Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part 2— antimicrobial choice, treatment regimens and compliance

Abstract

Systemic antimicrobials are critically important in veterinary healthcare, and resistance is a major concern. Antimicrobial stewardship will be important in maintaining clinical efficacy by reducing the development and spread of antimicrobial resistance. Bacterial skin infections are one of the most common reasons for using systemic antimicrobials in dogs and cats. Appropriate management of these infections is, therefore, crucial in any policy for responsible antimicrobial use. The goals of therapy are to confirm that an infection is present, identify the causative bacteria, select the most appropriate antimicrobial, ensure that the infection is treated correctly, and to identify and manage any underlying conditions. This is the second of two articles that provide evidence-led guidelines to help practitioners address these issues. Part 1 discussed the use of clinical signs, cytology and culture in diagnosis. This article will cover the rationale for topical and systemic antimicrobial therapy, including choice of first-, second- and third-line drugs, the dose, duration of therapy, compliance and identification of underlying predisposing conditions. In addition, there is guidance on cases of therapeutic failure and environmental hygiene. These guidelines will help veterinarians avoid the development and propagation of antimicrobial-resistant bacterial strains.

Drug Reaction Caused by Clavulanate Amoxicillin in Dogs: Report of two CasesDrug Reaction Caused by Clavulanate Amoxicillin in Dogs: Report of two Cases

“…Pyodermas is a high incidence condition in dogs, being the treatment based on the broad-spectrum antibiotic use [2,3]. In the reported animals antibiotic therapy with clavulanate-amoxycillin was chosen, one of the first antibiotic of choice for this condition [2,3], using the recommended dose for the specie 12.5 to 25mg/ kg of body weight orally twice daily [15].…”

“…These mechanisms alterations can predispose to colonization of bacteria and result in the development of pyoderma, cutaneous bacterial infection of high frequency in dogs [2,3]. The pyodermas treatment is based on the elimination of the base cause and/or predisposing factors if it is possible, as well as antibiotic therapy.…”

“…The pyodermas treatment is based on the elimination of the base cause and/or predisposing factors if it is possible, as well as antibiotic therapy. The antibiotics of choice are the broad-spectrum antibiotics as clavulanateamoxycillin, cefadroxil, cephalexin, clindamycin and lincomycin [1][2][3]. The use of antibiotics can lead to adverse reactions concomitant or subsequent to treatment, alteration known as pharmacodermia.…”

Evaluating synergy between marbofloxacin and gentamicin in Pseudomonas aeruginosa strains isolated from dogs with otitis externa

“…The usage of fl uoroquinolones in veterinary dermatology is recommended in those cases when susceptibility testing indicates that the pathogen is resistant to other classes of antimicrobials [32,33]. Some authors would recommend systemic usage of these antimicrobials instead of topical administration for treatment of external otitis or pyoderma [34], however, a much higher concentration can be achieved with the latter method.…”

“…As mentioned earlier, selection of resistant organisms is much less likely when fl uoroquinolones are used in combination, as several mutation mechanisms should occur at the same time to achieve a high level resistance in P. aeruginosa that can lead to therapeutic failure. However, non-prudent use of fl uoroquinolones and consequent development of resistance may lead to public health risk as bacteria can be reservoirs of antibiotic-resistant bacteria [33,35,36].…”