The Use and Misuse of Antibiotics

Antibiotics have the abillity to help your dog but may introduce bacterial resistance or allergies.

By | Posted: Fri Jul 23 00:00:00 PDT 2004

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Conversely, in urinary tract infections and in skin infection cases called pyoderma, long-term administration of antibiotics may be necessary to elimin ate tough infections. Often, with pyoderma, antibiotics are underprescribed. According to veterinary dermatologist Rusty Muse of Tustin, Calif., most pyoderma cases require an appropriate antibiotic for as long as six to eight weeks to be effective. Muse says, "The skin receives only 4 percent of the heart's output, so effective blood delivery of antibiotic concentrations has a much more difficult time saturating the skin cells in microbe-killing amounts than in organs well perfused with blood, such as the liver. At our dermatology clinic, we have discovered that about 10 percent of the 'allergy' patients are actually suffering from chronic pyoderma, and have not responded well to antibiotics previ-ously used. Sometimes that failure for an infection to clear is due to too low of a dose being given, or the dose not being given as often as directed or for as long as directed. In some cases, especially if a culture and sensitivity have not been done, the antibiotic chosen may not be the best choice for the specific bacteria causing the pyoderma.

"There are four principles to keep in mind regarding appropriate antibi-otic use," continues Muse. "One is that the correct choice of antibiotic needs to be made for a particular infection. The second is the proper dose must be given. Third is that the dose must be given at defined intervals because some medications should be given once a day, and others four times a day, to achieve consistent and effective tissue levels of the antibiotic. And finally, the antibiotic needs to be given long enough to truly affect a cure."

In general, most veterinarians select what they consider to be an appropriate medication, and if the results are not favorable, laboratory identification of the bacteria and testing for the bacteria's vulnerability to specific antibiotics is done. This is termed "doing a culture and sensitivity." Should this be done in every situation where an infection is discovered? According to Mark G. Papich, DVM, Professor of Clinical Pharmacology in the College of Veterinary Medicine at North Carolina State University, "For routine infections, empirical treatment with 'first line' drugs can be used without obtaining lab (culture and susceptibility) tests first. For refractory infections, or cases that are more serious and/or life-threatening, lab tests are recommended."

Some antibiotic failures might be due to early withdrawal of the drug by the owner, who stops treatment when it appears that an infection has cleared up. Every veterinarian has experienced the exasperation of an owner failing to comply with prescription instructions. A typical scenario goes like this: The veterinarian sees a patient again for the same problem a few months after prescribing an antibiotic. A different prescription is suggested to fight the infection and the owner says, "I've still got quite a few left from the last time, Doctor, should I just start those again?" So that's why the medication didn't work; it wasn't used for the entire treatment time!

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