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Lizard Formulary - Antimicrobials (view source)
Revision as of 14:54, 29 March 2010
, 14:54, 29 March 2010Created page with '{{unfinished}} ==Antimicrobials== Sample all suspected infections for microscopy, culture and sensitivity. The majority of bacterial infections in lizards are by Gram-negative …'
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==Antimicrobials==
Sample all suspected infections for microscopy, culture and sensitivity. The majority of bacterial infections in lizards are by Gram-negative organisms, particularly Enterobacteriacae. Therapy may be required before the results of bacterial sensitivity tests are known.
*Aminoglycosides and quinolones are effective against most aerobic pathogens and there is little bacterial resistance to them.
*The fluoroquinolone derivative enrofloxacin is bacteriocidal (inhibit microbial DNA gyrase) and is well distributed to tissues. It is active against a wide range of Gram-negative organisms as well Gram-positives and Mycoplama spp. It is not effective against anaerobes.
*Carbenicillin and ceftazidime are good broad-spectrum antibiotics useful against anaerobes as well as most Gram-negative pathogens. If Pseudomonas spp. and anaerobes are present, ceftazidime is the most appropriate choice.
The following has also been advised: amikacin in combination with ampicillin for respiratory infections; chloramphenicol for gastrointestinal infections; an aminoglycoside in combination with a broad spectrum penicillin for general systemic infections.
*All aminoglycosides may affect neuromuscular transmission leading to muscle weakness and cause nephrotoxicity especially in reptiles kept at more than 25°C. They are also more toxic in gravid females.
Any antibiotic therapy, but particularly gentamycin, should be accompanied by fluids to maintain adequate renal function and reduce the possibility of nephrotoxicity.
===Amikacin===
*Potentially nephrotoxic but no published data
*Administer fluids concurrently
*Frequently used with a penicillin or a cephalosporin
*2.5 mg/kg IM then 2.5-5 mg q72h
*50 mg/10ml saline x 30 min nebulisation q12h
*Maintenance temperature if species POTZ unknown is 25°C
===Amoxicillin===
*Use with an aminoglycoside
*20 mg/kg SC, IM q24h
*Maintenance temperature if species POTZ unknown is 26°C
===Ampicillin===
*May be used with an aminoglycoside
*3-6 mg/kg PO q12-24h
*3-10 mg/kg IM, SC q12-24h
===Carbenicillin===
*May be used with an aminoglycoside but at different time of day
*400 mg/kg IM, SC q24h
*Maintenance temperature if species POTZ unknown is 30°C
===Cefoperazone===
*Published data in tegus
*125 mg/kg IM q24h
===Cefotaxime===
*May be used with an aminoglycoside
*20-40 mg/kg IM q24h
*100 mg/10ml saline x 30 min nebulisation q12h
===Ceftazidime===
*20 mg/kg IM q72h
*Maintenance temperature if species POTZ unknown is 30°C
===Cefuroxime===
*50 mg/kg IM q48h
*Maintenance temperature if species POTZ unknown is 30°C
===Cephuroxime===
*50 mg/kg IM q48h
===Cephalexin===
*20-40 mg/kg PO q12h
===Cephaloridine===
*10 mg/kg IM, SC q12h
===Cephalothin===
*20-40 mg/kg IM q12h
===Chloramphenicol===
*May cause pigmentation changes in chameleons
*20 mg/kg PO, IM, SC q12h
*40mg/kg PO, IM, SC q24h
===Chlortetracycline===
*200mg/kg PO 24h
===Ciprofloxacin===
*11 mg/kg PO q48-72h
===Clindamycin===
*2.5-5 mg/kg PO q12h
*5 mg/kg PO q24h
===Dihydrostreptomycin===
*Administer fluids concurrently
*5 mg/kg IM q12-24h
===Dimetridazole===
*40 mg/kg PO q24h 5d
===Doxycycline===
*5-10 mg/kg PO q24h 10-45d
===Enrofloxacin===
*5-10mg/kg q24h PO, IM, SC, ICo
