bsava.com/Resources/Veterinary-resources/Position-statements/Responsible-use-of-antibacterials. Currently, she is a professor of veterinary dermatology at the University of Minnesota. Amoxicillin, cephalexin, and clindamycin are common prescriptions for this type of infection. Ciprofloxacin should not be used because of its reported poor absorption and bioavailability in dogs. Deep Pyoderma is usually preceded by superficial pyoderma if it had not been managed effectively. Subtherapeutic doses of systemic antimicrobials, including pulse therapy protocols, are currently strongly discouraged as they are likely to promote antimicrobial resistance. Reduced systemic antimicrobial use or duration. Mucocutaneous pyoderma is a local disorder that often develops alongside other dermatological health issues in dogs. Incidence of inducible clindamycin resistance in. 3. Epidermal collarettes on the ventral abdomen of a dog. fleas, mites). A small scraping of skin is all a vet needs to check for pathogens. Pinpointing the bacterial species responsible for your pet's skin issue is a priority, but your vet may also check for other health problems that could be complicating the inflammation. Morris DO, Loeffler A, Davis MF, et al. In addition, concern exists regarding potential transmission of antimicrobial-resistant strains among animals and humans. Failure to recognize staphylococcal antimicrobial resistance frequently results in ineffective empiric therapeutic choices and protracted clinical disease. Vet Record Dosage is determined based on your dog's weight. Suggested guidelines for using systemic antimicrobials in bacterial skin infections (2): antimicrobial choice, treatment regimens and compliance. 3. Only one dog (in group A) relapsed nine days after treatment discontinuation. When a systemic antibiotic is needed, selection of one with the narrowest spectrum of activity possible will minimize the selection of resistant organisms.4. Mucocutaneous pyoderma creates crusted lesions and fissures in sensitive areas, so bathing helps reduce the unsightly skin damage, odor and greasy fur associated with the disorder, according to the 2013 Western Veterinary Conference. Chloramphenicol and rifampin can be used safely in most dogs; however, close monitoring for potential aplastic anemia and liver toxicity, respectively, is needed. Hillier A, Lloyd DH, Weese JS, et al. Canine superficial pyoderma, also called bacterial folliculitis, is one of the most common problems veterinarians face, and the increasing prevalence of staphylococcal antimicrobial resistance poses a new challenge to treatment.Failure to recognize staphylococcal antimicrobial resistance frequently results in ineffective empiric therapeutic choices and protracted clinical disease. Suggested guidelines for using systemic antimicrobials in bacterial skin infections (2): antimicrobial choice, treatment regimens and compliance. Copyright © 2020 Today's Veterinary Practice. In dogs, superficial pyoderma is the most common form of pyoderma, and it is also the most common reason for antimicrobial use in small animal practice. He spent more tan 10 years nursing kittens, treating sick animals and domesticating semi-feral cats for a local animal shelter. The choice of systemic antimicrobial may be empiric in first-time, nonrecurrent pyoderma cases and in dogs that have not been exposed to multiple courses of systemic antimicrobials. To avoid the side effects of commercial drugs, you can always use coconut oil and apple cider vinegar to clear bacterial infections in dogs. Gold RM, Lawhon SD. De Lucia M, Bardagi M, Fabbri E, et al. Chloramphenicol and rifampin can be used safely in most dogs; however, close monitoring for potential aplastic anemia and liver toxicity, respectively, is needed. The basic principles of successful systemic antimicrobial therapy include proper antimicrobial selection, establishment of an effective dosage, and long enough duration of treatment to ensure complete resolution of the infection. 2. Poor nutrition, high stress levels and other general health factors can also leave your pet vulnerable to skin infections. Historically, rifampin was used in combination with other antimicrobials (e.g., doxycycline) due to concern with development of fast resistance; however, polyantimicrobial systemic therapy should be avoided due to potential for more resistance. These topical antibiotic therapies should be used until complete resolution of the skin infection. Vet Rec. Ideally, samples should be taken from pustules. The classifications above help determine the treatment regimen for each case of pyoderma: 1. References The treatment must be tailored to each patient. Recommended doses of systemic drugs for canine superficial