should be compatibile with pyoderma

- recognise the depth of pyoderma- surface, superficial,deep- each implies a diff therapy and prognosis

- if see seborrhoeic pyoderma- bacterial overgrowth syndrome

- papules, pustules and scaling - superficial folliculitis

- erosions and ulcers- pyotraumatic dermatitis

- ulcers and draining tracts- deep pyoderma

Primary lesion: leading edge of ulcers, non ulcerated nodules, intact pustules, furuncles

avoid: secondary, chronic and excoriated lesions- unless they are the only lesions

Gently CLIP HAIR

GENTLY debride crust or haemorrhage

Impression smear or direction impression smear

Adhesive tape strips

FNA

Staining 

Must: 

- non life threatening infection

- first episode

- SURFACE OR SUPERFICIAL PYODERMA

- consistent with STAPHYLOCOCCI

FOR: 

life threatening

deep pyoderma

clinical signs and cytology not consistent

Rod bacteria on cytology

Empirical ab not effective

- kirby bauer dis diffusion tests use antibiotic paper discs- zone of inhibition around the disc determines whether the bacteria are susceptible or resistant. 

- MIC- using E strips

- further testing PCR to confirm MRS( meticillin resistant staph)

after one or more BS ab course

non healing wounds

post op infections

if using topical- use culture results as guide for treatment 

not all require systemic AB

mild, non LT, limited focal infections

consider topical ABs or antimicrobials 

broad spectrum drugs important for animals and humans

- only if culture evidence shows that the first line defense ab wont work- need to prevent resistance. 

Enrofloxacin, marbofloxacin...FQs

treating multi drug resistant organisms

most are not licensed for animals

Aminoglycosides, chloramphenicol, rifampin

skin and chronic inflammation relatively avascular

- pus and decrotic debris inactivate sulfonamides, macrolides, lincosamides and aminoglycosides. 

- FQs- penetrate well into inflamed skin

- FQs, lincosamides, macrolides- accumulate in phagocytes

resolution of lesions and normal cytology

surface and superficial- usually 2-3 weeks

deep- often improved in 2 weeks, full res. in 4-6 weeks

REGULAR check ups to check response- every 7-14 days! 

- look for underlying cause, primary is rare

- topical antimicrobial shampoos and rinses

- maybe immunostimulants? ( staph vaccines, staph phage lysate)

- pulse ABs are a last resort- idiopathic recurrent, atopic dermatitis, cefalexin or clavulanate-amoxicillin

warm water baths or soaks

whirlpool baths

showers

contact time 10 min

2-3 times a week initially

2-4 times monthly for maintenance