*1-3 ml of 50 mg/250ml sterile water for nasal flush q12-24h with parenteral antibiotics
===Gentamycin===
*Do not use in animals over 20kg
*2.5 mg/kg SC q72h
*10-200 mg/15ml saline x 30 min nebulisation q12h
*Maintenance temperature if species POTZ unknown is 24°C
===Kanamycin===
*Administer fluids concurrently
*10 mg/kg SC, IM, IV q24h
*Maintenance temperature if species POTZ unknown is 24°C
===Lincomycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*6 mg/kg q12-24h
===Metronidazole===
*May be administered concurrently with amikacin
*Low dose may stimulate depressed immune system
*12.5-40 mg/kg q24h > 7d
*100-275 mg/kg PO as a single dose
===Oxytetracycline===
*May produce local reaction at injection site
*6-10 mg/kg IM, IV q24h
===Penicillin, benzathine , benzathine===
*May be administered concurrently with amikacin
*10,000 units/kg IM q48-96h
===Penicillin G===
*Infrequently used
*10,000-20,000 units/kg IM, SC, IV, ICo q8-12h
===Piperacillin===
*Administer fluids concurrently
*May be used with an aminoglycoside
*50-100 mg/kg IM q24h
*100-200 mg/kg IM q24-48h in chameleons
*100 mg/10ml saline x 30 min nebulisation q12h
===Streptomycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*Avoid with renal/hepatic dysfunction
*10 mg/kg IM q12-24h
===Sulphadiazine===
*Administer fluids concurrently
*Do not use with renal impaired animals
*25 mg/kg PO q24h
===Sulphadimethoxine===
*Potentially nephrotoxic
*Administer fluids concurrently
*90 mg/kg IM then 45 mg/kg q24h
===Tetracycline===
*May disturb the normal intestinal microflora
*10 mg/kg PO q24h
===Ticarcillin===
*Administer fluids concurrently
*50-100 mg/kg IM q24h
===Tobramycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*Potentiated by â-lactams
*2 mg/kg IM q24h
*2.5 mg/kg IM q12h in chameleons
===Trimethoprim/sulphadiazine===
*Administer fluids concurrently
*15 mg/kg IM q24
===Trimethoprim/sulphamethoxaline===
*Administer fluids concurrently
*10-30 mg/kg PO q24h
===Tylosin===
*Reported useful for mycoplasma respiratory infections
*5 mg/kg IM q24 10-60d
==Antimicrobials==
Sample all suspected infections for microscopy, culture and sensitivity. The majority of bacterial infections in lizards are by Gram-negative organisms, particularly Enterobacteriacae. Therapy may be required before the results of bacterial sensitivity tests are known.
*Aminoglycosides and quinolones are effective against most aerobic pathogens and there is little bacterial resistance to them.
*The fluoroquinolone derivative enrofloxacin is bacteriocidal (inhibit microbial DNA gyrase) and is well distributed to tissues. It is active against a wide range of Gram-negative organisms as well Gram-positives and Mycoplama spp. It is not effective against anaerobes.
*Carbenicillin and ceftazidime are good broad-spectrum antibiotics useful against anaerobes as well as most Gram-negative pathogens. If Pseudomonas spp. and anaerobes are present, ceftazidime is the most appropriate choice.
The following has also been advised: amikacin in combination with ampicillin for respiratory infections; chloramphenicol for gastrointestinal infections; an aminoglycoside in combination with a broad spectrum penicillin for general systemic infections.
*All aminoglycosides may affect neuromuscular transmission leading to muscle weakness and cause nephrotoxicity especially in reptiles kept at more than 25°C. They are also more toxic in gravid females.
Any antibiotic therapy, but particularly gentamycin, should be accompanied by fluids to maintain adequate renal function and reduce the possibility of nephrotoxicity.