pyoderma have been published in the ISCAID guidelines. Appropriate diagnostic tests, such as skin scrapings, trichogram, fungal culture, and skin biopsy, should be performed to rule out these conditions. Several published reports, including one in dogs,6 recommend the use of clindamycin only based on culture and susceptibility results due to a phenomenon called MLSB (macrolide-lincosamide-streptogramin B) that is associated with cross-inducible resistance among macrolides. You may also find some pimple like pustules on the affected skin. First-generation cephalosporins (e.g., cephalexin), Third-generation cephalosporins (e.g., cefpodoxime, cefovecin), Aminoglycosides (e.g., gentamicin, amikacin), Fluoroquinolones (e.g., enrofloxacin, marbofloxacin, difloxacin, orbifloxacin, pradofloxacin), Do not use ciprofloxacin (poor bioavailability in dogs). Veterinarians implement stain tests to identify common bacterial culprits so they can prescribe a tailored treatment for the infection. Skin infections associated with significant inflammation may benefit from short, limited courses of topicals containing glucocorticoids such as hydrocortisone, betamethasone, mometasone, or triamcinolone; however, care should be taken with these products, as chronic use of topical glucocorticoids can induce adverse cutaneous reactions (e.g., atrophic skin, wounds). Topical therapy is usually safer and reaches higher concentration in the skin compared with systemic antimicrobials. Get the latest peer-reviewed clinical resources delivered to your inbox. Other less commonly identified gram-positive bacteria include Staphylococcus schleiferi, Staphylococcus aureus, Staphylococcus xylosus, Staphylococcus epidermitis, and Streptococcus species. Fortunately, this condition is easily cured with over-the-counter medication. Recommended doses of systemic drugs for canine superficial pyoderma have been published in the ISCAID guidelines1 and elsewhere. The term methicillin-resistant staphylococcus (MRS) refers to any Staphylococcus species that is resistant to oxacillin; that is, it demonstrates in vitro resistance to all β-lactam antimicrobials, including all cephalosporins, penicillins (including potentiated amoxicillin), and carbapenem antimicrobials. The clinical consensus guidelines of the WAVD state that topical therapy using antibacterial agents with proven antistaphylococcal efficacy is the recommended treatment modality for any superficial pyoderma involving MDR or MRS, particularly those with localized lesions. 5. Mucocutaneous pyoderma is considered a surface condition, so topical treatments can be applied to most or all of the affected area. Guidelines for antimicrobial use in dogs and cats. Clinical signs of canine superficial pyoderma typically include erythematous papules and pustules (, ), which are usually associated with hair follicles. Treatment of Pyoderma in Dogs Treatment may include topical therapy and antibiotic therapy: Antibiotics to help kill the bacteria infection. The vet will prescribe the medication he believes is best suited for your pet's case. bsava.com/Resources/Veterinary-resources/Position-statements/Responsible-use-of-antibacterials. doi: 10.1111/vde.12404. Ideally, samples should be taken from pustules. Many dermatologists first select cephalexin or cefadroxil for empiric treatment of superficial pyoderma, with the second choice typically being amoxicillin clavulanate. Your veterinarian will also instruct you regarding continuing bathing routines that are required to clear the inf… Consult with the vet before cleaning the area or applying any other substance to your pet's skin. Moth-eaten alopecia on the dorsum of a dog. For these antimicrobials, increasing the dose increases efficacy but increasing the frequency of administration does not. Successively, scaling, crusts, and epidermal collarettes (Figure 2) are often present. 1. doi: 10.1111/vde.12444. Second-tier antimicrobials should only be used when culture and sensitivity results indicate that the bacterial isolate is not susceptible to any of the first-tier antimicrobials or when the patient experiences side effects from first-tier antimicrobials. may be used to stimulate immunity against the indicated bacteria and prevent or control pyoderma. Pyoderma in Dogs and Cats. Additionally, a recent study showed that rifampin, used as monotherapy, was shown to be efficacious in almost 72% of dogs with MDR methicillin-resistant Staphylococcus pyoderma;8 however, patients should be carefully monitored for resistance during treatment, especially when several months of treatment are needed. Patients with pyoderma should always be reevaluated by the veterinarian, who should not rely solely on the owner’s perception to determine if the