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PPT. questions Prudent use Flashcards

1
Q

Susceptible testing, main methods:

A

Disc diffusion method –> CLSI, how many mm diameter

Microdilution method –> Minimal inhibitory concentrations (MIC)

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2
Q

Bacteria pathogens BRDC (ruminants)

A

GRAM-negative – main causative agents

  • Pasteurella multocida A (80-90%)
  • Mannheimia haemolytica (80-90%)
  • Histophilus somni (5%)

GRAM-positive

  • Trueperella pyogenes (50%)
  • Mycoplasma bovis
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3
Q

What antibiotic can we use for BRDC in ruminants?

A

Best options: Florfenicol, Marcolides (tulathromycin, gamitromycin

Against mycoplasma bovis also causing itm(more frequently resistant to antibiotics)
- Fluroquinolones: most effective but highest priority critical microorganism
- Macrolides are also effective : Tulathromycin, gamithromycin, Lincospectin (linco +
spectomycin à synergistic against Mycoplasma)
o Act against M.bovis + fastidious microorganism = good against BRDC!

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4
Q

Lung:plasma

Tilmicosin
Tulathromycin
Gamithromycin
Tildipirosin

A

Tilmicosin 30-60x (3 days effective conc. in lung)
Tulathromycin 50-180x (6-10 days effective conc. in lung)
Gamithromycin 480X (10-14 days effective conc. in lung)
Tildipirosin 50 (14-28 day effective conc. in lung) –> Not effective against mycoplasma bovis

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5
Q

What Ab have bad distribution?

A

BAD: penicillin, cephalosporin, aminoglycoside – cannot cross the special barriers, the
penetration in the lungs is bad
OTHER: good or excellent

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6
Q

What can we use against mannheimia hemolytivca and pausterella multocida? Ruminant

A

Best agent Ceftiofur and Fluroquinolones BUT CIA – prefer the less valuable
drugs as the: Macrolides (tulathromycin, gamithromycin, tilmicosin)
florfenicols

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7
Q

Treatment Interdigital dermatitis (Mortellaro-disease)

A

Topical treatment! Foot bath 3x a week à montly
o 1. Zinc, copper-sulphate 5% + cationic detergents
o 2. Tetracycline containing spray
Topically – will reach a high concentration at the
given site of infection
Daily for one week à 3x a week for 2 weeks

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8
Q

Interdigital phlegmone (foot rot) treatment?

A

more severe
o Topical therapy won’t be enough
o Lameness + necrosis
o Systemic antibiotic treatment + NSAID (meloxicam
duration: 2 days, carprofen – longer duration of action 4-5 days)

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9
Q

Foot disease ruminants, AB?

A

Ceftiofur/Cefquinom: CIA

  • Highlight: Lincomycin, Tulathromycin, Cephalosporines, Florfenicol
  • Tetracycline ++, in small ru the resistance is good, in Ru (+++)
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10
Q

Calf diarrhea AB treament, mild case?

A 
PER OS
o Amoxicillin 
§ Small ru – rare resistance 
o Fluroquinolones 
o Aminoglycoside : ∅ Spectinomycin – bacteriostatic – resistance more frequent 
o Colistin – CIA
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11
Q

Calf diarrhea AB treament, severe case?

A

PARENTERAL (IV)
Bad absorption with IM, SC due to dehydration
Ceftiofur (high Dosage!)

Amoxicillin (sheep), amoxi-clav (most product is IM or SC, and we need IV –
quick action!)
Fluoroquinolones –> Enro, marbofloxacin

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12
Q

When are cows more sensitve to matsitis

A

Involution (right after drying off) –> most often G+

Transition (near calving) –> most often G-

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13
Q

Main causative agent of mastitis in cow?

