Background Superficial bacterial folliculitis (SBF) is usually caused by Staphylococcus pseudintermedius and routinely treated with systemic antimicrobial agents. Infection is a consequence of reduced immunity associated with alterations of the skin barrier and underlying diseases that may be difficult to diagnose and resolve; thus, SBF is frequently recurrent and repeated treatment is necessary. The emergence of multiresistant bacteria, particularly meticillin‐resistant S. pseudintermedius (MRSP), has focused attention on the need for optimal management of SBF. Objectives Provision of an internationally available resource guiding practitioners in the diagnosis, treatment and prevention of SBF. Development of the guidelines The guidelines were developed by the Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases, with consultation and advice from diplomates of the American and European Colleges of Veterinary Dermatology. They describe optimal methods for the diagnosis and management of SBF, including isolation of the causative organism, antimicrobial susceptibility testing, selection of antimicrobial drugs, therapeutic protocols and advice on infection control. Guidance is given for topical and systemic modalities, including approaches suitable for MRSP. Systemic drugs are classified in three tiers. Tier one drugs are used when diagnosis is clear cut and risk factors for antimicrobial drug resistance are not present. Otherwise, tier two drugs are used and antimicrobial susceptibility tests are mandatory. Tier three includes drugs reserved for highly resistant infections; their use is strongly discouraged and, when necessary, they should be used in consultation with specialists. Conclusions and clinical importance Optimal management of SBF will improve antimicrobial use and reduce selection of MRSP and other multidrug‐resistant bacteria affecting animal and human health.
Recognizing the importance of antimicrobial resistance and the need for veterinarians to aid in efforts for maintaining the usefulness of antimicrobial drugs in animals and humans, the Board of Regents of the American College of Veterinary Internal Medicine charged a special committee with responsibility for drafting this position statement regarding antimicrobial drug use in veterinary medicine. The Committee believes that veterinarians are obligated to balance the well-being of animals under their care with the protection of other animals and public health. Therefore, if an animal's medical condition can be reasonably expected to improve as a result of treatment with antimicrobial drugs, and the animal is under a veterinarian's care with an appropriate veterinarian-client-patient relationship, veterinarians have an obligation to offer antimicrobial treatment as a therapeutic option. Veterinarians also have an obligation to actively promote disease prevention efforts, to treat as conservatively as possible, and to explain the potential consequences associated with antimicrobial treatment to animal owners and managers, including the possibility of promoting selection of resistant bacteria. However, the consequences of losing usefulness of an antimicrobial drug that is used as a last resort in humans or animals with resistant bacterial infections might be unacceptable from a public or population health perspective. Veterinarians could therefore face the difficult choice of treating animals with a drug that is less likely to be successful, possibly resulting in prolonged or exacerbated morbidity, to protect the good of society. The Committee recommends that voluntary actions be taken by the veterinary profession to promote conservative use of antimicrobial drugs to minimize the potential adverse effects on animal or human health. The veterinary profession must work to educate all veterinarians about issues related to conservative antimicrobial drug use and antimicrobial resistance so that each individual is better able to balance ethical obligations regarding the perceived benefit to their patients versus the perceived risk to public health. Specific means by which the veterinary profession can promote stewardship of this valuable resource are presented and discussed in this document.
A randomized, controlled, blinded clinical trial was performed to determine whether butorphanol administered by continuous rate infusion (CRI) for 24 hours after abdominal surgery would decrease pain and surgical stress responses and improve recovery in horses. Thirty-one horses undergoing exploratory celiotomy for abdominal pain were randomly assigned to receive butorphanol CRI (13 g/kg/h for 24 hours after surgery; treatment) or isotonic saline (control). All horses received flunixin meglumine (1.1 mg/kg IV q12h). There were no significant differences between treatment and control horses in preoperative or operative variables. Treatment horses had significantly lower plasma cortisol concentration compared with control horses at 2, 8, 12, 24, 36, and 48 hours after surgery. Mean weight loss while hospitalized was significantly less for treatment horses than control horses, whether expressed as total decrease in body weight (13.9 Ϯ 3.4 and 27.9 Ϯ 4.5 kg, respectively) or as a percentage decrease in body weight (2.6 Ϯ 0.7 and 6.3 Ϯ 1.1%, respectively). Treatment horses were significantly delayed in time to first passage of feces (median times of 15 and 4 hours, respectively). Treatment horses had significantly improved behavior scores during the first 24 hours after surgery, consistent with the conclusion that they experienced less pain during that time. Butorphanol CRI during the immediate postoperative period significantly decreased plasma cortisol concentrations and improved recovery characteristics in horses undergoing abdominal surgery.Key words: Behavior; Colic; Cortisol; Pain management; Stress.I n recent years, there has been a growing interest in recognition and management of pain and surgical stress responses in veterinary medicine. [1][2][3][4][5][6] However, investigation of analgesia in horses has been largely limited to pharmacokinetic studies of drugs or the effects of these drugs in experimental models of induced pain. 5,7-14 Evaluations of analgesic efficacy in equine clinical patients are minimal and primarily focus on responses to nonsteroidal anti-inflammatory agents in horses with orthopedic pain or retrospective studies of responses of horses with colic to various analgesic medications. 5,12,[14][15][16][17] These studies have been complicated by difficulties in accurately assessing and quantifying pain in a nonverbal species. [2][3][4][5][6]16,[18][19][20] Horses undergoing exploratory celiotomy for acute abdominal pain usually receive flunixin meglumine, a nonsteroidal anti-inflammatory drug (NSAID), although doses and dose intervals have varied. In human beings, NSAID medications are considered insufficient for management of pain related to abdominal surgery and a combination of opiates Pullman, WA 99164; e-mail: dsellon@vetmed.wsu.edu. Submitted August 11, 2003; Revised December 9, 2003; Accepted January 16, 2004. Copyright and nonsteroidal analgesic agents is preferred as a multimodal plan for pain management. [21][22][23] Horses that do not exhibit classic behavioral signs of abd...
Currently in veterinary medicine, ciprofloxacin is often used in susceptibility testing to represent the entire class of fluoroquinolone antimicrobials. Using quality control organisms as well as clinical isolates, we compared the MIC of ciprofloxacin to those of three other fluoroquinolones used in animals and found that ciprofloxacin is not an adequate representative of other members of this class.
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