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An Urban Experience
phosphomycin, piperacillin, rifampin and ticarcillin. Drugs deemed critically important to human health (e.g. vancomycin, teicoplanin, linezolid etc.) should never
be used in animals. Some countries prohibit the use of human antibiotics not licensed for animals.
Dose and duration of treatment
Treatment should wait until antimicrobial sensitivity
test results are available. If immediate treatment is necessary, drug selection should be based on the most likely organisms and their susceptibility, later changing to a higher or lower tier drug as required. Animals should be weighed to allow accurate dosing. Surface and superficial pyodermas typically need 1-3 weeks of treatment. Full resolution of deep pyodermas may take 4-6 weeks or longer. Treatment should continue until clinical cure and normal cytology.
Owner compliance
Poor compliance compromises efficacy and encourages resistance. Compliance can be improved by using easy to administer drugs, clear written instructions, and good follow up.
Treatment failures and recurrence
Treatment failures can be associated with resistance, poor compliance, inadequate dose and duration, immunosuppressive drugs, and/or poor distribution to the target tissue. However, most recurrent pyodermas involve failure to manage the underling condition. Nevertheless, topical antiseptics or immunostimulants (e.g. Staphphage Lysate) can reduce the frequency of relapses.
Further reading and resources
· FECAVA posters and guidelines - policies
· BSAVA PROTECT antibiotic use guidelines - Resources/PROTECT.aspx
· International Society for Companion Animal Infectious Diseases - www.iscaid. org
· Beco L et al (2013) Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part one – diagnosis based on clinical presentation, cytology and culture. Veterinary Record 172 72-78.
· Beco L et al (2013) Suggested guidelines for using systemic antimicrobials in bacterial skin infections: part two – antimicrobial choice, treatment regimens and compliance. Veterinary Record 172 156-160.
· Brissot H et al (2016) GRAM: Guidance for the rational use of antimicrobials - recommendations for dogs and cats 2nd ed. Ceva Santé Animale, France.
· Forsythe P et al (2013) Update on treating canine staphylococcal skin infections. In Practice Focus Nov 2013.
· Hillier A et al (2014) Guidelines for the diagnosis and antimicrobial therapy
of canine superficial bacterial folliculitis (Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases). Veterinary Dermatology 25 163-75.
· Mueller RS et al (2012). A review of topical therapy for skin infections with bacteria and yeast. Veterinary Dermatology 23 330-e62.

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