Antimicrobial stewardship Flashcards
What are the consequences of using antimicrobials?
- Risk of antimicrobial resistance developing
- GI flora changes and can lead to
- Dysmotility
- Antimicrobial associated diarrhoea
- Can be fatal!
What are examples of each EMA antibiotic category?
- Category A – Avoid
- Rifampin
- Vancomycin
- Category B – Restrict
- Ceftiofur
- Enrofloxacin
- Category C – Caution
- Chloramphenicol
- Amikacin
- Clarithormycin/ Erythromycin/ Azithormycin
- Category D – Prudence
- Penicillin
- TMPS
- Oxytetracycline/ doxycycline
- Metronidazole
How can the risk of bacterial infections be reduced?
◦ Biosecurity protocols
◦ Vaccinations
What are indications for local therapy?
‣ Skin infections
‣ Sinus infections
‣ Abscess
‣ Distal limb (e.g. regional limb perfusion)
Can you use penicillin with streptocmycin in horses?
No - subtherapeutic
What is the only oral first line antimicrobial authorised in horses?
TMPS
When is the concurrent use of >1 antimicrobial indicated?
◦ Life threatening condition with insufficient time
◦ Mixed infections therefore >1 required for adequate spectrum
◦ Synergistic activity e.g procaine penicillin G and aminoglycosides
What are examples of cases where the use of antimicrobials is inappropriate?
- Equine asthma - inflammatory condition
- Foot Abscess
- Colitis/Diarrhoea (warranted in some cases)
- Non-antimicrobial effects
- Systemic doxycycline for eyes “anti-inflammatory effects”
- Congenital contracture – Oxytetracycline (?)
- Owner/client factors –> Change in mindset
- Underdosing
- 55% of horses received <90% of the recommended dose (wounds)
What are the first line (injectable and oral) antibiotics in horses?
- Injectable
- Penicillin + Gentamicin - best
- Oxytetracycline
- Oral
- TMPS - best
- Doxycycline
What antibiotic should you use to treat rhodococcus equi in foals?
Macrolides
