ANTIBIOTIC TABLES.

Table 1 Antibiotics dosage, routes and indications Antibiotic Amikacin Dosages and route Systemic - 15-25 mg/kg/ q 24hr/ IV or IM (divided 812 hr for foals) Local 250-500 mg/q24hr 6.6 -11 mg/kg/q 8-12hr/ IM or IV 11 mg/kg/q6-8hr/IV or IM Combination + indications Systemic - combined with penicillin or cephalosporin . Used alone for local -IV + IO perfusion and Intrasynovial treatment Systemic either alone or in combination with an aminoglycoside Systemic- can be used alone; usually combined with an amino glycoside Systemic can be used alone or combined with penicillin, variable dosage. Good for Staph. Infections Intrasynovial administration Used alone for infections resistant to other anitimicrobials. Not recommended for foals Used primarily with rifampin for Rodococcus infections Systemic combined with penicillin or a cephalosporin. Gram negative infections Used alone for local IV or IO perfusion and for intrasynovial injection Rarely used alone. Anaerobic infections Systemic used alone or combined with an aminoglycoside, ceftiopfur or TMS. Gram positive infections Used in combination with other antibiotics Used alone or in combination with penicillin, not recommended for initial treatment because of resistance Regional perfusion in situations for methicillin resistant staphylococccus species

Ampicillin Cefazolin (Cephalosporin) Ceftiofur

Enrofloxacin

H = 2.2 -4.4 mg/kg/q12hr IV or IM Foal = 46mg/kg/q12/IVorIM Local = 150mg - 2gm 7.5 mg/kg/q12hr/PO 5 mg/kg/q24/hr/IV 22/mg/kg/q6-8hr/PO Systemic 6.6mg/kg/q24/IV [administer slowly] or IM Local 500mg -1gm

Erythromycin Gentamicin

Metronidazole Penicillin

15 mg/kg/q6-8hr/PO or rectally Systemic 22,000-44,000 IU/kg/q6-12hr/IV or IM 10mg/kg/q12/PO 15mg/kg/q12/PO.

Fifampin Trimethoprim sulfa Vancomycin

Local only: 300 mg IO or IV

Doses: from Formulary, JLV-VTH, Colorado State University, 2005

Table 2. Systemic antibiotics.
Tissue(s) Involved cellulitis/lymphangitis Empiric Antibiotic Options cephalosporin + amikacin (or gentamicin); OR enrofloxacin (in adult horse) synovial structures (joint, tendon sheath, bursa) distal limb, foot cephalosporin + amikacin (or gentamicin); OR enrofloxacin (in adult horse) penicillin/cephalosporin + amikacin (or gentamicin) + metronidazole bone respiratory tract (e.g. penetrating neck or chest wound) as for synovial structures penicillin (pen G or ampicillin) + gentamicin + metronidazole; ceftiofur and amikacin can be substituted for penicillin and gentamicin, respectively bowel (e.g., penetrating belly wounds, open drainage for septic peritonitis) penicillin (pen G or ampicillin) + gentamicin; ceftiofur and amikacin can be substituted for penicillin and gentamicin, respectively

internal abscess muscle

penicillin (pen G or ampicillin) + rifampin penicillin (pen G or ampicillin) + metronidazole (for Clostridium sp.)

Borrowed with permission from: Orsini JA et al: Management of the severely infected wounds in equine patients, Clin Tech Eq Pract, 3: 2004

