tag:blogger.com,1999:blog-9212251348411401170.post2306053382079739331..comments2023-10-01T10:50:05.348-04:00Comments on The Homeless Parrot: The antibiotic warThe Homeless Parrothttp://www.blogger.com/profile/02566801733035183569noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-9212251348411401170.post-44170886753925045822011-03-02T22:55:27.343-05:002011-03-02T22:55:27.343-05:00Good points all around. I would disagree on only ...Good points all around. I would disagree on only two parts. I do think that antibiotics are warranted for most cat bite infections, as there can be infection deeper in the tissues than may be obvious, and the abscess can return. I've seen several that will open, drain, heal over, and then re-form. This can go on repeatedly until antibiotics are used.<br /><br />I also think that many times antibiotics are indicated with upper respiratory infections or tracheitis in dogs, as Bordetella is a bacterial infection. Now admittedly we don't normally do tracheal washes to confirm it, but I'd rather use something to treat a likely infection in the early stages before it turns in to pneumonia.<br /><br />Other than that I completely agree with your points. Too many people over-use antibiotics when the are not indicated. Just recently we treated a FLUTD case simply by putting it on a canned urinary diet. The urinalysis didn't show signs of infection, so we avoided antibiotics. I've also surprised clients because I never use these medications "just in case", especially if there are limited to no signs of infection.Chris Bern, DVMhttps://www.blogger.com/profile/01707072350884127181noreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-81850802016819553532011-03-02T04:37:31.796-05:002011-03-02T04:37:31.796-05:00Makes sense. Thank you!Makes sense. Thank you!Curious Catnoreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-19441527122853194122011-03-01T20:02:29.453-05:002011-03-01T20:02:29.453-05:00Another time you might continue abx in a clean/cle...Another time you might continue abx in a clean/clean contaminated surgery is in patients with immunocompromise, etc (diabetics, for example).The Homeless Parrothttps://www.blogger.com/profile/02566801733035183569noreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-30091245525295624802011-03-01T19:58:24.287-05:002011-03-01T19:58:24.287-05:00So, the way I choose peri-operative antibiotics is...So, the way I choose peri-operative antibiotics is according to current recommendations. If you are interested in references: both the Slatter and Fossum surgery textbooks devote a large chapter to this section.<br /><br />First, classify the surgery type.<br />1) clean<br />2) clean-contaminated<br />3) contaminated<br />4) dirty<br /><br />When entering a hollow viscus in a patient WITHOUT evidence of peritonitis or systemic compromise at the time of surgery, this is considered a clean-contaminated surgery. <br /><br />If gastric or SI, cefazolin or another similar abx is good (ampicillin, Unasyn, etc). <br /><br />If you enter the colon, a broader spectrum (such as "BAM" - baytril, ampicillin, metronidazole) is likely called for.<br /><br />These should be administered about 30 mins prior to the 1st surgical incision. For us and most others, this is done at induction. This allows the abx to reach good levels at the surgery site prior to surgery.<br /><br />If surgery is less than 90 minutes long, another dose is unneeded. If >90 min, another dose should be given. <br /><br />After that, as long as there was no gross abdominal contamination, abx should be discontinued. <br /><br />The point is that it gives you coverage while doing surgery and releasing bacteria, but you are not unnecessarily using abx once you are out of surgery. <br /><br />These are the current recommendations.The Homeless Parrothttps://www.blogger.com/profile/02566801733035183569noreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-16470152812936990692011-02-23T13:44:33.560-05:002011-02-23T13:44:33.560-05:00Can you say some more about perioperative abx? I&#...Can you say some more about perioperative abx? I'm a little confused about how this is an exception to the general principle of risks/benefits of single doses of abx and prophylactic abx. Intuitively, I can come up with a few thoughts but I'd love to hear what you have to say! :-)Curious Catnoreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-44212914337536942011-02-19T21:56:30.363-05:002011-02-19T21:56:30.363-05:00Good post. I have only worked for older practione...Good post. I have only worked for older practioners and i have a terrible time convincing clients (and staff) that their cat does not have a bacterial UTI.Nickihttps://www.blogger.com/profile/00547292170354458260noreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-35613423538156716202011-02-15T22:57:40.473-05:002011-02-15T22:57:40.473-05:00Totally agree! Another great post. I'm not sur...Totally agree! Another great post. I'm not sure if I'm brave enough to skip antibiotics for cat-bite abscesses...but that's what I said about giving up antibiotics post-prophy in severe perio disease and I got over that pretty quickly (ie I don't use them any more following MOST perio therapy procedures). I will give it some more thought and try to let the next one heal with the simple principles of flushing and wound healing!Unknownhttps://www.blogger.com/profile/09336089394215776843noreply@blogger.comtag:blogger.com,1999:blog-9212251348411401170.post-2581276126579131862011-02-15T22:46:05.497-05:002011-02-15T22:46:05.497-05:00Loved this post. As soon as I began reading, I imm...Loved this post. As soon as I began reading, I immediately thought of kennel cough and FLUTD as fitting the bill for over-prescription of antibiotics, but I didn't know about the others you mentioned. <br /><br />I also thought that it might be beneficial in the future to post something about how to identify and critique research articles. This would help clients as well as those in the veterinary field scrutinize the information they find online.<br /><br />"We are frequently faced with clients that tie our hands diagnostically and therapeutically." --Amen! Well-put!Anonymousnoreply@blogger.com