A

1.Streptococcus uberis
2. e.coli
3.Prototheca zopfii – no effective drugs against this pathogen – those animal infected
are not kept for long

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14
Q

Treatment clinical mastitis:

A

Serious case –> E.coli, Klebsiella (S. Aureus)

  • The main goal: prevention and treatment of bacteremia (40%)
  • Bactericidal activity à blood-milk barrier
Fluoroquinolones IV 
 o Marbofloxacin (Withdrawal period: 2d) 
 o Enrofloxacin (WP: 3d)

Tetracyclines IV
o Water-soluble (WP: 3d)

Pot. SA IV (WP: 3d)

+ infusion (Ca!), NSAID!

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15
Q

Intramammary mastitis treatment

A

oxacillin, cloxaxillin (strep, staph)
ampicillin, cloxacillin (steph, staph, e.coli)
cefalexin, kanamycin ((steph, staph, e.coli)
Amoxicillin + clavulinic acid (steph, staph, e.coli)
cefoperazone (steph, staph, e.coli)
Cefquinome (steph, staph, e.coli)

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16
Q

Major pathogens poultry:

A

Escherichia coli – does not cause enteritis in poultry!
Pasteurella multocida (fowl cholera)
Ornithobacterium rhinotracheale
Clostrodium perfringens (+ colinum)
Staphylococcus aures
Mycoplasma sp. (sonicia, meleagridis, gallisepticum)

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17
Q

AB not authorised in poultry

A

category B:> 3 &4 gen. cephalosporins

Category C: 1 &2 gen cephalosporins, and amoxicillin - clavulinic acid.

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18
Q

Narrow spectrum penicillins can treat? (poultry)

Phenoxymethylpenicillin (phenoxypen, phenocillin AUV)

A

Phenoxymethylpenicillin (phenoxypen, phenocillin AUV)
C. perfringens + other clostridum species
Swine erysipelas
Streptococcosis
Fowl cholera

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19
Q

Broadened spectrum penicillins can treat? (poultry)

Amoxicillin

A

Fowl cholera (1st choice)
Staphylococcus
enterococcus
ornithobacetrium rhinotracheale

C. perfringens + other clostridum species + Swine erysipelas (use NARROW instead)

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20
Q

Aminoglycosides can treat? (poultry)

A

Mycoplasma

Neomycin bacteriocidal, but spectinomycin bacteristatic.

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21
Q 
Polypeptide antibiotics  (poultry)
colistin
A

Category B à use it if no other drugs can be used!

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22
Q

Tetracylines (poultry)

A

Doxycycline (most potent, better absorption, excellent distribution)

Chlortetracycline (potent) and oxytetracycline

Fowl cholera (p. multocida)
o O. rhinotracheale
o Mycoplasmosis
o Bordetella avium

no toxic interaction with ionophore

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23
Q

Macrolides can treat ? (poultry)

A

Gram +
§ E. perfingens
§ E. rhusiopathiae
§ Staphylococcus spp

Gram –
§ Mycoplasma gallisepticum, m. synoviae
• Tilmicosin < tylosin < tylvalosin
§ O. rhinotracheale
• Tylosin &laquo_space;tilmicosin < tylvalosin

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24
Q

pasturella multocida & e. coli: Almost total resistance: against?

