Antibiotic Choices Flashcards by Thomas Conway

A young mixed breed dog presents with chronic diarrhoea. A faecal sample confirms Giardia. What is the appropriate treatment?

Fenbendazole

(Metronidazole ONLY if fenbendazole + environmental management fail)

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A Labrador puppy presents with haemorrhagic diarrhoea, fever, and lethargy. Bloodwork reveals neutropenia. What are the appropriate antibiotics choice?

Ampicillin or amoxicillin or cefalexin

Amoxicillin/clavulanate

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A Boxer presents with chronic diarrhoea of >3 weeks. Faecal exams and diet trials have not resolved the issue. When should antibiotics be considered?

A) Immediately prescribe metronidazole

B) After ruling out other causes and trialling diet changes

C) If there is evidence of bacterial overgrowth on culture

D) Empirical fluoroquinolone use

B and C

A prednisolone trail should also be performed before prescribing antibiotics.

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A middle-aged Cocker Spaniel presents with vomiting, jaundice, and elevated liver enzymes. Ultrasound shows bile duct inflammation. What are the appropriate antibiotic choices (first line and refractory cases)?

Amoxicillin/clavulanate
Ampicillin
Cefalexin

Refractory:
Marbofloxacin or enrofloxacin (dogs only) -> treat for 2 weeks then reassess. Monitor liver enzyme activities and bilirubin

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A female Dachshund presents with pollakiuria and haematuria. Urinalysis confirms a urinary tract infection. What are the most appropriate antibiotic choices?

Amoxicillin (± clavulanate)
Trimethoprim/sulphonamide

(Treat for 3-5 days)

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A neutered female Labrador presents with recurrent urinary tract infections. Previous cultures showed susceptibility to amoxicillin/clavulanate. Pending susceptibility results, what is the best empirical antibiotic choice?

A) Amoxicillin (± clavulanate)

B) Trimethoprim/sulphonamide

C) Fluoroquinolone

D) Doxycycline

B) Amoxicillin (± clavulanate)

If previous treatment was successful, use the SAME antibiotic as before.

If treatment was not successful - move onto another antibiotic (TMPS) while susceptibility testing is pending

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A 6-year-old intact male Golden Retriever presents with dysuria, tenesmus, and fever. Abdominal ultrasound reveals an enlarged prostate. What is the appropriate Treatment plan?

Start on antibiotics:
- TMPS
- Enrofloxacin or marbofloxacin

Treat for 2-4 weeks AND perform medical/surgical castration.

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A Cocker Spaniel presents with recurrent lower urinary tract signs. Urinalysis shows struvite crystals. What is the best treatment approach (choose 2)?

A) Amoxicillin (± clavulanate)

B) Fluoroquinolone

C) Dietary dissolution and urine acidification

D) Immediate surgery

A and C:
- Amoxicillin (± clavulanate)
- Dietary dissolution and urine acidification

Can consider surgical removal

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A middle-aged Labrador presents with polyuria, polydipsia, fever, and renal pain. Urinalysis shows pyuria and bacteriuria. What are the best antibiotic choices?

Fluroquinolone
TMPS

Consider IV is signs of sepsis

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A Spaniel with a recent fracture repair surgery presents with lameness, swelling, and purulent discharge at the surgical site. Radiographs suggest osteomyelitis. Which antibiotic is appropriate?

A) Cefalexin

B) Cefuroxime

C) Amoxicillin/clavulanate

D) Metronidazole

C) Amoxicillin/clavulanate

And culture fresh tissue!

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A 7-year-old Border Collie presents with facial swelling, pain, and pyrexia. There is evidence of an infected tooth root. What is the most appropriate antibiotic therapy?

A) Amoxicillin/clavulanate

B) Metronidazole

C) Doxycycline

D) Fluoroquinolone

A) Amoxicillin/clavulanate

(Treat for emergency pain relief; definitive treatment requires dental intervention)

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A 5-year-old domestic shorthair cat presents with gingivitis, halitosis, and mild oral pain. There are no signs of deep infection or abscess formation. What is the most appropriate first-line treatment?

A) 0.12% chlorhexidine mouthwash or gels/pastes

B) Amoxicillin/clavulanate

C) Metronidazole

D) Doxycycline

A) 0.12% chlorhexidine mouthwash or gels/pastes

(Oral infections without systemic involvement can often be managed with topical treatments)

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A Cocker Spaniel presents with conjunctival hyperaemia and ocular discharge. There are no other ocular abnormalities. Which antibiotics are appropriate?

Fusidic acid
Chlortetracycline
Chloramphenicol

Consider viral infections if not responding.

Primary bacterial causes of conjunctivitis are uncommon in dogs - rule out KCS, allergic disease, eyelid abnormalities

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A cat presents with persistent conjunctivitis and ocular discharge. PCR confirms Chlamydophila felis. What is the appropriate treatment?

