs against MRSP, MRSA (pyoderma):

Mupirocin, fusidic

Combinations should be used because of one step mutations

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systemic drugs against MRSP, MRSA (pyoderma):

Rifampicin (combination) - hepatotox (give protectants)
Amikacin - nephrotox
Florfenicol - not convenient here (some countries have chloramphenicol)

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3rd line treatment of pyoderma:

remember always susceptibility test!!!!

Macrolides - Azithromycin, clarithromycin

AMEG A - vancomycin, teicoplanin, linezolid
nephrotox, never in FPA

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If you were to give a pyoderma treatment to a dog and the dog needed to be on the drugs for 5 weeks, how many weeks should the dog be on the treatment?

6 weeks!!!! Always one week more of recovery !!!!

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Is systemic treatment needed for otitis externa?

not without complications

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Is systemic treatment needed for otitis media?

yes

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Otitis treatment with gram + bacteria:

Wash so the AB can reach the bacteria.

Ear drop with:

Gentamicin – ototoxic – check membrane!!
Polymyxin-b– check membrane!!

What can you use if the tympanic membrane is damaged?

Orbifloxacin
Marbofloxacin
Florfenicol

Systemic - same as pyoderma

Otitis treatment with gram - bacteria: (local)

Pseudomonas:
Local cleaner–kill biofilm
- EDTA + combination with chlorhexidine

Local (ear drop)

Gentamicin (1st) – check membrane
Tobramycin(1st) - check membrane
Polymyxin-b
Marbofloxacin

Systemic:
-Glucocorticoids inj.

Otitis treatment with gram - bacteria: (systemic)

Glucocorticoids inj. - if it is so painful that we can’t clean it. will reduce the swelling.

(After test )
Per os: ciprofloxacin (1st)&raquo_space;marbofloxacin&raquo_space; enrofloxacin (cats very harmful!! – retinopathy )

Gram + bacteria causing otitis:

Staphylococcus pseudintermedius
(+ others)
Streptococcus canis
Streptococcus otitis

Gram - bacteria causing otitis:

Pseudomonas aeruginosa

E.coli

Mastitis is dogs and cats -

Pathogenic bacteria:

Staphylococcus spp. (g+)
Streptococcus spp. (g+)
E. coli (endotoxin – G-)

If the mastitis is caused by e.coli what medication should we give with the AB?

Meloxicam (NSAIDs) because it has antiendotoxic effect

Systemic treatment of septic mastitis:

Amox + clav + enrofloxacin

Why can we use amoxcillin inseptic mastitis if it does not penetrate the milk-blood barrier?

If the mastitis is septic the barrier are broken and the AB can reach it.

Systemic treatment of non- septic mastitis:

TEST FIRST! YOU HAVE TIME! AB that penetrate the Milk-blood barrier: - Clindamycin – lincosamides - Macrolides Gram-negative - Fluoroquinolones

If the dog has puppies but need AB treatment what should we do?

- Puppies will get the AB, so artificial milk are needed and milking out the milk. - If the owner don’t want to, diarrhea can happen (not good for baby pups :( ) -Fluoroquinolones – cartilage damage, not given under 1 year of age. (Off- label)

When should we avoid usage of AB?

Milder cases that can be healed by them self, where bacteria is not present or no infective agents at all!

Pathogens of gingivitis

- Streptococcus spp., - Pasteurella spp., - Porphyromonas spp. After a while : Bacteroides spp., Fusobacterium spp., Porphyromonas spp., Prevotella spp.

Treatment of gingivitis:

Amoxicillin + clavulanic acid (1st) Metronidazole + spiramycin Cefovecin – only if the other don’t work Pradofloxacin, clindamycin and apiramycin – If the bones are infected- not amox!