bacterial infection has resolved. Treatment of pyoderma in the dog typically involves the use of both topical and systemic antibacterial therapies. In very pruritic patients, a short (1—2 week) course of oral anti-inflammator… Using antibiotics responsibly in companion animals. In the author’s opinion, topical fluoroquinolones should not be used empirically and should also be saved for more resistant cases if other topicals are not effective. Figure 1. Surface pyoderma; Superficial pyoderma; Deep pyoderma; Surface and superficial pyoderma can cause severe itching in your dog and can also be the cause of hair loss near the infected area or the redness in skin. Guardabassi L, Houser GA, Frank LA, et al. Superficial pyoderma in dogs is a mild pyoderma infection that’s limited to the skin’s surface, while deep pyoderma affects all layers of the dog’s skin and can be more difficult to deal with. The author usually considers clindamycin or doxycycline as the first choices for second-tier antimicrobials for MDR or MRS cases, based on their efficacy for these infections and their safety profile. These products may also be used for maintenance to help prevent infection in cases of common pyoderma recurrence. The most commonly used antibiotics include cepahlexin, Clavulanic acid-amoxicillin (Clavamox), Clindamycin, and Cefovecin injectable (Convenia). In one study, treatment with topical 4% chlorhexidine products showed resolution of clinical signs in all dogs and was found to be as effective in treating superficial pyoderma as systemic therapy with amoxicillin-clavulanic acid. Figure 4. Moth-eaten alopecia on the dorsum of a dog. Clinical signs cannot differentiate susceptible from resistant infections. It is a staph or other bacterial infection that targets wounds on your dog's skin, resulting in deep or superficial … Targeted antibiotics are administered to kill specific bacteria when the lab tests reveal the strain responsible for the infection. The choice of systemic antimicrobial may be empiric in first-time, nonrecurrent pyoderma cases and in dogs that have not been exposed to multiple courses of systemic antimicrobials. The dog patient will also be checked for presence of parasites (e.g. Vets tend to label pyoderma as either “superficial” or “deep.” Again, no great mystery here. A Suicide Support Resource for Veterinary Workplaces. The author, based on experience and other publications,5-7 modifies the ISCAID tiers for more strict antimicrobial stewardship (Box 3). Mupirocin, a carboxylic acid ointment, is highly effective against MRS skin infections and can be used for localized treatment; however, the author uses mupirocin only in resistant cases, when other topicals are not effective or demonstrate resistance in vitro. Veterinary School Applications Are Up 19% — What Does that Mean for the Profession? Educating clients about their pet’s pyoderma and treatment has been shown to improve compliance. Superficial pyoderma is common in dogs and rare in cats. Baths should be given 2 to 3 times per week during the first 2 weeks of treatment and then 1 to 2 times per week until the infection clears. It is currently recommended by veterinary dermatologists to treat superficial pyoderma until 1 week after complete clinical resolution of the infection. Shampoos, mousses, lotions, wipes, sprays, and rinses containing antiseptics such as chlorhexidine (commonly used by the author), benzoyl peroxide, ethyl lactate, hydroxyl acids (i.e., acetic acid, lactic acid, and malic acid), and hypochlorous acid may be used 1 to 3 times weekly up to daily for resolution of localized and generalized lesions, as well as for maintenance to help prevent recurrence of infection. The presence of allergic dermatitis, parasites or other sources of skin irritation increase the severity of pyoderma and allow it to resurface even after effective treatment. It is important that the right antibacterial agent is chosen. Pythiosis (Oomycosis, Lagenidiosis, Swamp Cancer, Bursatti, Leeches) in Dogs, Cats and Horses ... Snake Bite Prevention and Treatment for Dogs. To prevent frequent recurrence of superficial pyoderma, it is crucial to try to identify and control the underlying primary disease (e.g., allergy, endocrinopathy) that typically predisposes dogs to pyoderma. Deep pyoderma is also relatively common in the dog. Anecdotal evidence suggests that autogenous bacterins and commercial bacterial antigens (e.g., Staphage Lysate [Delmont Laboratories, delmontlabs.com] and Propionibacterium acnes [ImmunoRegulin; Neogen Vet animalsafety.neogen.com]) may be used to stimulate immunity against the indicated bacteria and prevent or control pyoderma. INDICATIONS OF PYODERMA IN YOUR DOG. British Veterinary Association. The need