Systemic doxycycline
Amoxicillin/clavulanate (pregnant queens/kittens)

(Treat for 21–28 days)

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A cat presents with conjunctivitis and mild respiratory signs. Cytology confirms Mycoplasma felis. What is the most appropriate treatment?

Topical chlortetracycline
Systemic doxycycline

(Treat for 21–28 days)

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A Labrador presents with blepharospasm and mild ocular discharge. Fluorescein stain reveals a superficial corneal ulcer. What is the appropriate antibiotic therapy?

Topical chloramphenicol

(Treat until the corneal ulcer has re-epithelialized. If failing to heal rule out KCS and eyelid abnormalities)

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A Spaniel presents with a deep corneal ulcer and stromal loss. Cytology reveals bacterial infection. What are the best antibiotic choices?

Topical chloramphenicol + gentamicin

Topical chloramphenicol + ciprofloxacin

Topical chloramphenicol + ofloxacin

(if corneal perforation, consider systemic amoxicillin/clavulanate)

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A Boxer presents with exophthalmos, pain on opening the mouth, and fever. Advanced imaging suggests an orbital abscess. What are the best initial antibiotic choices?

Amoxicillin/clavulanate

Cefalexin + metronidazole

Cefalexin + clindamycin

(Treat for a minimum of 2 weeks; consider drainage via oral mucosa behind last molar)

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A Border Collie presents with pyrexia, tachycardia, and hypotension. Bloodwork reveals systemic inflammatory response. What is the best empirical antibiotic therapy?

How does this change if there has been recent (<3 months) beta lactam administration?

Amoxicillin/clavulanate

Recent beta lactam = Fluoroquinolone + Clindamycin
- Enrofloxacin (dogs)
- Marbofloxacin (cats)

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A Golden Retriever presents with abdominal pain, vomiting, and fever. Abdominal ultrasound reveals free fluid. You confirm septic peritonitis What are the best initial antibiotic choices?

How would this change if the colon was perforated?

Amoxicillin/clavulanate (if recent beta lactam administration, then ADD fluroquinolone)

Cefuroxime + Clindamycin

If colonic perforation = ADD Metronidazole to above choices.

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A Border Collie presents for a routine check-up. Bloodwork reveals a mild neutropenia (>1000/µl) but the dog is otherwise well. What is the recommended treatment?

A) No antibiotics required

B) Cefalexin PO

C) Amoxicillin/clavulanate PO

D) Trimethoprim/sulphonamide PO

No antibiotic required unless signs of infection develop

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A Springer Spaniel presents with moderate neutropenia (<1000/µl) but is clinically stable. What is the recommended antibiotic choice (multiple correct answers)?

B) Cefalexin PO

C) Amoxicillin/clavulanate PO

D) Trimethoprim/sulphonamide PO

A Doberman presents with pyrexia, lethargy, and severe neutropenia (<500/µl). What is the best antibiotic choice?

A) Amoxicillin/clavulanate IV

B) Cefalexin PO

C) Trimethoprim/sulphonamide IV

D) Fluoroquinolone IV

Amoxicillin/clavulanate IV

Another choice would be = Cefuroxime IV

Which of the following scenarios would require IV antibiotics and which IV antibiotics would you give?

A) Moderate neutropenia (<1000/µl)

B) Mild neutropenia (>1000/µl)

C) Severe neutropenia (<500/µl).

D) Moderate neutropenia (<1000/µl) and unwell

E) Mild neutropenia (>1000/µl) and unwell

C) Severe neutropenia (<500/µl).

D) Moderate neutropenia (<1000/µl) and unwell

E) Mild neutropenia (>1000/µl) and unwell

Amoxicillin/clavulanate IV

Cefuroxime IV

A German Shepherd presents with progressive ataxia, spinal pain, and fever. MRI confirms discospondylitis. What are the appropriate antibiotic choices?

Cefalexin Amoxicillin/clavulanate Trimethoprim/sulfadiazine Clindamycin IV if severe neurological compromise or signs of sepsis. Treat for 6-8 weeks.

A Labrador presents with a swollen, painful stifle joint and fever. Synovial fluid analysis shows neutrophilic inflammation with intracellular bacteria. What are the appropriate antibiotic choices?

Cefalexin Amoxicillin/clavulanate (Treat for 4 weeks or until synovial fluid neutrophils <3%)

A Spaniel with a recent fracture repair presents with lameness, swelling, and purulent discharge at the surgical site. Radiographs suggest osteomyelitis. What are the appropriate antibiotics?

