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Dermatology > Therapy for Bacterial Skin Disease - Santoro > Flashcards

Therapy for Bacterial Skin Disease - Santoro Flashcards

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Dermatology Board Prep flashcards
1
Q

persistent infection if affected

A

less than two weeks since the first

recurrent if after 2 weeks

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2
Q

underlying causes

A 
demodex
allergies
endocrine
immunodeficiency (FeLV)
physical (trauma)
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3
Q

Always ______ before abx

A

cytology and then culture

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4
Q

what should you culture

A

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

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5
Q

culture and antibiotics?

A

stop abx 3-5 days before culture

if you cant stop, tell the lab

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6
Q

cocci bacteria

A

staph (intermedius) 99% of the time

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7
Q

rod shaped bacteria

A

e. coli
psuedomonas
you don’t really know

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8
Q

if many bacteria are isolated use abx to

A

kill the various organisms, if not possible focus on staph

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9
Q

mimimum length of therapy for superficial pyoderma

A

3-4 weeks

or 7-10 days past resolution of clinical signs

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10
Q

minimum length of therapy for deep pyoderma

A

2-3 months, or 4 weeks past resolution of signs

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11
Q

topical therapy is mandatory for

A

deep infection

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12
Q

first tier

A

macrolides (-like)
first gen cephalosporins
amoxicillin
sulfonamides

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13
Q

second tier

A 
therd gen cephalosporins
doxycycline, minocycline
flurorquinolones
chloramphenicol
rifampin
aminoglycosides
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14
Q

third tier

A

for super resistant bugs

  • vancomycin
  • linezolid
  • Teicoplanin
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15
Q

most staph produce ______ which needs to be considered when choosing abx

A

beta-lactamase

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16
Q

beta lactamase resistant abx

A

oxacillin
dicloxacillin
nafcillin
(expensive, just don’t?)

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17
Q

beta lactamase susceptible abx

A

ampicillin, amoxicillin, penicillin

Don’t use on the skin!! bc most staph will produce beta lactamase

18
Q

beta lactams we can use on the skin

A 
amoxicillin with clavulanic acid
(primarily g+, bacteriocidal)
cephalosporins - cephalexin
(G+, cidal, common first line)
- both have GI side effects
19
Q

MRSA

A

mecA gene
oxacillin is used to test to confirm MRSA?
tx with clindamycin

20
Q

clindamycin

A

good penetration in fibrotic tissues

21
Q

clindamycin

A

good penetration in fibrotic tissues

good for MRSA

22
Q

Erythromycin

A
  • inhibits cytochrome P450, slows drug metabolism
  • narrow, ideal for staph
  • GI side effects
  • efficacy is time dependent
23
Q

lincomycin

A

not as commonly used as erythromycin

  • bacteriostatic, macrolide-like
  • better absorption and distribution than erythromycin, rapid resistance and cross-reactive with erytromycin
24
Q

macrolide inducible resistance

A
  • bacteria resistant to macrolides have potential to be resistant to clindamycin
  • D test
25
Q

potentiated sulfonamides

A
  • 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)
26
Q

silver sulphadiazine

A

psuedomonas
topical
skin and ears

27
Q

doxycycline

A
  • resistant cases
  • time dependent
  • anti-inflam
  • v/d/nausea
  • doxy and minocycline prices fluctuate a lot
28
Q

Chloramphenicol

A
  • broad
  • bacteriostatic
  • inhib P450
  • risk with humans; gi upset in animals and peripheral neuropathy in large dogs
29
Q

3rd gen cephalosporins

A
  • primarily gram negative

- cefovecin (convenia) cefpodoxime

30
Q

fluoroquinolones

A 
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)
31
Q

good tissue penetration

A

clindamycin

fluoroquinolones

32
Q

Enrofloxacin

A
  • metabolized into
33
Q

fluoroquinolones

A

enrofloxacin
orbifloxacin
moxifloxacin
pradofloxacin

34
Q

mupirocin

A

bacteriocidal topical cream
great for staph
minimal systemic absorption
made for MRSA

35
Q

polymyxin B

A

for resistant pseudomonas or staph

36
Q

antibiotic usage

A

full dosage!
adequate time!
treat staph
avoid steroids

37
Q

long term abx therapy

A

not recomended

38
Q

try to use _______ abx

A

veterinary approved

39
Q

topical antiseptics

A

chlorhexidine - mild irritant, kills bacteria fungi viruses

benzoyl peroxide - good for staph but irritating

40
Q

vetericyn spray

A

oxyclorine (simillar to bleach)
used for MRSA
well tolerated

Dermatology (18 decks)

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