Which medications in the drug class Antibiotics are used in the treatment of Animal Bites in Emergency Medicine?

Updated: Sep 18, 2018
  • Author: Alisha Perkins Garth, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Antibiotics

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Levofloxacin

Levofloxacin is for pseudomonal infections and infections due to certain multidrug resistant gram-negative organisms.

Metronidazole

Metronidazole is an imidazole ring-based antibiotic active against various anaerobic bacteria and protozoa. It is used in combination with other antimicrobial agents (except for C difficile enterocolitis).

Ampicillin and sulbactam (Unasyn)

Ampicillin and sulbactam is a drug combination of beta-lactamase inhibitor with ampicillin. It interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms.

Ticarcillin and clavulanate potassium (Timentin)

The ticarcillin and clavulanate potassium combination inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active growth. It is an antipseudomonal penicillin plus beta-lactamase inhibitor that provides coverage against most gram-positive organisms, most gram-negative organisms, and most anaerobes.

Piperacillin and tazobactam sodium (Zosyn)

Piperacillin and tazobactam sodium combination is an antipseudomonal penicillin plus beta-lactamase inhibitor. It inhibits the biosynthesis of cell wall mucopeptide and is effective during the stage of active multiplication.

Imipenem and cilastatin (Primaxin)

The combination of imipenem and cilastatin is for treatment of multiple organism infections in which other agents do not have wide-spectrum coverage or are contraindicated due to potential for toxicity.

Ertapenem (Invanz)

Ertapenem has bactericidal activity that results from the inhibition of cell wall synthesis and is mediated through ertapenem binding to penicillin-binding proteins. It is stable against hydrolysis by a variety of beta-lactamases, including penicillinases, cephalosporinases, and extended-spectrum beta-lactamases. Ertapenem is hydrolyzed by metallo-beta-lactamases.

Meropenem (Merrem IV)

Meropenem is a bactericidal broad-spectrum carbapenem antibiotic that inhibits cell-wall synthesis. It is effective against most gram-positive and gram-negative bacteria. Meropenem has slightly increased activity against gram-negatives and slightly decreased activity against staphylococci and streptococci compared with imipenem.

Amoxicillin and clavulanate (Augmentin)

Amoxicillin and clavulanate is a drug combination that extends the antibiotic spectrum of penicillin to include bacteria normally resistant to beta-lactam antibiotics. Amoxicillin and clavulanate is first-line therapy for the prophylactic treatment of dog, human, and cat bites (see Medication Summary above). It is also indicated for skin and skin structure infections caused by beta-lactamase–producing strains of Staphylococcus aureus.

Cefuroxime (Ceftin, Kefurox, Zinacef)

Cefuroxime is a second-generation cephalosporin that maintains gram-positive activity that first-generation cephalosporins have; it adds activity against P mirabilis, H influenzae, E coli, K pneumoniae, and M catarrhalis. The condition of the patient, the severity of infection, and the susceptibility of the microorganism determine proper dose and route of administration.

Ciprofloxacin (Cipro)

Ciprofloxacin is a fluoroquinolone with activity against pseudomonads, streptococci, MRSA, S epidermidis, and most gram-negative organisms, but no activity against anaerobes. It inhibits bacterial DNA synthesis and, consequently, growth.

Clindamycin (Cleocin)

Clindamycin is a lincosamide for the treatment of serious skin and soft tissue staphylococcal infections. It is also effective against aerobic and anaerobic streptococci (except enterococci). Clindamycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Sulfamethoxazole/trimethoprim (Bactrim, Bactrim DS, Septra, Septra DS)

Sulfamethoxazole/trimethoprim inhibits bacterial growth by inhibiting the synthesis of dihydrofolic acid.

Amoxicillin (Trimox, Biomox, Amoxil)

Amoxicillin alone is effective against Pasteurella species. However, it is not indicated for skin and skin structure infections caused by beta-lactamase–producing strains of Staphylococcus aureus. A second antibiotic, such as cephalexin, is needed for Staphylococcus infections.

Azithromycin (Zithromax)

Azithromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. It treats mild-to-moderate microbial infections.

Doxycycline (Doryx, Vibramycin, Bio-Tab)

Doxycycline inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.


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