A

Macrolides in poultry

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25
Lincosamides can treat ? (poultry)
Combined with spectinomycin Mycoplasmosis C. perfringens Staphylococcosis
26
Pleuromutilins can treat ? (poultry)
Tiamulin o Mycoplasmosis o O. rhinotracheale o Gram + bacteria, p. multocida: weak Ionophore interactions
27
Potentiated sulphonamides can treat ? (poultry)
Ø mycoplasma Fastidious (P. multocida) o B. avium o E. coli
28
Potentiated sulphonamides side effects
Potentiated sulphonamides
29
Fluoroquinolones can treat ? (poultry)
``` Category B - Clinical usage o E. coli + mycoplasma species (CRD) o Fowl cholera o A. paragallinarum o B. avium o O. rhinotracheale: frequent resistance ```
30
Fluoroquinolones frequent resistance ? (poultry)
O. rhinotracheale & E. coli
31
E. coli sensitivity test
1. Aminopenicillins: amoxicillin << amoxicillin-clavulenic acid 40-70% vs 1-10% 2. Aminoglycosides: neomycin, spectinomycin – 20-30% 3. Colistin – approx. 5% 4. Tetracyclines L - > 40-90% 5. Florfenicol – low, < 10% 6. Potentiated SA – 25-40% 7. Fluoroquinolones – 60-80% Low sensitivity remains Category D à normally 1st choice for e. coli but in poultry = no result
32
Pasteurella multocida (fowl cholera) : most preferred AB
Amoxicillin, florfenicol, doxycycline, potentiated SA can use enrofloxacin & tylvalosin as well.
33
Ornithobacterium rhinotracheale: most preferred AB
amoxicillin, doxycycline, florfenicol
34
Clostridium perfringens: most preferred AB
phenoxymethylpenicillin can also use: Amoxicillin, tylosin, lincomycin
35
Major pathogens swine:
-Clostridium perfingenC - Spaphylococcus hycus - Streptococcus suis - Erysipelothrix rhusiopathiae - Escherichia Coli Time dependent bactericidal agents Bacteriostatic agents Bactericidal agents! - Salmonella spp. - PDS, MMA - Pasturella multocida - Actinobacillus pleuropneumoniae - Haemophilus parasuis - Lawsonia intracellularis - Brachyspira hyodysenteriae - Leptospira Pomona, L. tarassovi - Mycoplasma hyopneumoniae - Mycoplasma hyorhins - Mycoplasma hyosynoviae - Mycoplasma suis
36
Diarrhea (swine)
- Clostridium perfingens C - Escherichia coli - Salmonella spp. - Lawsonia intracellularis – ileitis - Brachyspira hyodysenteriae – dysentery
37
Clostridium perfingens C treatment (swine)
Necrotic enteritis | - Penicillin (phenoxymethylpenicillin), amoxicillin
38
Swine dysentry treatment?
``` Tylvalosin Tiamulin Lincomycin Tiamulin Valnemulin ```
39
Polyserositis (swine) best treatment?
Florfenicol (works on all 3 main pathogens: h.parasuis. strep.suis & M. hyorhinis)
40
“who will make the bed?” PRDC (Porcine Respiratory Disease Complex)
Mycoplasma hyopneumonia o PRRS, SIV, PCV-2 o Environment
41
(Porcine Respiratory Disease Complex): who will lie in the bed?
Actinobacillus pleuropneumoniae o Pasteurella multocida o Bordetella bronchiseptica --> (atrophic rhinitis) o Glässerella parasuis + our favorites: § Streptococcus suis § Mucoplasma hyorhinis
42
Mycoplasma hyopneumoniae treatment? (swine)
Tylvalosin Tulathromycin Tiamulin and valnemulin
43
Actinobacillus pleuropneumoniae treatment? (swine)
Florfenicol Ceftiofur Cefquinome Enro, marbo
44
Staphylococcus hyicus treatment? (swine)
Amoxicillin-clavulanic acid (amoxicillin alone not enough) Tylosin Lincomycin PotSA
45
Erysipelothrix rhusiopathiae treatment? (swine)
Penicillin (NARROW) | Amoxicillin
46
Mycoplasma hyosynoviae treatment? (swine)
Tylvalosin, tulathromycin, gamithromycin
47
Types of pyderma?
Surface Supf. Deep
48
Surface pyoderma
only on surface, not in deeper tissue – treated with shampoo | --> Intertrigo, hot spot
49
Superficial pyoderma