Cefalexin or Cefuroxime Amoxicillin/clavulanate IV for 2–3 days, then oral for 6–8 weeks

A Labrador presents with a moist, inflamed lesion on the neck. Cytology shows cocci and diagnose a surface pyoderma. What is the best treatment approach? A) Topical 2–4% chlorhexidine B) Systemic cefalexin C) Fusidic acid ± glucocorticoid D) Systemic amoxicillin/clavulanate

Topical 2–4% chlorhexidine If severe or unresponsive: Fusidic acid ± glucocorticoid (cocci), silver sulphadiazine (rods)

A Bulldog presents with pruritus and crusted papules. Cytology reveals cocci and you diagnose a superficial pyoderma. What is the most appropriate antibiotic therapy? A) Topical 2–4% chlorhexidine B) Systemic clindamycin C) Systemic clindamycin D) Systemic amoxicillin/clavulanate

Topical 2–4% chlorhexidine If non-responsive, use in conjunction with a topical antimicrobial: Systemic clindamycin Systemic cefalexin Systemic amoxicillin/clavulanate Systemic TMPS

A German Shepherd presents with painful skin lesions and draining tracts. Cytology shows intracellular cocci and you diagnose a deep pyoderma. What is the best approach? A) Systemic clindamycin B) Systemic cefalexin C) Topical 2–4% chlorhexidine and Culture and susceptibility testing D) Systemic amoxicillin/clavulanate

Topical 2–4% chlorhexidine and Culture and susceptibility testing (Systemic antibiotics only if painful/septic, while awaiting culture results - Treat for at least 3 weeks and reassess every 2 weeks)

A small breed dog presents with scooting and perianal discomfort. There is mild swelling but no evidence of abscessation. What is the best treatment approach? A) Manual evacuation and flushing with chlorhexidine B) Systemic antibiotics C) Topical polypharmacy ear product D) Fluoroquinolone

Manual evacuation and flushing with chlorhexidine +/- Topical polypharmacy ear product

A Terrier presents with a swollen, painful perianal area and purulent discharge. What antibiotics are appropriate? A) Trimethoprim/sulphonamide B) Amoxicillin/clavulanate C) Cefalexin D) Fluoroquinolone

(Drain and flush as appropriate; treat for cellulitis if present) A) Trimethoprim/sulphonamide B) Amoxicillin/clavulanate

A Cocker Spaniel presents with erythematous, pruritic ear canals and malodorous discharge. Cytology reveals cocci. What is the best treatment approach? A) Antiseptic ear cleaner B) Topical fusidic acid/framycetin C) Systemic antibiotics D) Antiseptic ear cleaner + topical +/- systemic steroid products

D) Antiseptic ear cleaner + topical +/- systemic steroid products (Systemic antibiotics not indicated unless otitis media is suspected)

When treating otitis externa, what would you start on, and when would you introduce topical antibiotics?

Start on:Antiseptic ear cleaner + topical +/- systemic steroid products Use topical antibiotics if no response after 7 days: - Topical fusidic acid/framycetin - Topical florfenicol

A Labrador presents with head shaking and purulent ear discharge. Cytology reveals rods. What is the treatment approach? How would this change if Pseudomonas was cultured?

Antiseptic ear cleaner while awaiting culture Topical gentamicin Topical framycetin If Pseudomonas is cultured, add Tris-EDTA and continue topical antibitic = Treat until cytology is negative

A young Beagle presents with a persistent, dry, hacking cough lasting more than 10 days. The dog is otherwise bright and eating well. What are the best antibiotic choices (if any)?

Doxycycline Amoxicillin/clavulanate (Treat only if signs persist >10 days and/or the dog is unwell) Culture nasal tissue (not nasal discharge) for refractory cases!

A cat presents with sneezing, ocular discharge, and mild lethargy. Symptoms have persisted for more than 10 days. What are the best antibiotic choices (if any)?

Doxycycline Amoxicillin/clavulanate (Treat only if signs persist >10 days and/or the dog is unwell) Culture nasal tissue (not nasal discharge) for refractory cases!

A Golden Retriever presents with tachypnoea, coughing, and lethargy. Thoracic radiographs confirm pneumonia. What is the first-line antibiotic choice? What is the antibtioc of choice is this first line fails? What is there is suspected Bordetalla Bronchiseptica

Amoxicillin/clavulanate (Oxygen therapy and analgesia may be sufficient in some cases) If deterioration or failure to respond: Fluoroquinolone + Clindamycin Suspected Bordetalla Bronchiseptica: Doxycycline

A Border Collie presents with respiratory distress. Thoracic ultrasound confirms pleural effusion, and thoracocentesis reveals purulent fluid. What are the choices for initial antibiotic therapy? How does this change if norcardia suspected?