===Amikacin===
*Potentially nephrotoxic but no published data
*Administer fluids concurrently
*Frequently used with a penicillin or a cephalosporin
*2.5 mg/kg IM then 2.5-5 mg q72h
*50 mg/10ml saline x 30 min nebulisation q12h
*Maintenance temperature if species POTZ unknown is 25°C
===Amoxicillin===
*Use with an aminoglycoside
*20 mg/kg SC, IM q24h
*Maintenance temperature if species POTZ unknown is 26°C
===Ampicillin===
*May be used with an aminoglycoside
*3-6 mg/kg PO q12-24h
*3-10 mg/kg IM, SC q12-24h
===Carbenicillin===
*May be used with an aminoglycoside but at different time of day
*400 mg/kg IM, SC q24h
*Maintenance temperature if species POTZ unknown is 30°C
===Cefoperazone===
*Published data in tegus
*125 mg/kg IM q24h
===Cefotaxime===
*May be used with an aminoglycoside
*20-40 mg/kg IM q24h
*100 mg/10ml saline x 30 min nebulisation q12h
===Ceftazidime===
*20 mg/kg IM q72h
*Maintenance temperature if species POTZ unknown is 30°C
===Cefuroxime===
*50 mg/kg IM q48h
*Maintenance temperature if species POTZ unknown is 30°C
===Cephuroxime===
*50 mg/kg IM q48h
===Cephalexin===
*20-40 mg/kg PO q12h
===Cephaloridine===
*10 mg/kg IM, SC q12h
===Cephalothin===
*20-40 mg/kg IM q12h
===Chloramphenicol===
*May cause pigmentation changes in chameleons
*20 mg/kg PO, IM, SC q12h
*40mg/kg PO, IM, SC q24h
===Chlortetracycline===
*200mg/kg PO 24h
===Ciprofloxacin===
*11 mg/kg PO q48-72h
===Clindamycin===
*2.5-5 mg/kg PO q12h
*5 mg/kg PO q24h
===Dihydrostreptomycin===
*Administer fluids concurrently
*5 mg/kg IM q12-24h
===Dimetridazole===
*40 mg/kg PO q24h 5d
===Doxycycline===
*5-10 mg/kg PO q24h 10-45d
===Enrofloxacin===
*5-10mg/kg q24h PO, IM, SC, ICo
*1-3 ml of 50 mg/250ml sterile water for nasal flush q12-24h with parenteral antibiotics
===Gentamycin===
*Do not use in animals over 20kg
*2.5 mg/kg SC q72h
*10-200 mg/15ml saline x 30 min nebulisation q12h
*Maintenance temperature if species POTZ unknown is 24°C
===Kanamycin===
*Administer fluids concurrently
*10 mg/kg SC, IM, IV q24h
*Maintenance temperature if species POTZ unknown is 24°C
===Lincomycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*6 mg/kg q12-24h
===Metronidazole===
*May be administered concurrently with amikacin
*Low dose may stimulate depressed immune system
*12.5-40 mg/kg q24h > 7d
*100-275 mg/kg PO as a single dose
===Oxytetracycline===
*May produce local reaction at injection site
*6-10 mg/kg IM, IV q24h
===Penicillin, benzathine , benzathine===
*May be administered concurrently with amikacin
*10,000 units/kg IM q48-96h
===Penicillin G===
*Infrequently used
*10,000-20,000 units/kg IM, SC, IV, ICo q8-12h
===Piperacillin===
*Administer fluids concurrently
*May be used with an aminoglycoside
*50-100 mg/kg IM q24h
*100-200 mg/kg IM q24-48h in chameleons
*100 mg/10ml saline x 30 min nebulisation q12h
===Streptomycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*Avoid with renal/hepatic dysfunction
*10 mg/kg IM q12-24h
===Sulphadiazine===
*Administer fluids concurrently
*Do not use with renal impaired animals
*25 mg/kg PO q24h
===Sulphadimethoxine===
*Potentially nephrotoxic
*Administer fluids concurrently
*90 mg/kg IM then 45 mg/kg q24h
===Tetracycline===
*May disturb the normal intestinal microflora
*10 mg/kg PO q24h
===Ticarcillin===
*Administer fluids concurrently
*50-100 mg/kg IM q24h
===Tobramycin===
*Potentially nephrotoxic
*Administer fluids concurrently
*Potentiated by â-lactams
*2 mg/kg IM q24h
*2.5 mg/kg IM q12h in chameleons
===Trimethoprim/sulphadiazine===
*Administer fluids concurrently
*15 mg/kg IM q24
===Trimethoprim/sulphamethoxaline===
*Administer fluids concurrently
*10-30 mg/kg PO q24h
===Tylosin===
*Reported useful for mycoplasma respiratory infections
*5 mg/kg IM q24 10-60d