Suggested Treatment Options by Condition [Companion]

The Ohio State University College of Veterinary Medicine

Reference Tables

Suggested Treatment Options by Condition [Companion]

(C/S = culture and susceptibility testing)

Cardiovascular Diseases (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Bacteremia	Streptococcus canis, Staphylococcus spp. (aureus, pseudintermedius, schleferi), Escherichia coli, Enterococcus spp. Actinomyces spp. Rickettsia spp. Anaplasma spp. Mycoplasma spp.	(Ampicillin or Clindamycin) + Amikacin	(Ampicillin or Clindamycin) + Fluoroquinolone	C/S should guide treatment; add metronidazole if anaerobic component suspected.
Infectious Endocarditis	Streptococcus canis Staphylococcus spp. (aureus, schleiferi, pseudintermedius, lugdunensis) Escherichia coli Enterococcus spp. Pasteurella spp. Acinetobacter baumannii Bartonella spp.	Ampicillin + Amikacin	Ampicillin + Fluoroquinolone	C/S should guide treatment.

Critical Care Conditions (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Peritonitis	Clostridium spp. Escherichia coli Mycobacterium microti Enterococcus spp. Pasteurella multocida	(Ampicillin or Clindamycin) + Fluoroquinolone	(Ampicillin or Clindamycin) + Amikacin	C/S should guide treatment; add metronidazole if anaerobic component suspected.
Sepsis	Streptococcus canis Staphylococcus spp. (aureus, pseudintermedius, schleferi) Escherichia coli Enterococcus spp. Actinomyces spp. Rickettsia spp. Anaplasma spp. Mycoplasma spp.	(Ampicillin or Clindamycin) + Fluoroquinolone	(Ampicillin or Clindamycin) + Amikacin	C/S should guide treatment; add metronidazole if anaerobic component suspected.

Gastrointestinal Diseases (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Anal Sacculitis		Amoxicillin-Clavulanic Acid		Used in conjunction with lavage and local treatment.
Bacterial Enteritis	Campylobacter spp. Salmonella enterica Clostridium spp. (difficile, perfringens) Salmonella spp.	(See note)		Choose treatment based on most likely or culture-confirmed organism (e.g. enrofloxacin for salmonellosis, metronidazole for Clostridium species, etc.).
Cholangitis / Cholangiohepatitis		Beta-Lactam + Enrofloxacin	Beta-Lactam + Amikacin	Choice of beta-lactam should be guided by C/S.
Hemorrhagic Gastroenteritis	Anaerobiospirillum spp. Clostridium perfringens	Metronidazole
Hepatic Encephalopathy		Metronidazole
Periodontitis, Gingivitis, etc.		Clindamycin	Amoxicillin-Clavulanic Acid	Used in conjunction with dental cleaning.

Nervous System Diseases (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Discospondylitis		Amoxicillin-Clavulanic Acid or Cephalexin	Enrofloxacin	C/S should guide treatment.
Meningitis		Chloramphenicol or Doxycycline	Trimethoprim-Sulfa	Add metronidazole if anaerobic component suspected.

Ocular Diseases (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Bacterial Conjunctivitis	Chlamydophila spp. Corynebacterium spp. Mycoplasma spp.	Doxycycline		May need to be used in conjunction with an antiviral agent (e.g. famciclovir) esp. in cats.
Corneal Ulcer	Pseudomonas aeruginosa Streptococcus canis Staphylococcus spp. (pseudintermedius, aureus, schleiferi)	Neomycin-Polymyxin-Bacitracin		Topical treatment.

Orthopedic Infections (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Osteomyelitis	Enterococcus spp.	Clindamycin	Enrofloxacin or Amikacin	C/S should guide treatment; if possible, withhold treatment until results return; use in conjunction with surgical debridement.
Septic Arthritis	Streptococcus pyogenes Staphylococcus aureus Pasteurella spp. Klebsiella spp. Escherichia coli Chlamydophila spp. Borrelia burgdorferi	Amoxicillin-Clavulanic Acid or Cephalexin	Doxycycline (see note)	C/S should guide treatment; doxycycline recommended for suspected vector-borne bacterial polyarthritis.

Prophylaxis (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Clean Surgery		(Not indicated)
Contaminated or Colorectal Surgery		(Cefazolin or Ampicillin-Sulbactam) ± Metronidazole

Respiratory Tract Diseases – Lower Respiratory Tract (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Bacterial pneumonia (incl. aspiration)	Escherichia coli Streptococcus canis Pasteurella multocida Pseudomonas aeruginosa Staphylococcus aureus Streptococcus equi sub zooepidemicus Bordetella bronchiseptica	Ampicillin or Ampicillin-Sulbactam	(Enrofloxacin or Pradofloxacin) + Clindamycin	Clindamycin not an appropriate choice if there is a suspected anaerobic component. If Enterobacterales (e.g. E. coli, Enterobacter spp, Proteus spp, Klebsiella spp are suspected use the alternative treatment while waiting for culture results.
Bacterial Pneumonia – suspected Mycoplasma		Doxycycline or Azithromycin	Oxytetracycline
Pyothorax	Fusobacterium spp. Escherichia coli Nocardia spp. Bacteroides spp. Actinomyces viscosus Streptococcus spp. Staphylococcus spp. Clostridium spp. Mycoplasma spp. Klebsiella spp. Pasteurella spp. Streptococcus spp.	Ampicillin-Sulbactam ± Fluoroquinolone	Ampicillin or Clindamycin	Drainage ± lavage recommended in combination with antimicrobial therapy.
Tracheobronchitis	Bordetella bronchiseptica Streptococcus equi sub zooepidemicus Pseudomonas spp.	Not Indicated	Amoxicillin-Clavulanic Acid or Doxycycline	Infectious canine tracheobronchitis is more often associated with viral agents than bacteria; antimicrobial therapy is indicated for cases with culture-confirmed secondary bacterial infection.

