Skin Infections

Identify underlying disease as skin infection is ALWAYS secondary Antibiotics are not indicated for
  • Malassezia dermatitis
  • Ectoparasites
  • Pruritus
  • Anal sac impactions

Surface pyoderma (hot spots & intertrigo)​

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Topical treatment ONLY
  • 2–4% chlorhexidine or other antiseptics q1–3d
If not responsive or very severe
  • Fusidic acid ± glucocorticoid (cocci)
  • Silver sulphadiazine (if rods)

Superficial pyoderma​

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Topical treatment ONLY is appropriate
  •  
Review after 2–3 weeks and continue until underlying cause controlled
  • 2–4% chlorhexidine q1–3d
If non-responsive to topical antibiotic therapy
  • Clindamycin
  • Trimethoprim/sulphonamide
  • Cefalexin
  • Amoxicillin/clavulanate
Systemic antibiotics ALWAYS in combination with topical antiseptics (q1–3d)
  •  
Treat for 2 weeks then reassess. If poor response investigate resistance (cytology, culture and susceptibility testing)
  •  
Use doses at upper end of range
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ALWAYS culture if there is a history of MRSP/MRSA OR prior antibiotic courses OR if rods are seen on cytology
  •  

Deep pyoderma​

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Whilst culture and susceptibility testing pending, ONLY start systemic antibiotic (as for superficial pyoderma) if painful OR risk of septicaemia
  • Concurrent topical treatment with 2–4% chlorhexidine q1–3d
Treat for minimum 3 weeks and reassess q2w (consult QR code)
  •  

Anal Sac Inflammation​

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Topical treatment ONLY
  • Manual evacuation, flushing with chlorhexidine ± packing with topical polypharmacy ear product (avoid products containing EMA category B antibiotics)

Anal Sac Abscess​

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Flush and drain as appropriate
  •  
ONLY if signs of cellulitis
  • Trimethoprim/sulphonamide
  • Amoxicillin/clavulanate
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