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Dermatology (VEM 5387) > Treatment of Bacterial Skin Diseases (Marsella) > Flashcards

Treatment of Bacterial Skin Diseases (Marsella) Flashcards

1
Q

Choice of abx determined by…

A
  • Susceptibility of the bacteria
  • Concurrent disease
  • Depth of infection
  • Length of tx
  • Breed
  • Age
  • Owner constraints (time, money, drug admin)
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2
Q

Abx spectrum choice

A
  • Start w/ narrow spectrum
    • Some abx develop resistance rapidly
    • Never use big guns first for pyoderma
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3
Q

Abx & glucocorticoid use?

A

Don’t do it!

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4
Q

Abx therapy for mixed infections

A
  • If possible, select abx effective against various organisms
  • If not possible, select abx effective against staph
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5
Q

Reasons for treatment failure

A
  • Failure to ID all underlying causes
  • Wrong abx
  • Inappropriate dose
  • Inappropriate length
  • Concurrent steroids
  • foreign body reaction
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6
Q

1st line abx for pyoderma

A
  • Erythromycin
  • Lincomycin
  • Clindamycin
  • 1st generation cephalosporins
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7
Q

2nd line abx for pyoderma

A
  • Potentiated sulfonamides
  • 3rd generation cephalosporins
  • Amoxicillin/clavulanic acid
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8
Q

3rd line abx for pyoderma

A
  • Fluoroquinolones
  • Chloramphenicol
  • Rifampin
  • Amikacin
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9
Q

Erythromicin mechanism of action

A
  • Macrolide, inhibits ribosomal protein synthesis
  • Bacteriostatic
  • Time-dependent
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10
Q

Erythromycin spectrum

A

Narrow spectrum for staphylococcus

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11
Q

Adverse effects of erythromycin

A
  • Inhibition of cytochrome P450 (drug interactions)
  • GI
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12
Q

Lincomycin mechanism of action

A
  • Macrolide-like
  • Bacteriostatic
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13
Q

Disadvantage of lincomycin

A

Rapid resistance (cross-reactive w/ erythromycin)

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14
Q

Clindamycin mechanism of action

A

Related to lincomycin (marcrolide-like)

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15
Q

Clindamycin uses

A
  • Superficial pyoderma
  • Deep pyoderma (recurrent infections)
  • Cases of S. schleiferi
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16
Q

Advantage of clindamycin

A

Well tolerated by most patients

17
Q

Cephalosporin mechanism of action

A
  • Inhibition of synthesis of bacterial cell wall
  • bacteriocidal
18
Q

First generation cephalosporin (cephalexin) uses

A
  • 1st line
  • broad spectrum, but primarily gram+
19
Q

First generation cephalosportin (cephalexin) disadvantages/adverse effects

A
  • Increasing reports of resistance
  • Vomiting/diarrhea
  • Immune-mediated hemolytic anemia
  • Immune-mediated thrombocytopenia
  • Urticaria
  • Drug eruptions (EM, TEN, PF)
  • (Rarely - neurotoxicity, neutropenia, interstitial nephritis)
20
Q

Potentiated sulfonamides mechanism of action

A

Interfere w/ synthesis of folic acid

21
Q

Potentiated sulfonimides adverse effects

A
  • Sulfa groups are very allergenic and my trigger hypersensitivity reactions (types I, II, III)
  • Anemia, leukopenia, thrombocytopenia
  • Fever
  • KCS (keratoconjunctivitis sicca)
  • Hepatopathy
  • Arthropathy (shifting leg lameness)
  • Cutaneous eruptions
  • Hypothyroidism
  • Polymyositis
22
Q

Potentiated sulfonamides contraindications

A
  • Anti-acids interfere w/ absorption
  • Do NOT use in dobermans and rotweillers
    • Incr. risk of arthropathy
    • possible defect of detox
23
Q

Silver sulphadiazine

A
  • Topical sulfonamide
  • Broad spectrum
  • Ideal for pseudomonas
24
Q

Third generation cephalosporins

A
  • Convenia, simplicef
  • Gram negative
  • Broader spectrum than 1st gen
  • Use as 1st choice only if compliance issues are anticipated (injection that lasts several days rather than owners giving pill)
25
Q

Beta-lactamase resistant penicillins

A
  • Oxacillin, dicloxacillin, nafcillin
  • Expensive
  • Excellent for staph
  • TID
26
Q

Amoxicillin/Clavulanic acid

A
  • Broad spectrum (primarily gram+)
  • Bacteriocidal
  • Rapid absorption
  • GI adverse effects
27
Q

Chloramphenicol mechanism of action

A
  • Inhibiting ribosomal protein synthesis
  • Metabolized by liver
  • Bacteriostatic
  • Broad spectrum
28
Q

Chloramphenical adverse effects

A
  • Depression of microsomal enzymes (inhibits metabolism of other drugs)
  • Aplastic anemia in owners (wear gloves when handling)
  • GI, anorexia
  • Elevated liver enzymes
  • Anemia
  • Peripheral neuropathy (large breed dogs)
29
Q

Fluoroquinolones mechanism of action

A
  • Inhibiting DNA gyrase (DNA replication)
  • Bacteriocidal
  • Concentration dependent
  • Great penetration in tissues
  • Accumulate in neutrophils and macrophages
30
Q

Fluoroquinolone uses

A
  • Broad spectrum
  • Effective against Staph and Pseudomonas
  • Resistant cases (NOT 1st line)
31
Q

Fluoroquinolone disadvantages/adverse effects

A
  • Absorption inhibited by anti-acids
  • GI
  • Neurological
    • Seizures
  • Arthropathy (incr. risk when receiving cyclosporins)
  • Blindness (cats, Baytril)
  • Do NOT give in cats or growing dogs
32
Q

Enrofloxacin (Baytril)

A
  • Metabolized into ciprofloxacin
  • Food admin incr. amount of cipro
33
Q

Fluoroquinalones (examples)

A
  • Enrofloxacin (Baytril)
  • Marbofloxacin (Zeniquin)
  • Orbifloxacin (Orbax)
  • Moxifloxacin
  • Pradofloxacin (veraflox)
34
Q

Doxycycline

A
  • Resistant cases
  • Time dependent
  • Anti-inflammatory
  • Vomit/diarrhea, nausea, yellow staining of teeth
  • Esophageal strictures in cats
35
Q

Mupirocin

A
  • Topical abx
  • Good for Staph
  • Minimal systemic absorption
36
Q

Polymyxin B

A
  • Topical abx
  • Used for resistant Pseudomonas
  • Binds to cell membrane (more permeable)
37
Q

Long term abx therapy (good/bad?)

A
  • Not recommended
  • Avoid pulse therapy (administration of supra-pharmacologic doses of drugs in an intermittent manner to enhance the therapeutic effect and reduce the side effects)

Dermatology (VEM 5387) (17 decks)

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