Respiratory Tract Diseases – Upper Respiratory Tract (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Feline Upper Respiratory Tract Disease	Usually viral Chlamydia spp. Bordetella spp.	Doxycycline	Amoxicillin-Clavulanic Acid
Rhinitis or Sinusitis	Bordetella bronchiseptica Mycoplasma spp.	Not indicated if primary rhinitis/sinusitis	Doxycycline or Amoxicillin-Clavulanic Acid for secondary rhinitis/sinusitis	C/S is of limited use because of commensal nasopharyngeal flora.

Skin and Ear Infections (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Otitis Externa	Pseudomonas aeruginosa Staphylococcus spp. (aureus, pseudintermedius) Pasteurella spp. Escherichia coli Klebsiella spp. Corynebacterium spp. Proteus spp.	(see note)		Topical treatment recommended over systemic treatment except in cases of chronic or recurrent infection; initially choose cephalexin or enrofloxacin based on ear cytology.
Otitis Media/Interna	Pseudomonas aeruginosa Staphylococcus spp. (aureus, pseudintermedius) Pasteurella spp. Escherichia coli Klebsiella spp. Corynebacterium spp. Proteus spp.	(see note)		Topical or surgical treatment often recommended over systemic treatment; in cases where systemic treatment is warranted, initially choose cephalexin or enrofloxacin based on ear cytology.
Pyoderma (surface; e.g. fold pyoderma)	Staphylococcus spp. (aureus, pseudintermedius) Pseudomonas spp.	Not Indicated (see note)		Topical treatment is sufficient.
Pyoderma (superficial; e.g. folliculitis)	Staphylococcus spp. (pseudintermedius, schleiferi, aureus, coagulans) Pseudomonas aeruginosa Pasteurella spp.	Cephalexin or Clindamycin or Amoxicillin-Clavulanic Acid	Empirical, unless recurrent then choose based on culture/susceptibility
Pyoderma (deep; e.g. furunculosis)	Staphylococcus spp. (aureus, pseudintermedius, schleiferi, coagulans) Pasteurella spp. Pseudomona spp.	Cephalexin or Clindamycin	Choose based on culture/susceptibility	C/S should guide treatment; enrofloxacin is an acceptable empiric choice when there is high index of suspicion for Pseudomonas aeruginosa (e.g. groomer-associated deep pyoderma).

Urogenital Diseases (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Leptospirosis (suspected or confirmed)		Doxycycline
Lower Urinary Tract Infection	Escherichia coli Klebsiella spp. Proteus spp. Enterococcus spp. Enterobacter spp. Pseudomonas aeruginosa Streptococcus spp.	Amoxicillin	Trimethoprim-Sulfa	Enrofloxacin or pradofloxacin are suitable therapeutic options where there is documented resistance to amoxicillin or trimethoprim-sulfa (or contraindication to use of sulfa drugs).
Mastitis	Escherichia coli Staphylocccus spp. Streptococcus spp.	Amoxicillin-Clavulanic Acid	Chloramphenicol	Chloramphenicol should only be used if it is possible to wean puppies/kittens from the mother.
Prostatitis	Escherichia coli	Enrofloxacin	Trimethoprim-Sulfa
Pyelonephritis (Upper Urinary Tract Infection)	Escherichia coli Leptospira spp. Staphylococcus spp. Enterococcus spp. Streptococcus spp.	Cefpodoxime or Enrofloxacin	Cefotaxime or Ceftazidime
Pyometra	Escherichia coli Streptococcus canis	Amoxicillin-Clavulanic Acid + Enrofloxacin	Amoxicillin-Clavulanic Acid + Aminoglycoside	Ideally used in conjunction with ovario-hysterectomy surgery; also applicable to metritis.
Struvite Urolithiasis	Staphylococcus spp. Proteus spp.	Amoxicillin-Clavulanic Acid	Trimethoprim-Sulfa

Wounds and Abscesses (Back to Reference) ↩

Condition	Targeted Organisms	First Line	Alternative Treatment	Notes
Dog Bite or Traumatic Wound (new)	Pasteurella spp. Streptococcus spp. Staphylococcus spp Corynebacterium spp. Fusobacterium spp. Bacteroides spp. Actinomyces spp.	Amoxicillin-Clavulanic Acid	Amoxicillin-Clavulanic Acid + Aminoglycoside
Dog Bite or Traumatic Wound (previously treated)		(See note)		Prior treatment increases likelihood of resistance; C/S should guide treatment.
Feline Bite Wound/Abscess	Pasteurella multocida Streptococcus spp. Corynebacterium spp. Enterococcus spp Porphyromonas spp.	Amoxicillin-Clavulanic Acid	Pradofloxacin (cats only)
Surgical Site Infection		Cephalexin or Clindamycin		C/S should guide treatment.

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