November 2023 11 3) Colloid solutions These solutions can be used in selected patients to increase oncotic pressure and expand circulating plasma volume. The type of colloid, volumes and speed of administration and risk of adverse effects vary among colloid solutions. The efficacy and safety profiles should be carefully considered before administration. 4) Fresh blood Giving the complexities of component processing and storage of blood products, veterinarians should be able to perform at least fresh whole blood transfusion for the treatment of severe hypovolaemia, anaemia and/or thrombocytopenia and factor replacement in coagulopathies within 4 to 6 hours of blood collection in dogs and cats. In some countries, veterinary blood banks are available. Quality control and transfusion practices of fresh blood should be optimal. 5) Lipid emulsions Fat emulsion solutions are used as a source of calories and essential fatty acids in parenteral nutrition. They are also used for the treatment of poisoning by fat soluble compounds including local anaesthetic and ivermectin toxicity. 6) Monoclonal antibodies anti-nerve growth factor These medicines are used for the treatment of osteoarthritis in dogs (bedinvetmab) and cats (frunevetmab). They may be beneficial when NSAIDs are contra-indicated or if pain is refractory to the administration of NSAIDs. ANTIMICROBIAL DRUGS Antibacterial and antiprotozoal drugs Systemic administration Core List 1) Amoxicillin This aminopenicillin is recommended as the first choice for treatment of bacterial cystitis and a variety of infections, including those caused by anaerobic bacteria. 2) Amoxicillin/clavulanic acid or a first-generation cephalosporin (cephalexin or cefadroxil) These β-lactams are widely used for management of superficial or deep pyoderma and other common skin and soft tissue infections associated with Staphylococci and other Gram-positive bacteria. 3) Ampicillin or benzylpenicillin Injectable preparations of these penicillins are recommended for treatment of life-threatening infections such as sepsis and acute pneumonia in combination with fluoroquinolones as well as acute treatment for the zoonotic infection, leptospirosis. 4) Cefazolin This injectable first-generation cephalosporin is recommended as the first choice when surgical prophylaxis is indicated. 5) Clindamycin This lincosamide is recommended in some countries as the first choice for management of canine superficial or deep pyoderma and elsewhere is considered an important alternative to amoxicillin/clavulanic acid and first generation cephalosporins for these indications. It is also recommended for treatment of infections involving anaerobic bacteria. Injectable preparations are important for combination therapy of life-threatening infections such as sepsis and acute pneumonia in association with fluoroquinolones or other antimicrobials providing Gram-negative coverage. Clindamycin has been shown to reach therapeutic levels in the central nervous system and it is also used for the treatment of infections with Mycoplasma, Neospora and Toxoplasma. 6) Doxycycline or minocycline This tetracycline is an essential antimicrobial for treatment of upper and lower respiratory tract infections, Lyme borreliosis and a variety of infections caused by obligate intracellular bacteria (Ehrlichia canis, Rickettsia rickettsii, Mycoplasma and Anaplasma spp.). 7) Enrofloxacin, marbofloxacin, orbifloxacin or pradofloxacin [The “OIE List of Antimicrobial Agents of Veterinary Importance” state that Fluoroquinolones (together with third and fourth generation cephalosporins and colistin) should: (1) not be used as preventive treatment, (2) not to be used as a first-line treatment unless justified, when used as a second-line treatment,it should ideally be based on the results of bacteriological tests and (3) extra-label/off label use should be limited and reserved for instances where no alternatives are available. Such use should be in agreement with the national legislation in force. https://www.oie.int/fileadmin/Home/eng/Our_scientific_expertise/ docs/pdf/AMR/A_OIE_List_antimicrobials_July2 019.pdf These fluoroquinolones are the first choices for treatment of prostatitis and meningitis due to their ability to penetrate the blood/prostate and blood/brain barriers, respectively. Injectable preparations are needed for treatment of lifethreatening infections such as pyelonephritis, or sepsis and acute pneumonia when used in combination with clindamycin or a penicillin. They are also useful for treatment of infections caused by bacteria that are resistant to first line agents. 8) Metronidazole This nitroimidazole is recommended for management of selected bacterial and protozoal enteric infections. 9) A sulfonamide potentiated with a dihydrofolate reductase inhibitor (e.g. sulfadiazine/trimethoprim) Potentiated sulfonamides are recommended as a first line agent for treatment of bacterial cystitis and are useful antimicrobials for treating skin and other infections, including central nervous system infections caused by susceptible bacteria and protozoa. Leading Article
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