Table 3. antibiotic options and effectiveness for treatment

Gram-positive bacteria Enterococcus faecalis ampicillin (100%), amoxicillin/clavulanic acid (100%), chloramphenicol (90%), tetracycline (90%), erythromycin (40%) Enterococcus faecium ampicillin (90%), amoxicillin/clavulanic acid (90%), chloramphenicol (80%), tetracycline (70%), erythromycin (10%) Rhodococcus equi ceftiofur (100%), ceftizoxime (100%), gentamicin (100%), trimethoprimsulfonamide (100%), rifampin (88%), amikacin (87%), chloramphenicol (63%), erythromycin (63%), cephalothin (39%), tetracycline (25%) Staphylococcus aureus chloramphenicol (97%), amikacin (94%), enrofloxacin (94%), rifampin (94%), cephalothin (91%), amoxicillin/clavulanic acid (88%), erythromycin (76%), ceftiofur (69%), oxacillin (67%), trimethoprim-sulfonamide (55%), gentamicin (45%), ceftizoxime (36%), tetracycline (36%), penicillin G (30%) coagulase-negative Staphylococcus sp. amikacin (100%), amoxicillin/clavulanic acid (100%), cephalothin (97%), rifampin (97%), enrofloxacin (96), chloramphenicol (94%), tetracycline (81%), ceftiofur (77%), oxacillin (77%), ceftizoxime (74%), gentamicin (74%), trimethoprim-sulfonamide (74%), erythromycin (61%), penicillin G (13%) Streptococcus zooepidemicus amoxicillin/clavulanic acid (100%), ampicillin (100%), ceftiofur (100%), ceftizoxime (100%), cephalothin (100%), chloramphenicol (100%), erythromycin (100%), penicillin G (100%), trimethoprim-sulfonamide (100%), rifampin (71%), gentamicin (7%), amikacin (0%) Gram-negative bacteria Actinobacillus sp. (A. suislike, A. equuli, A. ligniersii) amikacin (100%), amoxicillin/clavulanic acid (100%), ceftiofur (100%), ceftizoxime (100%), cephalothin (100%), chloramphenicol (100%), gentamicin (100%), penicillin G (100%), ampicillin (89100%),

trimethoprim-sulfonamide (86100%), tetracycline (86100%), trimethoprim-sulfonamide (86100%), erythromycin (030%) Escherichia coli amikacin (100%), enrofloxacin (100%), ceftizoxime (97%), ceftiofur (94%), ticarcillin (94%), amoxicillin/clavulanic acid (93%), chloramphenicol (91%), gentamicin (86%), cephalothin (73%), tetracycline (71%), ampicillin (68%), trimethoprim-sulfonamide (60%) Klebsiella pneumoniae amikacin (100%), ceftiofur (100%), ceftizoxime (100%), enrofloxacin (100%), ticarcillin (87%), chloramphenicol (80%), amoxicillin/clavulanic acid (79%), gentamicin (67%), trimethoprim-sulfonamide (67%), cephalothin (66%), tetracycline (54%), ampicillin (14%) Pasteurella sp. amikacin (100%), amoxicillin/clavulanic acid (100%), ampicillin (100%), cephalothin (100%), chloramphenicol (100%), gentamicin (100%), penicillin G (100%), tetracycline (100%), trimethoprim-sulfonamide (100%), ceftiofur (83%), ceftizoxime (83%), enrofloxacin (83%), erythromycin (33%) Salmonella sp. (S. agona, S. typhimurium, S. sp.) amikacin (100%), amoxicillin/clavulanic acid (100%), ceftiofur (100%), ceftizoxime (100%), cephalothin (100%), enrofloxacin (100%), tetracycline (7392%), ticarcillin (5491%), gentamicin (4982%), trimethoprimsulfonamide (1582%), ampicillin (082%), chloramphenicol (082%) Serratia marcescens ceftizoxime (100%), enrofloxacin (100%), ceftiofur (75%), tetracycline (50%), amikacin (0%), amoxicillin/clavulanic acid (0%), cephalothin (0%), chloramphenicol (0%), gentamicin (0%), ticarcillin (0%), trimethoprimsulfonamide (0%) * Organisms isolated from horses at the University of California, Davis during 1998.

Suggested reading 1.Stashak TS: Clinical Techniques in Equine Practice; Wound Management Series. Ed by James Orsini, 3: 2004 Theroret C: Veterinary Clinic of North America; Equine Practice; Wound Management.21: