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CRS2 > Antibiotic Selection > Flashcards

Antibiotic Selection Flashcards

1
Q

Which antibiotics are beta-lactams?

A

Penicillin and cephalosporins

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2
Q

How do beta-lactams work?

A
  • Inhibit cell wall synthesis
  • Bactericidal
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3
Q

Spectrum of activity of beta-lactams?

A
  • Many gram positive organisms
  • Some gram negative organisms
  • Most obligate anaerobes
    • Eg Strep equi var equi and zooepidemicus
  • Metronidazole cannot be used in meat producing animals, have to sign them out of the food chain.
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4
Q

Spectrum of activity of Penicillin G?

A
  • IV form of penicillin
    • not licensed
  • Most gram positive and gram negative cocci
  • Some aerobic and anaerobic bacilli
  • Not pseudomonas
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5
Q

Why is Benzathine penicillin G (Pen LA) often avoided in equine practice?

A
  • Slow absorption
  • Fails to reach MIC
  • AVOID IT
  • Most licensed doses are ineffective at maintaining MIC
  • datasheet doses therefore inappropriate and so often avoided
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6
Q

Compare the use of penicillins between small animal and equine practice.

A
  • Often first line in small animal medicine
  • Requirement for IM dosing makes less popular in equine use
    • Effective for most respiratory and skin diseases
    • Procaine has a >4-6 week racing prohibition
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7
Q

Spectrum of activity of Cephalosporins?

A
  • Effective against Staph aureus
  • Effective against anaerobes (except bacteroides)
    • Same anaerobe potential as penicillins
  • Second, third and fourth generation drugs
    • More gram negative effects
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8
Q

Which is the licensed Cephalosporin which is used in equine practice?

A
  • Ceftiofur (IM) – Equine
  • Only licensed one
  • Effective at licensed dose
  • Can use IV too
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9
Q

Which small animal cephalosporin is also available (although not licensed for equids)?

A

Cephalexin (SA) – oral

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10
Q

Spectrum of activity of Aminoglycosides?

A
  • Bactericidal
  • Spectrum of activity
    • Aerobic gram negative bacteria
    • Staphylococci
    • Not effective vs anaerobes (inability to pass into cell)
  • Mechanims: Inhibit protein synthesis
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11
Q

Toxicity of aminoglycosides?

A
  • Nephrotoxic
    • Usually reversible but occasionally get accumulation in proximal tubule leading to cell death
  • Ototoxic??? (theoretically)
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12
Q

How widely used are aminoglycosides in equine practice?

A
  • Widely used in equine medicine
  • Usually used in combination
    • Gentamicin and penicillin
      • Go to antibiotic for a wide range of infections
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13
Q

What are aminoglycosides used for in equine medicine?

A
  • Used for bone and joint disease
  • Surgical colic
  • Extends gram negative cover when used with penicillin
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14
Q

Spectrum of activity of Tetracyclines?

A
  • Bacteriostatic, inhibit protein synthesis
  • Spectrum of activity
    • Gram positive
    • Gram negative
    • Mycoplasma
    • Rickettsia and Ehrlichia (Anaplasma phagocytophila )
    • Poor anaerobic effects
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15
Q

Which is the only licensed method of administration for tetracyclines in the horse?

A
  • IM use leads to inflammation
  • IV Use only in horses
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16
Q

Toxic effects of tetracyclines?

A
  • Diarrhoea – in hind gut fermenters (change in GI flora)
  • Cardiac dysrrhthmias (following rapid IV administration)
  • GI irritant
17
Q

Resistance to Sulphonamides / Pyrimidines?

A
  • Probably most widely used in equine practice
  • Widespread resistance following long term use
18
Q

Formulations available of Sulphonamides / Pyrimidines?

A
  • Probably most widely used in equine practice
    • Powder for food, IV and paste formulations available
19
Q

Spectrum of activity of sulphonamides/pyrimidines?

A
  • Bacteriostatic alone, bactericidal
  • Mechanism of action
    • Inhibit DNA synthesis (purines)
  • Spectrum of activity
    • Gram positive, gram negative
    • Not anaerobes
20
Q

Toxicity of TMP-S in the horse?

A
  • CARDIOVASCULAR COLLPASE AND DEATH
    • Following IV use in the sedated horse (alpha 2)
    • Specific contraindication not to use it with an alpha 2
    • Give it very slow IV or IM
  • Haemolytic anaemia
  • Aplastic anaemia – rare
  • NEONATAL LOSS – AVOID IN LAST TRIMESTER
21
Q

Toxicity of TMP-S in the dog?

A
  • Immune mediated polyarthropathy (Doberman)
  • Acute renal failure (crystalluria)
22
Q

What can TMP-S be used for?

A
  • Respiratory disease
  • Skin disease
  • Liver disease
  • Available IV and PO
23
Q

Why is TMP-S not useful for strangles?

A

Cannot use in strangles as do not work with purulent material

24
Q

Spectrum of activity of Quinolones?

A
  • Broad spectrum
    • Mainly gram negative
      • Including pseudomonas
    • Poor gram positive
      • Not effective against streptococci (not a useful drug for treating horses with respiratory disease)
    • No anaerobic
  • Mechanism of action
    • DNA inhibition (DNA gyrase)
25
Q

Side effects of quinolones?

A
  • Damage to cartilage when used in skeletally immature animals
  • Don’t use in skeletally immature animals
26
Q

Uses of quinolones?

A
  • Respiratory, skin, urinary
  • Gram negative disease
  • Exotics
  • Use a poultry formulation as there is no license
27
Q

Which antibiotics are protected?

A

Quinolones, 2nd and 3rd cephalosporins and maybe the aminoglycosides may be blocked by the EU

28
Q

How useful are Macrolides in horses?

A
  • Treatment of Rhodococcus equi infections in foals
  • AVOID IN ADULT HORSES
  • NO VPL in veterinary species
29
Q

Side effects of macrolides?

A
  • Severe diarrhoea
  • Effects on bacterial flora
  • Increased intestinal motility (Motilin receptors)
30
Q

Uses of rifampin in equids?

A
  • Used in combination with macrolides for the treatment of R equi
  • Must be used in combination
31
Q

Spectrum of activity of Metronidazole?

A
  • Effective against anaerobes
    • Bacteroides, Clostridium spp
    • Rarely used on its own
  • Used for mixed infections where anaerobes expected
    • GI disease (Helicobacter), wounds, dental
32
Q

Side effects of metronidazole?

A
  • Nausea, anorexia (2%)
  • Causes them to go off their food
33
Q

What must you ensure if giving a horse metronidazole?

A
  • Cannot be given to horses entering human food chain
  • Therefore any horse receiving metronidazole must be permanently declared as not being suitable for human consumption
  • Clients responsibility to do this
  • You responsibility to inform them

CRS2 (64 decks)

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