Equine Health Update EHU Vol 20 Issue 02 - Page 45

Ocular SAEVA Neosporin Procedures Local therapy for all ocular problems and Policies | EQUINE Conjunctivitis Fusidic acid Mild corneal ulceration Consider artificial tears/ plasma Gentamicin Gentamicin Most cases trauma Ciprofloxacin Ciprofloxacin Consider keratomycosis Severe corneal ulceration Melting corneal ulceration Antibiotic use policy Miscellaneous rder to comply with good antimicrobial stewardship gely rests on a document produced by the New Zealand Veterinary Endocarditis Penicillin & Gentamicin Trimethoprim & ion-it most closely resembles the South African situation. Sulphadiazine & for us by Dr Pia Randleff-Rasmussen- Drakenstein Veterinary Clinic Rifampicion Fluoroquinolones Core Principles Trimethoprim & Penicillin & Gentamicin Neutropenia >1 & <2.4x10°/; Sulphadiazine Pyrexia of unknown origin the impacts of antimicrobial use on human and animal health is made by all Penicillin & Gentamicin Penicillin & Gentamicin Neutropenia <1x x 10°/l or administering antimicrobial agents. & Metronidazole nditions that could require antimicrobial therapy is a key focus of veterinary Neonate <3 Weeks antimicrobial agents only as required to maintain their health and welfare. Neonatal pneumonia Ceftiofur Penicillin & ng the number of animals given antimicrobial agents are employed where this Gentamicin/Amikacin mise animal health or welfare. Septice arthritis / synovitis Penicillin & Trimethoprim & bial agents are used, dose rates and regimens are designed to improve efficacy Gentamicin/Amikacin Sulphadiazine ment. Oxytetracycline or ents considered more important in human medicine are not used as first line Doxycycline Patent urachus Not indicated Oxytetracycline or e only employed when use is likely to deliver superior outcomes. Doxycycline Unbilical infection Trimethoprim & Peniciilin & Sulphdiazine Gentamicin/Amikacin SEPSIS Ceftiofur high doses (5- Penicillin & 10 mg/g TID) Gentamicin/Amikacin SEVERE SEPSIS Ceftiofur & Pencillin & Gentamicin & Gentamicin/Amikacin Metronidazole Meningitis Ceftiofur Penicillin & Gentamicin/Amikacin Prophylaxis Pre-Operative Post-Operative Blood and urine cu ltures before therapy Blood cultures at peak fever BEFORE Abs Avoid antimicrobials where viral cause, e.g. equine corona virus, is suspected *Clinically important but justified in neonate due to high mortality Consider source (lungs, GI, umbilicus), if latrogenic, consider MRSA (Macrolides / Fluoroquinolones) Abs not indicated unless sepsis is involved. Avoid dehydration at all costs Infection + 2 of: tachycardia, abnormal Temp, Resp. WBC Defined as sepsis with organ dysfunction, hypoperfusion, or hypotension No BBB in meningitis Consider source Duration of post-operative treatment Clean surgery Penicillin 24 hours, i.e. one dose Contaminated surgery Pencillin & Gentamicin Penicillin & Gentamicin 5 days High risk surgery Penicillin & Gentamicin Penicillin & Gentamicin 10 days, then reassess. Consider TMP-S if longer treatment required • Volume 20 Issue 2 | July 2018 • 45