Therapy for Bacterial Skin Disease - Santoro Flashcards
persistent infection if affected
less than two weeks since the first
recurrent if after 2 weeks
underlying causes
demodex allergies endocrine immunodeficiency (FeLV) physical (trauma)
Always ______ before abx
cytology and then culture
what should you culture
a primary lesion if at all possible
(under edge of collarette if need to use a secondary lesion)
avoid ulcerated or opened lesion, they’re infected
culture and antibiotics?
stop abx 3-5 days before culture
if you cant stop, tell the lab
cocci bacteria
staph (intermedius) 99% of the time
rod shaped bacteria
e. coli
psuedomonas
you don’t really know
if many bacteria are isolated use abx to
kill the various organisms, if not possible focus on staph
mimimum length of therapy for superficial pyoderma
3-4 weeks
or 7-10 days past resolution of clinical signs
minimum length of therapy for deep pyoderma
2-3 months, or 4 weeks past resolution of signs
topical therapy is mandatory for
deep infection
first tier
macrolides (-like)
first gen cephalosporins
amoxicillin
sulfonamides
second tier
therd gen cephalosporins doxycycline, minocycline flurorquinolones chloramphenicol rifampin aminoglycosides
third tier
for super resistant bugs
- vancomycin
- linezolid
- Teicoplanin
most staph produce ______ which needs to be considered when choosing abx
beta-lactamase
beta lactamase resistant abx
oxacillin
dicloxacillin
nafcillin
(expensive, just don’t?)
beta lactamase susceptible abx
ampicillin, amoxicillin, penicillin
Don’t use on the skin!! bc most staph will produce beta lactamase
beta lactams we can use on the skin
amoxicillin with clavulanic acid (primarily g+, bacteriocidal) cephalosporins - cephalexin (G+, cidal, common first line) - both have GI side effects
MRSA
mecA gene
oxacillin is used to test to confirm MRSA?
tx with clindamycin
clindamycin
good penetration in fibrotic tissues
clindamycin
good penetration in fibrotic tissues
good for MRSA
Erythromycin
- inhibits cytochrome P450, slows drug metabolism
- narrow, ideal for staph
- GI side effects
- efficacy is time dependent
lincomycin
not as commonly used as erythromycin
- bacteriostatic, macrolide-like
- better absorption and distribution than erythromycin, rapid resistance and cross-reactive with erytromycin
macrolide inducible resistance
- bacteria resistant to macrolides have potential to be resistant to clindamycin
- D test
potentiated sulfonamides
- potential for immune response (I,II, or III hypersensitivity reaction)
- Don’t use in Dobermans and Rotties! arthropathy
- hepatic necrosis, cutaneous eruptions, not used as much in dogs (horses seem to have more resistance to side effects)
silver sulphadiazine
psuedomonas
topical
skin and ears
doxycycline
- resistant cases
- time dependent
- anti-inflam
- v/d/nausea
- doxy and minocycline prices fluctuate a lot
Chloramphenicol
- broad
- bacteriostatic
- inhib P450
- risk with humans; gi upset in animals and peripheral neuropathy in large dogs
3rd gen cephalosporins
- primarily gram negative
- cefovecin (convenia) cefpodoxime
fluoroquinolones
gram +/- bacteriocidal save for resistance cases!! don't give with iron/ca /sucralfate - great penetration in tissues - once a day in a very high dose (above MPC mutant prevention concentration)
good tissue penetration
clindamycin
fluoroquinolones
Enrofloxacin
- metabolized into
fluoroquinolones
enrofloxacin
orbifloxacin
moxifloxacin
pradofloxacin
mupirocin
bacteriocidal topical cream
great for staph
minimal systemic absorption
made for MRSA
polymyxin B
for resistant pseudomonas or staph
antibiotic usage
full dosage!
adequate time!
treat staph
avoid steroids
long term abx therapy
not recomended
try to use _______ abx
veterinary approved
topical antiseptics
chlorhexidine - mild irritant, kills bacteria fungi viruses
benzoyl peroxide - good for staph but irritating
vetericyn spray
oxyclorine (simillar to bleach)
used for MRSA
well tolerated