Amoxicillin/clavulanate IV If recent beta-lactam use: Clindamycin + Enrofloxacin (dogs) or Marbofloxacin (cats) Norcardia: TMPS

A dog is undergoing a surgical procedure. Under what conditions would prophylactic antibiotics be indicated? A) Clean surgery lasting <90 minutes B) Surgery involving an implant or joint capsule penetration C) Routine dental procedures D) Postoperative use for any procedure Are there any other situations where prophylactic antibiotic would be considered? What would you add if anaerobic involvement is highly likely?

B) Surgery involving an implant or joint capsule penetration Prolonged clean surgery >90 minutes, Entry into a hollow viscus In debilitated or immunosuppressed patients Anaerobic involvement --> add metronidazole!

A patient requires perioperative antibiotic prophylaxis for a prolonged clean surgery. Which antibiotics are appropriate?

Cefuroxime IV Cefazolin IV Amoxicillin/clavulanate IV (Administer 30–60 minutes before incision; add metronidazole for colonic surgery)

A female dog presents with an open cervix pyometra and systemic illness. An ovariohysterectomy is planned. What antibiotics are appropriate perioperatively?

If stable - No antibiotics If unwell, consider: - Amoxicillin (± clavulanate) - Cefalexin + enrofloxacin

A client opts for medical management of a closed cervix pyometra in a breeding bitch. What is the appropriate antibiotic therapy?

Amoxicillin (± clavulanate)

A lactating bitch presents with a swollen, painful mammary gland and fever. What are the most appropriate antibiotic choices for mastitis?

Cefalexin Amoxicillin/clavulanate TMPS (Treat for 2-3 weeks or until offspring are weaned (early weaning is NOT recommend))

A cat presents with lethargy, pale mucous membranes, and regenerative anaemia. PCR confirms Mycoplasma haemofelis. What is the appropriate treatment? A) Doxycycline B) Amoxicillin/clavulanate C) Metronidazole D) Trimethoprim/sulphonamide

A) Doxycycline (Treat for 2–4 weeks)

A dog presents with jaundice, azotaemia, and fever. PCR confirms Leptospira infection. What are the appropriate antibiotics?

Doxycycline Amoxicillin (+/- clavulanate)

A dog with chronic liver disease presents with neurological signs. Diet and lactulose have been ineffective. What is the initial treatment plan and what are antibiotics are considered?

Diet and lactulose should be first line therapies. Antibiotics should only be used if signs persist: - Metronidazole (at a reduced dose) - Amoxicillin - Ampicillin Use until clinical signs are controlled.

A Jack Russell Terrier presents with a small superficial bite wound but is otherwise bright and eating well. What is the best treatment approach? A) Wound lavage with isotonic solution B) Systemic amoxicillin/clavulanate C) Systemic cefuroxime D) Fluoroquinolone

Wound lavage with isotonic solution (Systemic antibiotics not required unless signs of infection develop)

A Border Collie has sustained a traumatic wound over the thoracic region. What is the first thing you do? A) Wound lavage with saline B) Further investigation (imaging, surgical exploration) C) Systemic amoxicillin/clavulanate D) No treatment needed

Further investigation (imaging, surgical exploration) - Consider antibiotics later if there is suspicion of cavity penetration.

A Golden Retriever presents with multiple bite wounds, pyrexia, and lethargy. What are the appropriate antibiotic choices?

Amoxicillin/clavulanate Cefuroxime ± cefalexin Antibiotics use if systemically unwell. pyrexic or suspicion of cavity penetration.

A dog presents with a fresh bite wound at a critical site. What is the best antibiotic choice for short-term prophylaxis? A) No antibiotics B) Amoxicillin/clavulanate C) Fluoroquinolone D) Trimethoprim/sulphonamide What else would you do alongside antibiotics?

Amoxicillin/clavulanate (for 1–3 days) - Short-term prophylaxis may be used for critical sites Thorough flushing with saline + open wound management.

A dog presents with mild erythema and exudate from a recent surgical incision, but is otherwise well. What is the best treatment approach? A) Frequent saline lavage B) Systemic cefalexin C) Systemic fluoroquinolone D) Systemic metronidazole

A) Frequent saline lavage (Topical management is preferred unless deeper infection develops)

A Labrador presents with purulent discharge and local cellulitis around a surgical incision site. What antibiotics are appropriate?

Cefuroxime or Cefalexin Amoxicillin/clavulanate Add Fluoroquinolone to above (if rods are seen on cytology) If there is a history of MRSP/MRSA - await susceptibility results before adapting treatment.

A German Shepherd presents with an infected orthopaedic implant and systemic signs of illness. What is the best initial approach?

Systemic antibiotics based on cytology. Can start on; - Cefuroxime or Cefalexin - Amoxicillin/clavulanate - Add Fluoroquinolone to above (if rods are seen on cytology Removal of infected implant material Wound lavage (Source control is critical for successful treatment)