Page 1469 - Small Animal Internal Medicine, 6th Edition

CHAPTER 92 Practical Antimicrobial Chemotherapy 1441

TABLE 92.7 TABLE 92.8
VetBooks.ir Empirical Antibiotic Choices for Dogs and Cats With Empirical Antibiotic Choices for Dogs and Cats With
Urogenital Infections
Respiratory Infections
ORGAN SYSTEM OR FIRST CHOICE SYNDROME OR
INFECTIOUS AGENT ANTIBIOTICS INFECTIOUS AGENT FIRST CHOICE ANTIBIOTICS

Feline acute bacterial Doxycycline OR Aerobic infection Amoxicillin OR
upper respiratory Amoxicillin (uncomplicated) Trimethoprim-sulfonamide
infection (URI) Aerobic infection Amoxicillin OR
Feline chronic bacterial URI Doxycycline OR (complicated) Trimethoprim-sulfonamide
Based on culture and AND
susceptibility testing Adjust based on culture and
Canine infectious Doxycycline OR sensitivity results
respiratory disease Amoxicillin-clavulanate Brucella canis Quinolone alone OR
complex (bacterial Minocycline or doxycycline
component) cycled with a quinolone
Bacterial bronchitis (dogs Doxycycline OR every 2 weeks
or cats) Based on culture and Leptospira spp. Penicillin G or ampicillin IV
susceptibility testing during acute phase THEN
Uncomplicated “community Doxycycline OR Doxycycline to eliminate
acquired” pneumonia Fluoroquinolone carriers
Pneumonia with clinical Enrofloxacin and Mastitis First-generation
#
evidence of sepsis* ampicillin or cephalosporin OR
clindamycin AND Amoxicillin or amoxicillin-
Adjust based on culture clavulanate
and susceptibility testing Mycoplasma/Ureaplasma Doxycycline OR
Pyothorax (dogs or cats)* Enrofloxacin and penicillin Quinolone
#
or clindamycin AND Prostatitis (gram negative Trimethoprim-sulfonamide OR
+
Adjust based on culture agents) Quinolone AND
and susceptibility testing Adjust based on culture and
susceptibility testing
*For animals with clinical findings of life-threatening disease, the Prostatitis (gram positive Clindamycin AND
consensus of the ISCAID Working Group was to administer dual agents) Adjust by culture and
agent therapy with the potential for de-escalation of therapy based sensitivity results
on culture and antimicrobial susceptibility testing (Lappin et al.,
2017). Pyelonephritis Fluoroquinolone AND
# Enrofloxacin is often chosen as there is a veterinary product for Adjust by culture and
parenteral administration to dogs and the drug has a wide sensitivity results
spectrum against gram-negative organisms and Mycoplasma spp. Pyometra Trimethoprim-sulfonamide OR
There are other drugs with a wide spectrum against gram-negative
bacteria that can be substituted based on antimicrobial Quinolone and ampicillin if
susceptibility testing. evidence of sepsis AND
Adjust by culture and
sensitivity results
develop intermittent bacteremia; the source of infection
is commonly the genitourinary or GI systems. Continu- IV, Intravenous; PO, oral.
ous bacteremia occurs most frequently in association with
bacterial endocarditis. Bacteremic animals can have inter-
mittent fever, depression, and clinical signs associated with 2006). Bacterial endocarditis is often caused by Staphylococ-
the primary organ system infected. Sepsis is the systemic cus aureus, E. coli, or β-hemolytic Streptococcus spp.; Bar-
response to infection and is manifested by peripheral circu- tonella spp. are now recognized as important causes of
latory failure (septic shock). bacterial endocarditis and myocarditis (see Chapters 6, 7 and
Staphylococcus spp., Streptococcus spp., Enterococcus spp., 94) in both dogs and cats (Fenimore et al., 2011).
Corynebacterium spp., Escherichia coli, Salmonella spp., Kleb- If the source of bacteremia or bacterial endocardi-
siella spp., Enterobacter spp., Pseudomonas spp., Proteus spp., tis is likely from an area with mixed flora, such as the GI
Pasteurella spp., Clostridium spp., Fusobacterium spp., Bac- tract, or if the animal has life-threatening clinical signs of
teroides spp., and Bartonella spp. organisms are commonly disease, an antibiotic or combination of antibiotics effec-
isolated from the blood of bacteremic animals (Sykes et al., tive against gram-positive, gram-negative, aerobic, and