longer treatment period, often need systemic treatment | --> Folliculitis, impetigo, epidermal collarette
50
Deep pyoderma
most severe, very painful, need systematic ABs, treatment for 4-8 weeks, sometimes 12 weeks --> Furunculosis, cellulitis, german shepherd pyoderma, acral lick dermatitis
51
PATHOGENIC BACTERIA (pyoderma)
Staphylococcus pseudointermedius: almost always present (normal bacteria on skin flora) à frequently produce beta lactamase (penicillinase) Staph. aureus (from owner) + Streptococcus canis (not so frequent)
52
S. pseudointermedius Treatment
cant use amoxicillin alone, must combine with clavulinuc acid (suicide inhibitor) Cehpalosporins also resistant to beta lactams NB! MRSP & MRSA
53
Deep pyoderma shampoo
Benzoyl peroxide shampoo – more heavy acting agent Makes skin very dry and vulnerable à should use hydrating agent
54
good against MRSA/MRSP (pyoderma)
Mupirocin (local & systemic) Fusidic acid (5% resistance, local & systemic)
55
SYSTEMIC TREATMENT PYODERMA | 1 line choice
Doseage (deep pyoderma) --> higher doses due to penetration of skin 1st line cefalexin BID Amoxicillin clavulanic acid Cefavecin (log DOA, can use in aggressive animal, inj) Potentiated SA : Sulfamethoxazole ( can cause KCS, no long term) Lincosamines: Clindamycin (bacteriostatic)
56
SYSTEMIC TREATMENT PYODERMA | 2nd line choice
Susceptibility test Fluoroquinolones: Enrofloxacin, marbofloxacin, ciprofloxacin (prado in case of deep) Antibiotics against MRSP, MRSA
57
Antibiotics against MRSP, MRSA
Local: mupirocin, fusidic acid Systemic: rifampicin amikacin florfenicol
58
SYSTEMIC TREATMENT PYODERMA | 3rd line choice
Only after suseptibility test Macrolides: Azithro & clarithomycin Vancomycon , teicoplanin, linezolid (AMEG A à never used in food producers! + very valuable for human medicine)
59
Duration of pyoderma treatment
At least 3-4 weeks (surface) Deep pyoderma: 4-8 weeks (12 weeks) ONE WEEK MORE OF RECOVERY – give drugs for one more week after the animal looks healthy
60
OTITIS EXTERNA
Gram + (inflamed, itchy ear, some swelling) o Staphylococcus pseudointermedius (+ other) o Streptococcus canis (+ other) Gram – (severe inlfamed, and painful) o Pseudomonas aeruginosa o Escherichia coli
61
STAPHYLOCOCCUS – OTITIS THERAPY
Local (ear cleaner + ear drop) o Chlorhexidine ear cleaner à fill ear with solution, let it work ``` AB o Gentamicin o Polymyxin-B o Orbifloxacin o Marbofloxacin o Florfenicol ```
62
STREPTOCOCCUS – OTITIS TREATMENT?
Resistant against the drugs mentioned under staph. treatment à but since there is such a high concentration (several 100x higher than the MIC of the bacteria) in the ear drops à will for sure kill the streptococcus
63
PSEUDOMONAS – OTITIS THERAPY
Local (ear cleaner) o EDTA, chlorhexidine o Alkalizing ``` Local (ear drop) o Gentamicin o Tobramycin o Polymyxin-B o Marbofloxacin ``` Systemic o Glucocorticoids (systemic effect) o Per os: ciprofloxacin >> marbofloxacin >> enrofloxacin § HIGH DOSES
64
MALASSEZIA – OTITIS TREATMENT
``` Local (ear cleaner) o Chlorhexidine - Local (ear drops) o Thiabendazole o Clotrimazole o Miconazole o Posaconazole o Terbinafin ```
65
Mastitis in SMALL ANIMAL
Staphylococcus spp. - Streptococcus spp. - E. coli à can cause sepsis (endotoxin à shock) à most severe - Microscopic examination (Gram -)
66
Systemic treatment Mastitis in SMALL ANIMAL
Septic (amoxi clav + enro) --> lifethreatening Broad spectrum, given IV Non-septic --> susceptibility test o Gram + : Clindamycin & Macrolides o Gram – : Fluoroquinolones, o Puppies: ABs cause side effects § Weaning of animals --> milk should be mechanically removed
67
Pharyngitis, Tonsillitis pathogens
