Page 1467 - Small Animal Internal Medicine, 6th Edition

CHAPTER 92 Practical Antimicrobial Chemotherapy 1439

TABLE 92.2 TABLE 92.3
VetBooks.ir Potential Antibiotic Toxicities Empirical Antibiotic Choices for Dogs and Cats With
Cutaneous and Soft Tissue Infections
ANTIBIOTIC EXAMPLES
TOXICITY
INFECTIOUS AGENT FIRST CHOICE ANTIBIOTICS
Aminoglycosides Renal tubular disease
Neuromuscular blockade Abscesses Amoxicillin OR
Ototoxicity (anaerobes) 1,2 Clindamycin OR
Beta lactams Immune-mediated diseases Metronidazole OR
(penicillins and Vomiting or diarrhea First- or second-generation
cephalosporins) cephalosporins
Chloramphenicol Bone marrow/aplastic anemia Actinomyces Penicillins OR
(predominantly cats and humans) Clindamycin OR
Inhibition of drug metabolism Chloramphenical OR
Doxycycline Esophagitis or strictures in cats given Minocycline
tablets or capsules Gram-negative or Quinolones
Macrolides/ Vomiting or diarrhea resistant pyoderma
lincosamides Cholestasis Nocardia Penicillins (high dose) OR
Esophagitis or strictures in cats given Minocycline OR
clindamycin capsules Trimethoprim-sulfonamide OR
Nitroimidazoles Neutropenia (metronidazole) Amikacin OR
Imipenem cilastatin
CNS toxicity (metronidazole and
ronidazole) Staphylococcal Clindamycin or lincomycin OR
Quinolones Failure of cartilage development in pyoderma First-generation cephalosporins
OR
young, growing animals Amoxicillin-clavulanate OR
Retinal dysfunction in some cats with Trimethoprim-sulfonamide
some formulations (enrofloxacin in
particular) 1 Cefovecin can be considered if the cat is impossible to medicate
Potentiation of seizures orally.
Sulfonamides Hepatic-cholestasis or acute hepatic 2 Amoxicillin-clavulanate is not generally required for simple cat bite
necrosis (rare) abscesses and should be considered as a second choice drug if the
Macrocytic anemia (long-term need is approved by culture.
administration in cats)
Thrombocytopenia
Suppurative, nonseptic polyarthritis
(predominantly Doberman)
Keratoconjunctivitis sicca
Renal crystalluria (rare)
Tetracyclines Renal tubular disease
Cholestasis
Fever, particularly in cats
Inhibition of drug metabolism
Teeth browning in puppies and
kittens (not
doxycycline or minocycline)

CNS, Central nervous system.

FIG 92.1
wounds, open wounds, open fractures, osteomyelitis, peri- Caudal stomatitis in a cat with suspected secondary
tonitis, bacterial hepatitis, pyometra, vaginitis, bacteremia, anaerobic bacterial infection.
and valvular endocarditis should be suspected to be infected
with anaerobes (Fig. 92.1). Anaerobic infections also should serosanguineous discharge, neutrophilic inflammation with
be considered in animals with a history of fighting, a foreign cytologically evident bacteria but negative aerobic culture,
body, recent surgery, recent dental procedures, a history and the presence of “sulfur granules” on cytology. Flaccid
of immunosuppressive drugs or diseases, infections resis- paralysis (Clostridium botulinum), rigid paralysis and trismus
tant to aminoglycosides or fluoroquinolones, lesions with (Clostridium tetani), and subcutaneous gas production occur
a putrid odor or black discharge, a painful lesion with a in association with some anaerobic infections.