Veterinary Medicine - November 2008 - (Page PD7)

Table 1: Antibiotics for treatment of staphylococcal pyoderma Poor choices Poor choices due to frequent resistance of coagulase-positive Staphylococcus strains: • Ampicillin • Amoxicillin • Penicillin • Other non-penicillinase resistant penicillins • Tetracyclines • Non-potentiated sulfa drugs. Adequate choices Adequate initial choices for staphylococcal pyoderma, but 10% to 30% of staphylococcal strains will be resistant. These are also poor choices for prolonged or repeated use because of the likelihood of drug resistance development over time. The potentiated sulfa drugs have been more often associated with idiosyncratic adverse drug reactions, so some clinicians avoid them. Drug Dosage Clindamycin Erythromycin Lincomycin Trimethoprim-sulfa combinations 5.5 to 11 mg/kg po b.i.d. 10 to 15 mg/kg po t.i.d. 22 mg/kg po b.i.d. 15 to 30 mg/kg po b.i.d. Good choices Antibiotics that are good initial choices for pyoderma and that are generally good choices for prolonged or repeated use, because of apparent diﬃculty with which drug resistance develops over time. Note that some dermatologists recommend a higher-than-labeled dose for amoxicillin-clavulanic acid (given below) in treating skin infections. Client compliance is likely to be better with injectable cefovecin or once-daily cefpodoxime. Drug Dosage Amoxicillin-clavulanic acid Cefovecin Cefpodoxime Cephalexin 15 to20 mg/kg po b.i.d. to t.i.d. 8 mg/kg subcutaneously, repeated in 14 days if indicated 5 to10 mg/kg po s.i.d. 22 to30 mg/kg po b.i.d. Additional choices Antibiotics that are often eﬀective for staphylococcal infections but that should not be used for routine cases. Reserve these antibiotics for unusual situations such as methicillin-resistant staphylococci (chloramphenicol) or nonstaphylococcal infections—such as Pseudomonas (ﬂuoroquinolones). Note the ﬂexible dosage range for the ﬂuoroquinolones; the correct dose to use is ideally based on the minimal inhibitory concentration (MIC) of the organism, but in general is the highest for Pseudomonas and midrange for staphylococci. Drug Dosage Chloramphenicol Enroﬂoxacin Marboﬂoxacin Orbiﬂoxacin 40 to 50 mg/kg po t.i.d. 5 to 20 mg/kg po s.i.d. 2.75 to 5.5 mg/kg po s.i.d. 2.5 to 7.5 mg/kg po s.i.d. SPONSORED BY PFIZER ANIMAL HEALTH 7

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Veterinary Medicine - November 2008 Contents Leading Off Editors' Guest Just Ask the Expert Letters Practice Makes Perfect Clinical Exposures Practice Matters Idea Exchange Author Guidelines A Challenging Case: Esophageal Leiomyoma in a Dog Osteoarthritis in Cats: What We Now Know About Recognition and Treatment Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - November 2008

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