| The choice of prophylactic antibiotic and protocol remains controversial. A wide variety of microorganisms is found in the flora of the mouth and saliva. Antibiotic prophylaxis requires a drug with antimicrobial activity against '''Gram-positive and Gram-negative aerobes and anaerobes'''. The timing of administration of antibiotics is critical. It is generally accepted that antibiotics should be administered '''within 2 hours of the surgery''' and '''not continued for more than 4 hours after the procedure''' <font color="red">(Peterson, 1994; Callender, 1999)</font color>. In addition, antibiotics must be given at a '''high enough dose''' to reach a tissue level four times higher than the MIC of the causative organisms. A number of studies have shown that ampicillin, amoxicillin-clavulanic acid, certain [[cephalosporins]] and [[Macrolides and Lincosamides|clindamycin]] meet the above requirements in dogs, cats and humans <font color="red">(Callender, 1999; Johnson et al, 1997; Harvey et al, 1995a; Harvey et al, 1995b; Mueller et al, 1999).</font color> | | The choice of prophylactic antibiotic and protocol remains controversial. A wide variety of microorganisms is found in the flora of the mouth and saliva. Antibiotic prophylaxis requires a drug with antimicrobial activity against '''Gram-positive and Gram-negative aerobes and anaerobes'''. The timing of administration of antibiotics is critical. It is generally accepted that antibiotics should be administered '''within 2 hours of the surgery''' and '''not continued for more than 4 hours after the procedure''' <font color="red">(Peterson, 1994; Callender, 1999)</font color>. In addition, antibiotics must be given at a '''high enough dose''' to reach a tissue level four times higher than the MIC of the causative organisms. A number of studies have shown that ampicillin, amoxicillin-clavulanic acid, certain [[cephalosporins]] and [[Macrolides and Lincosamides|clindamycin]] meet the above requirements in dogs, cats and humans <font color="red">(Callender, 1999; Johnson et al, 1997; Harvey et al, 1995a; Harvey et al, 1995b; Mueller et al, 1999).</font color> |
− | A standard protocol often consists of ampicillin prior to surgery (at the time of catheter placement for anesthesia) and repeated after 6 hours if the catheter is still in place. Metronidazole is given intravenously in addition to ampicillin in the presence of severe infection to ensure a wider anaerobic spectrum. | + | A standard protocol often consists of ampicillin prior to surgery (at the time of catheter placement for anaesthesia), repeated after 6 hours if the catheter is still in place. Metronidazole is given intravenously in addition to ampicillin in the presence of severe infection to ensure a wider anaerobic spectrum. |