Current state of antimicrobial resistance in veterinary dermatology

Présenté par Anthony Yu, B. Sc., D.M.V., M. Sc., Dipl. ACVD

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Questions

1. You diagnose a dog presenting with epidermal collarettes with a superficial pyoderma (confirmed via cytology) and prescribe a course of cephalexin. After 2 weeks’ treatment, the owners report that the skin lesions are worsening, not resolving. Do you: *

Increase the dose of cephalexin

Continue cephalexin and add a second systemic antibiotic

Reassess the dog in person and perform a bacterial culture and susceptibility

Discontinue cephalexin and switch to a different systemic antibiotic

2. A dog presents with a simple case of superficial pyoderma (confirmed via cytology). If antiseptic shampoos/mousses are not an option, what would prompt you to perform a bacterial culture and susceptibility test before starting systemic antibiotics? *

Previous history of methicillin-resistant Staphylococcal pseudintermedius skin infection

Repeated courses of systemic antibiotics for another condition were used in the last 4–6 months

Intracellular rod-shaped bacteria are the predominant organism detected on cytology

All of the above

3. Which of the following would be the most appropriate empirical antibiotic choice for an uncomplicated case of bacterial skin infection in a dog or cat? *

Marbofloxacin

Cefovecin (Convenia)

Amoxicillin

Clindamycin

4. Which of the following properties are consistent with MicroSilver+ shampoo: *

Anti-inflammatory

Effective against multidrug-resistant bacteria

Adheres well to skin and hair, providing 7 days of residual activity

All of the above

5. True or False. Frequent repeated use of Chlorhexidine may predispose a patient to develop resistance to this antiseptic agent. *

True

False

6. In which of the following scenarios is it appropriate to use ONLY topical antimicrobial therapy? *

Generalized superficial bacterial folliculitis and dermatitis

Deep bacterial pyoderma with draining tracts

When engulfed bacteria are identified on skin cytology from a dog with multifocal pustular dermatitis

Surface bacterial dermatitis where multiple cocci are noted on cytology in the absence of neutrophils

7. True or False. Linezolid is the empiric antibiotic of choice to treat methicillin-resistant S. pseudintermedius. *

True

False

8. True or False. When treating a case of deep pyoderma, systemic antibiotics based on culture and sensitivity should always be accompanied by topical antimicrobial therapy when possible. *

True

False

9. Which of the following is not a risk factor for a dog developing a methicillin-resistant S. pseudintermedius skin infection? *

Recent antimicrobial use

Regular visits to veterinary offices or a long period of hospitalization

The owner works in a veterinary setting

Long-term use of symptomatic allergy medications at appropriate doses

10. Which of the following statements is incorrect: *

Bacterial infections are ALWAYS attributable to a primary underlying etiology, such as allergies and endocrinopathies

Prolonged weekly bathing in COOL to COLD water with chlorhexidine shampoo is recommended to prevent further breakout infections in dogs

The anti-inflammatory and antimicrobial properties of MicroSilver+ shampoo make it appropriate for use in pets with allergies who are also predisposed to secondary infections

Phovia, a form of fluorescence photobiomodulation using blue LED and a chromophore gel, is an effective medical device therapeutic option for treating Multidrug-resistant bacterial skin infections