Therapy for Bacterial Skin Disease - Santoro

Question 1

persistent infection if affected

Answer 1

less than two weeks since the first

recurrent if after 2 weeks

Question 2

underlying causes

Answer 2

demodex
allergies
endocrine
immunodeficiency (FeLV)
physical (trauma)

Question 3

Always ______ before abx

Answer 3

cytology and then culture

Question 4

what should you culture

Answer 4

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

Question 5

culture and antibiotics?

Answer 5

stop abx 3-5 days before culture

if you cant stop, tell the lab

Question 6

cocci bacteria

Answer 6

staph (intermedius) 99% of the time

Question 7

rod shaped bacteria

Answer 7

e. coli
psuedomonas
you don’t really know

Question 8

if many bacteria are isolated use abx to

Answer 8

kill the various organisms, if not possible focus on staph

Question 9

mimimum length of therapy for superficial pyoderma

Answer 9

3-4 weeks

or 7-10 days past resolution of clinical signs

Question 10

minimum length of therapy for deep pyoderma

Answer 10

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

Question 11

topical therapy is mandatory for

Answer 11

deep infection

Question 12

first tier

Answer 12

macrolides (-like)
first gen cephalosporins
amoxicillin
sulfonamides

Question 13

second tier

Answer 13

therd gen cephalosporins
doxycycline, minocycline
flurorquinolones
chloramphenicol
rifampin
aminoglycosides

Question 14

third tier

Answer 14

for super resistant bugs

• vancomycin
• linezolid
• Teicoplanin

Question 15

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

Answer 15

beta-lactamase

Question 16

beta lactamase resistant abx

Answer 16

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

Question 17

beta lactamase susceptible abx

Answer 17

ampicillin, amoxicillin, penicillin

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

Question 18

beta lactams we can use on the skin

Answer 18

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

Question 19

MRSA

Answer 19

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

Question 20

clindamycin

Answer 20

good penetration in fibrotic tissues

Question 21

clindamycin

Answer 21

good penetration in fibrotic tissues

good for MRSA

Question 22

Erythromycin

Answer 22

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

Question 23

lincomycin

Answer 23

not as commonly used as erythromycin

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

Question 24

macrolide inducible resistance

Answer 24

• bacteria resistant to macrolides have potential to be resistant to clindamycin
• D test

Question 25

potentiated sulfonamides

Answer 25

- 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)

Question 26

silver sulphadiazine

Answer 26

psuedomonas topical skin and ears

Question 27

doxycycline

Answer 27

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

Question 28

Chloramphenicol

Answer 28

- broad - bacteriostatic - inhib P450 - risk with humans; gi upset in animals and peripheral neuropathy in large dogs

Question 29

3rd gen cephalosporins

Answer 29

- primarily gram negative | - cefovecin (convenia) cefpodoxime

Question 30

fluoroquinolones

Answer 30

``` 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) ```

Question 31

good tissue penetration

Answer 31

clindamycin | fluoroquinolones

Question 32

Enrofloxacin

Answer 32

- metabolized into

Question 33

fluoroquinolones

Answer 33

enrofloxacin orbifloxacin moxifloxacin pradofloxacin

Question 34

mupirocin

Answer 34

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

Question 35

polymyxin B

Answer 35

for resistant pseudomonas or staph

Question 36

antibiotic usage

Answer 36

full dosage! adequate time! treat staph avoid steroids

Question 37

long term abx therapy

Answer 37

not recomended

Question 38

try to use _______ abx

Answer 38

veterinary approved

Question 39

topical antiseptics

Answer 39

chlorhexidine - mild irritant, kills bacteria fungi viruses | benzoyl peroxide - good for staph but irritating

Question 40

vetericyn spray

Answer 40

oxyclorine (simillar to bleach) used for MRSA well tolerated