LIFE THREATENING INFECTIONS

Use of antibiotics other than those listed should be based on susceptibility testing
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There is no universally accepted veterinary definition of sepsis, but it may be suspected in dogs and cats who are systemically unstable due to a presumptive or diagnosed bacterial burden, clinically this may manifest as:
  • Refractory hypotension (systolic <90 mmHg) despite appropriate volume resuscitation
  • Hypoglycaemia requiring supplementation
  • Neutropenia

Bacteraemia Or Sepsis:​​

  • Amoxicillin/clavulanate 20 mg/kg IV q8h
If recent (<3 months) beta lactam administration​​
  • Fluoroquinolone (enrofloxacin 10 mg/kg IV q24h (dogs)
  • Marbofloxacin 5 mg/kg IV q24h (cats)
  • Clindamycin 11 mg/kg IV q12h
  • metronidazole 10 mg/kg IV q12h
  • 1) Investigations must be performed to identify likely source and obtain samples (i.e. urine, bile, effusions, airway wash).
  • 2) Source control surgery required if amenable
  • 3) Transition to oral medication when clinical signs improve.
  • 4) Base duration on improvement in clinical signs (patient demeanour, pyrexia ‡ CRP (dogs only)

Septic Peritonitis​​

  • Amoxicillin/clavulanate 20 mg/kg IV q8h
  • ADD fluoroquinolone if recent (<3 months) beta lactam administration If amoxicillin/clavulanate unavailable
If amoxicillin/clavulanate unavailable​
  •  
  • Cefuroxime 20 mg/kg IV q8h AND clindamycin 11 mg/kg IV q12h
  • metronidazole 10 mg/kg IV q12h
If colonic perforation
  •  
  • ADD metronidazole 10 mg/kg IV q12h
  • 1) Definitive source control essential as soon as possible
  • 2) Transition to oral administration when clinical signs improve. Base duration on improvement in clinical signs (patient demeanour, pyrexia ± CRP (dogs only))
  • 3) Courses as short as 4 days are used in humans

Neutropenia:

Mild (neutrophil count >1000/μl) AND well
  • No antibiotic required
Moderate (neutrophil count <1000/μl) AND well​​
  • Cefalexin PO
  • Amoxicillin/clavulanate PO
  • Trimethoprim/sulphonamide PO
Severe (neutrophil count <500/μl) OR mild/moderate neutropenia AND unwell.​
  • For example: Hypotension despite fluids, hypoglycaemia with sepsis suspected, severe gastrointestinal signs or pyrexia)
  • Amoxicillin/clavulanate
  • Cefuroxime IV
Stop antibiotics when neutrophil count >1000/μl
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