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RATIONAL CHOICE OF ANTIBIOTICS FOR BONE INFECTIONS

First broadcast on www.provet.co.uk


This information is provided by Provet for educational purposes only.

You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

The rational choice of antibiotic for use in bone infections involves consideration of the type of organisms that are present, the sensitivity of the organism(s) to different antibiotics and the concentration of antibiotic that can be achieved in the bone.

Various reports have been published on the type of organisms that are commonly found in bone infections in animals and the following bacteria are most commonly cultured - either singly, or as mixed infections :

  • Staphylococcus
  • Streptococcus
  • Escherichia coli
  • Proteus spp

A mixed infection containing a combination of gram-positive and gram-positive organisms is quite common. Samples should be taken for culture and sensitivity before antibiotics are administered. Until the results are available broad spectrum antibiotics are usually preferred as first-line treatment. Antibiotics which are most commonly used for bone infections include :

  • Ampicillin
  • Amoxicilliin
  • Cephalexin
  • Cephaloridine
  • Cephalothin sodium
  • Gentamicin
  • Kanamycin
  • Sodium Penicillin G

To ensure adequate bone concentrations are reached authors often recommend slightly higher doses of these drugs than is normally recommended for soft tissue infections.

In some parts of the world fungal infections are seen including :

  • Adiaspyromycosis (rare)
  • Actinomycetes
  • Aspergillosis (common upper respiratory tract disease)
  • Blastomycosis (North America - US and Canada)
  • Cephalosporium (rare)
  • Coccidioidomycosis (SW US)
  • Cryptococcosis
  • Histoplasmosis (Reported worldwide)
  • Nocardiosis (reported worldwide)
  • Paecilomycosis (rare)

Treatment for fungal infections include :

For actinomycosis infection :

  • Iodine washes and streptomycin

For aspergillosis :

  • Nystatin
  • Amphotericin B

For coccidioddomycosis and blastomycosis :

  • Amphotericin B
  • Ketoconazole

For nocardiosis :

  • Penicillin and streptomycin (in high doses)
  • Sulfadiazine - for 6-12 weeks

 

Updated January 2016