for this test has increased with the emergence of MDR infections in veterinary medicine. There is no current indication that use of antimicrobials affects isolation of causative bacteria in canine superficial pyoderma; therefore, samples may be collected for culture whenever indicated, regardless of administration of antimicrobials. Other causes of folliculitis and pustular disease should be considered, including demodicosis, dermatophytosis, sterile pustular diseases such as pemphigus foliaceus (. Dr. Koch graduated with a degree in veterinary medicine from the Federal University of Mato Grosso do Sul in Brazil. Topical antimicrobials were used in most cases. He graduated from the University of Delaware with a bachelor's degree in journalism. The basic principles of successful systemic antimicrobial therapy include proper antimicrobial selection, establishment of an effective dosage, and long enough duration of treatment to ensure complete resolution of the infection. Loeffler A, Cobb MA, Bond R. Comparison of a chlorhexidine and a benzoyl peroxide shampoo as sole treatment in canine superficial pyoderma. Clinical signs cannot differentiate susceptible from resistant infections. 2. Using the correct dose, frequency of administration, and duration of antimicrobials is crucial for a successful outcome when treating any infection. British Veterinary Association. Snakebite: First Aid. Your vet will check for parasites and other alternate causes of skin disease. Battersby I. Very superficial or localized cases of canine pyoderma may be treated with topical antibacterial medications alone (Table 1). Accessed November 2020. 3. Figure 2. How is Pyoderma Treated? Morris DO, Loeffler A, Davis MF, et al. Treatment for Pyoderma consists of antibiotic therapy for a minimum of 3 – 4 weeks. With the identification of methicillin-resistant and multidrug-resistant Staphylococcus spp, the treatment of pyoderma has become more challenging. If pustules are not present, samples may be collected from exudate beneath crusts, epidermal collarettes, and, if needed, from papules (by rupturing the papules with a 22-gauge needle). Gastrointestinal signs were reported in 15% of treated dogs. to help veterinarians adequately diagnose and treat pyoderma, using judicious antimicrobial therapy to prevent bacterial resistance. Clinical signs of canine superficial pyoderma typically include erythematous papules and pustules (Figure 1), which are usually associated with hair follicles. (A) Dog with superficial pyoderma along the dorsum before topical therapy with chlorhexidine shampoo and mousse. Each dog’s case is different because it could be chronic or recurrent. In order to appropriately and successfully use antibiotics in the treatment of canine superficial pyoderma, it is important for veterinarians to be familiar with these potentially underlying diseases. Therefore, reduction of the overall use of antimicrobials in veterinary medicine, especially systemic antimicrobials, can help reduce antimicrobial resistance. Epidermal collarettes on the ventral abdomen of a dog.Figure 3. All animals were housed in single cages at 17–20°C with a 12 h : … In dogs, superficial bacterial folliculitis (SBF) is the commonest form of canine pyoderma, which is in turn, the principal reason for antimicrobial use in small animal practice. Equally important is the need for an adequate duration of treatment. The need for this test has increased with the emergence of MDR infections in veterinary medicine. 7. Beco L, Guaguère E, Méndez CL, et al. Your veterinarian will develop a course of treatment depending on the results of her diagnosis. Treatment of pyoderma is usually aimed at resolving the bacterial infection and addressing the underlying cause, if applicable. Responsible use of antimicrobials in veterinary practice. 6. The first step in treating superficial pyoderma properly is to confirm the diagnosis. Mucocutaneous pyoderma is a local disorder that often develops alongside other dermatological health issues in dogs. De Lucia M, Bardagi M, Fabbri E, et al. Potentiated sulfonamides are often efficacious against S pseudintermedius; however, they can have many side effects (e.g., hypothyroidism, keratoconjunctivitis sicca, hypersensitivity reaction in certain breeds), especially when given for a long period of time. Follow his recommendations for managing other ailments as you continue to administer the prescribed treatment for your pet's pyoderma. Many diseases have the potential to predispose dogs to the development of superficial pyoderma. Additionally, a recent study showed that rifampin, used as monotherapy, was shown to be efficacious in almost 72% of dogs with MDR methicillin-resistant. Spaying your Female Dog. Pyoderma in dogs can cause a great deal of discomfort in your dog. Median duration of rifampicin treatment was five weeks for superficial pyoderma and four weeks for deep pyoderma. 