Very commonly caused by streptococcus spp.! (S. canis) --> NO beta lactamase, so sensitive to penicillins Pasteurella, or by viruses Æ culturing should be done. o Streptococcus Pyogenes is ZOONOTIC.
68
Pharyngitis, Tonsillitis treatment
Penicillin’s (NARROW spectrum). Cephalosporins (1st GENERATION) Macrolides (azithromycin, clarithromycin)
69
Rhinitis (+ sinusitis)
BacterialÆ superinfection (almost always secondary!) x Purulent rhinitis is seen in case of bacterial infection x Streptococcus spp. x Staphylococcus spp. x Pasteurella multocida (very typical in cats) x Bordetella bronchiseptica x Chlamydophila, Mycoplasma spp
70
Rhinitis (+ sinusitis) Treatment
Tetracyclines - DOXYCYCLIN--> a very good choice (10mg/Kg, once daily) Macrolides - AZITROMYCIN, CLARITROMYCIN Æ Can (10g/kg, twice daily) x Fluoroquinolones except pradofloxacin (CIA, so should always culture before starting treatment) --> not good against streptococcus. x Pot. SA: less effective against streptococcus spp, but very good against Bordetella. Penicillin’s, Cephalosporins --> will only use if we know the infection is caused by streptococcus, Pasteurella. Better options.
71
Feline rhinotracheitis: Treatment
Doxycycline (chlamydia, bordetella) Amoxicillin +/- clavulanic acid (fe)-- good in case of Pasteurella Macrolides (azithromycin, clarithromycin) Antibiotic eye drop, or ointments containing tetracycline.
72
Bronchitis, pneumonia | life-threatening case
Amoxicillin clavulanic acid Cephalosporins (cefuroxime, ceftriaxone, ceftzidime) Aminoglycosides: Tobramycin, amikacin, gentamycin Fluoroquinolones
73
Bronchitis, pneumonia: Not Life-threatening case
Tetracyclines, Macrolides | Potentiated sulphonamides
74
Kennel cough treatment
1st choice Doxycycline → anti-inflammatory Potentiated sulphonamides --> very good against Bordetella Macrolides (clarithromycin, azithromycin) → anti inflammatory 2nd choice: Fluoroquinolones 3rd choice: Amoxicillin clavulanic acid, cephalosporines : not good against Bordetella nor mycoplasma. Not the best penetration.
75
Aspiration pneumonia (pneumonitis)
Life threatening case, we must act fast: Broad spectrum beta lactam + enrofloxacin (aminoglycosides can be used instead of enrofloxacin, but nephrotoxic!) + metronidazole. Glucocorticoid are contraindicated
76
Pyothorax
Broad spectrum beta lactam + enrofloxacin (aminoglycosides can be used instead of enrofloxacin, but nephrotoxic!) + metronidazole)
77
Gingivitis, periodontitis
``` Amoxicillin + clavulanic acid Metronidazole + spiramycin Clindamycin Cefovecin Pradofloxacin ```
78
ARD - Antibiotic responsive diarrhea
Tylosin Metronidazol Oxytetracycline
79
immune modulators
alter the immune system in a good way, Tylosin Metronidazol Oxytetracycline
80
Parvoviriosis
amoxicillin + clavulanic acid + enrofloxacin IV (get consent from owner to use enrofloxacin, due to the potential cartilage damage)
81
Chronic colitis Treatment
Metronidazole! Tylosin Mesalazine
82
Histiocytic ulcerative colitis:
Enrofloxacin! (4 weeks of treatment. But as always, be aware of cartilage damage
83
Best drug options in case of cystitis:
``` 1st line choices o amoxicillin o amoxicillin + clavulanic acid o cefalexin potentiated sulphonamides ``` 2nd line choices o cefovecin o fluoroquinolones o nitrofurantoin/fosfomycin/amikaci Nitrofurantoin (just used in UTI)
84
Prostatitis
Fluoroquinolones: in case of prostatitis FQ can be a first line drugs, but only in these cases. Potentiated sulfonamides! (Side effects) Phenicol’s! (Side effects: BM suppression, anemia...etc)
85
Recommended drugs for UTI’s
Amoxicillin (ampicillin

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