1 When a diagnosis of pyoderma … Statistically significant increases of ALT (P = 0.045) and ALP (P = 0.0002) values after 3-4 weeks of treatment was observed. Mupirocin, a carboxylic acid ointment, is highly effective against MRS skin infections and can be used for localized treatment; however, the author uses mupirocin only in resistant cases, when other topicals are not effective or demonstrate resistance in vitro, as this is the most important topical antimicrobial used to treat methicillin-resistant S aureus (MRSA) in humans. The diagnosis includes recognition of the typical clinical signs, the exclusion of other similar conditions, and confirmation via skin cytology, plus or minus bacterial culture and susceptibility testing.3 This approach helps prevent inappropriate use of antimicrobial therapy for skin diseases that are not associated with pyoderma. Virbac South Africa: Canine Bacterial Pyoderma, Western Veterinary Conference: using Antibiotics Wisely for Pyoderma in the Age of Methicillin Resistance, Dr. Robert Hilton: Bacterial Infections of the Skin, Delaware Valley Academy of Veterinary Medicine: Tips for the Treatment of Canine Pyoderma. When a systemic antibiotic is needed, selection of one with the narrowest spectrum of activity possible will minimize the selection of resistant organisms. Guide to Antimicrobial Use in Animals. Pyoderma in dogs is directly treated with antimicrobial therapy — either oral antibiotics or topical antibacterial medication, shampoo or spray applied to the affected area. Anecdotal evidence suggests that autogenous bacterins and commercial bacterial antigens (e.g., Staphage Lysate [Delmont Laboratories. ]) One of the most important factors leading to the emergence of antimicrobial-resistant bacteria is the use and misuse of antimicrobial therapy. The typical duration of treatment for superficial pyoderma is 3 to 4 weeks, but more time may be needed. Web Design by PHOS Creative, https://todaysveterinarypractice.com/table-of-contents-january-february-2021/, BOX 1 When to Perform Bacterial Culture and Sensitivity Testing, BOX 2 Benefits of Topical Therapy for Canine Superficial Pyoderma, Box 3 Selection of Systemic Antimicrobials for Canine Pyoderma. Using antibiotics responsibly in companion animals. Specific antimicrobial guidelines and clinical consensus on treating bacterial skin infections have been developed by the International Society for Companion Animal Infectious Diseases (ISCAID, iscaid.org) and the World Association for Veterinary Dermatology (WAVD, wavd.org) to help veterinarians adequately diagnose and treat pyoderma, using judicious antimicrobial therapy to prevent bacterial resistance.1,2 To treat canine pyoderma successfully, it is important to recognize its clinical signs, confirm the infection, and identify and treat any underlying cause to help prevent pyoderma recurrence. Conventional Canine Pyoderma Treatment Conventional treatment involves the use of antibiotics, topical therapy, and when appropriate, treatment of the underlying causes. If pustules are not present, samples may be collected from exudate beneath crusts, epidermal collarettes, and, if needed, from papules (by rupturing the papules with a 22-gauge needle). Rifampicin treatment of canine pyoderma due to multidrug-resistant meticillin-resistant staphylococci: a retrospective study of 32 cases. If selected properly, systemic antimicrobial therapy is very effective in cases of canine superficial pyoderma. Therefore, when considering the use of clindamycin, it is important to verify that all tested macrolides show in vitro susceptibility. Chloramphenicol, rifampin, and aminoglycosides are often last-resort options for MDR staphylococcal infections, mostly due to more severe potential adverse effects. Antibiotics used for deep pyoderma are similar to those used for superficial infections of the skin. The clinical consensus guidelines of the WAVD state that empirical drug selection for systemic therapy is always contraindicated when a multidrug-resistant infection is suspected based on historical factors, due to the high prevalence of multidrug resistance within these strains.2 The ISCAID guidelines, last updated in 2014, outline 3 tiers of antimicrobials and their recommended use for canine superficial pyoderma.1 Clinical use by veterinary dermatologists may vary from these guidelines. 3 The median age of the nine beagles was 2.3 years (range 1.4–5 years), and the median weight was 9.2 kg (range 7.6–11.3 kg). Superficial bacterial infections are usually to blame, but many additional sources of skin irritation should be considered. Vet Dermatol 2014;25(3):163-175. Follow-up visits are very important for evaluation of the response to therapy and to decide when to discontinue the antimicrobial. Quentin Coleman has written for various publications, including All Pet News and Safe to Work Australia. Additionally, owners should be educated about the need to avoid or minimize systemic antimicrobial use so they can be part of the solution to the global fight against antimicrobial resistance. Appropriate diagnostic tests, such as skin scrapings, trichogram, fungal culture, and skin biopsy, should be performed to rule out these conditions. Cytology is also very important for identification of co-infection with other microorganisms such as. The clinical consensus guidelines of the WAVD state that topical therapy using antibacterial agents with proven antistaphylococcal efficacy is the recommended treatment modality for any superficial pyoderma involving MDR or MRS, particularly those with localized lesions.2. Pyoderma is a skin infection caused by bacteria, fungi, or parasites. What Is Pyoderma? For these antimicrobials, increasing the dose increases efficacy but increasing the frequency of administration does not. 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). 5. Oral or systemic antibiotics are a basic treatment measure for canine pyoderma. This is more serious but fortunately rarer. The first step in treating superficial pyoderma properly is to confirm the diagnosis. Specific antimicrobial guidelines and clinical consensus on treating bacterial skin infections have been developed by the International Society for Companion Animal Infectious Diseases (ISCAID. ) Papules and pustules on the inguinal and medial thigh area of a dog. Canine pyoderma is a group of various skin diseases and an accurate diagnosis is mandatory. Vet Dermatol 2014;25(3):163-175. 5. Your veterinarian will develop a course of treatment depending on the results of her diagnosis. Treatment can be done with relative ease … Six dogs already had been used to establish the canine model of superficial pyoderma. Battersby I. 2013;172(6):156-160. Historically, rifampin was used in combination with other antimicrobials (e.g., doxycycline) due to concern with development of fast resistance; however, polyantimicrobial systemic therapy should be avoided due to potential for more resistance. Otherwise, antimicrobial selection should always be based on results of culture and susceptibility testing. 4 Dr. Griffin recommends using topical products containing 3% or higher chlorhexidine with standalone products, or 2% or higher in combination products. 4. 6. Pyothorax in Dogs and Cats. ), but it can also assist in more rapid resolution of lesions and reduce the duration of systemic antimicrobial use. aModified by author from Hillier A, Lloyd DH, Weese JS, et al. To prevent the unnecessary use of systemic antimicrobials, topical therapy should always be recommended in cases of superficial pyoderma before systemic therapy is considered. Recommendations for approaches to meticillin-resistant staphylococcal infections of small animals: diagnosis, therapeutic considerations and preventative measures: Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. 8. The author considers cefovecin and cefpodoxime to be second-tier antimicrobials because they are third-generation cephalosporins, with a broader spectrum than other cephalosporins such as cephalexin and cefadroxil. The rise of antimicrobial resistance requires veterinarians to shift their approach in treating bacterial skin infections, particularly in regard to the use and selection of systemic antimicrobials. Staphylococcus pseudintermedius is the most common cause of superficial pyoderma in dogs. 1. Before antimicrobials are administered, the diagnosis of superficial pyoderma needs to be supported by cytologic findings demonstrating coccoid bacteria, often associated with inflammatory cells (typically degenerate neutrophils) and, when present, bacteria phagocytosis (, ). General or "broad spectrum" antibiotics, like cephalosporins, are prescribed when the bacterial agent is unknown or if it does not respond to other medication. The ISCAID guidelines include clindamycin and lincomycin in the first tier of antimicrobials.1 The author prefers to reserve these agents for second-tier use based on culture and susceptibility testing when other choices, such as cephalosporins, are not options. Medication he believes is best suited for your pet 's symptoms disappear before the treatment regimen for case... Antibacterial medications alone ( superficial pyoderma dog treatment 1 ), and Streptococcus species used complete. 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