Today's Veterinary Practice

MAY-JUN 2013

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| MeThicillin-ResisTanT sTaPhylococcal infecTions References 1. Kania Sa, williamson nl, frank la, et al. Methicillin resistance of staphylococci isolated from the skin of dogs with pyoderma. Am J Vet Res 2004; 65:1265-1268. 2. Bemis da, Jones rd, frank la, et al. evaluation of susceptibility test breakpoints used to predict meca-mediated resistance in Staphylococcus pseudintermedius isolated from dogs. J Vet Diagn Invest 2009; 21:5358. 3. cole lK, Kwochka Kw, hillier a, et al. Identification of oxacillin-resistant staphylococci in dogs with end-stage otitis. Vet Rec 2006; 159:418-419. 4. Medhus a, Slettemehas JS, Marstein l, et al. Methicillin-resistant Staphylococcus aureus with the novel mecc gene variant from a cat suffering from chronic conjunctivitis. J Antimicrob Chemother 2012; 0:1-2. 5. Kriegskorte a, Ballhausen B, Idelevich ea, et al. human MrSa isolates with novel genetic homolog, Germany [letter to the editor]. Emerg Infect Dis 2012; 18:1016-1018. 6. paterson GK, larsen ar, robb a, et al. The newly described meca homologue, mecalGa251, is present in methicillinresistant Staphylococcus aureus isolates from a diverse range of host species. J Antimicrob Chemother 2012; 67:2809-2813. 7. cohn la, Middleton Jr. a veterinary perspective on methicillin-resistant staphylococci. J Vet Emerg Crit Care 2010; 20:31-45. 8. ruscher c, lubke-Becker a, Semmler T, et al. widespread rapid emergence of a distinct methicillin- and multidrug-resistant Staphylococcus pseudintermedius (MrSp) genetic lineage in europe. Vet Microbiol 2010; 144:340-346. 9. Morris do, rook Ka, Shofer fS. Screening of Staphylococcus aureus, Staphylococcus intermedius, and Staphylococcus schleiferi isolates obtained from small companion animals for antimicrobial resistance: a retrospective review of 749 isolates (2003-04). Vet Dermatol 2006; 17:332-337. 10. loeffler a, linek M, Moodley a, et al. first report of multiresistant, meca-positive Staphylococcus intermedius in europe: 12 cases from a veterinary dermatology referral clinic in Germany. Vet Dermatol 2007; 18:412-421. 11. Kadlec K, Schwarz S, perreten v, et al. Molecular analysis of methicillin-resistant Staphylococcus pseudintermedius of feline origin from different european countries and north america. J Antimicrob Chemother 2010; 65:1826-1837. 12. Sasaki T, Kikucki K, Tanaka y, et al. reclassification of phenotypically identified Staphylococcus intermedius strains. J Clin Microbiol 2007; 45:2770-2778. 13. weese JS, faires Mc, frank la, et al. factors associated with methicillin-susceptible and methicillin-resistant Staphylococcus pseudintermedius infection in dogs. JAVMA 2012; 240:1450-1455. 14. Bannoehr J, Ben Zakour nl, waller aS, et al. population genetic structure of the Staphylococcus intermedius group: Insights into agr diversification and the emergence of methicillin-resistant strains. J Bacteriol 2007; 189:8685-8692. 15. fitzgerald Jr. The Staphylococcus intermedius group of bacterial pathogens: Species re-classification, pathogenesis and the emergence of meticillin resistance. Vet Dermatol 2009; 20:490-495. 32 16. piriz S, valle J, Mateos eM, et al. In vitro activity of fifteen antimicrobial agents against methicillin-resistant and methicillin-susceptible Staphylococcus intermedius. J Vet Pharmacol Therap 1996; 19:118-123. 17. Gortel K, campbell Kl, Kakoma I, et al. Methicillin resistance among staphylococci isolated from dogs. Am J Vet Res 1999; 60:1526-1530. 18. abraham Jl, Morris do, Griffeth Gc, et al. Surveillance of healthy cats and cats with inflammatory skin disease for colonization of the skin by methicillin-resistant coagulasepositive staphylococci and Staphylococcus schleiferi ssp. schleiferi. Vet Dermatol 2007; 18:252-259. 19. Griffeth Gc, Morris do, abraham Jl, et al. Screening for skin carriage of methicillinresistant coagulase-positive staphylococci and Staphylococcus schleiferi in dogs with healthy and inflamed skin. Vet Dermatol 2008; 19:142-149. 20. hanselman Ba, Kruth S, weese JS. Methicillin-resistant staphylococcal colonization in dogs entering a veterinary teaching hospital. Vet Microbiol 2008; 126:277-281. 21. Gingrich en, Kurt T, hyatt dr, et al. prevalence of methicillin-resistant staphylococci in northern colorado shelter animals. J Vet Diagn Invest 2011; 23:947950. 22. couto n, pomba c, Moodley a, et al. prevalence of meticillin-resistant staphylococci among dogs and cats at a veterinary teaching hospital in portugal. Vet Rec 2011;169: 72. 23. cain cl, Morris do, o'Shea K, et al. Genotypic relatedness and phenotypic characterization of Staphylococcus schleiferi subspecies in clinical samples from dogs. J Vet Res 2011; 72:96-102. 24. cain cl, Morris do, rankin Sc. clinical characterization of Staphylococcus schleiferi infections and identification of risk factors for acquisition of oxacillin-resistant strains in dogs: 225 cases (2003-2009). JAVMA 2011; 239:1566-1573. 25. frank la, Kania Sa, hnilica Ka, et al. Isolation of Staphylococcus schleiferi from dogs with pyoderma. JAVMA 2003; 222:451-454. 26. Bemis da, Jones rd, hiatt le, et al. comparison of tests to detect oxacillin resistance in Staphylococcus intermedius, Staphylococcus schleiferi, and Staphylococcus aureus isolates from canine hosts. J Clin Microbiol 2006; 44:3374-3376. 27. Kawakami T, Shibata S, Murayama n, et al. antimicrobial susceptibility and methicillin resistance in Staphylococcus pseudintermedius and Staphylococcus schleiferi subsp. coagulans isolated from dogs with pyoderma in Japan. J Vet Med Sci 2010; 72:1615-1619. 28. vanni M, Tognetti r, pretti c, et al. antimicrobial susceptibility of Staphylococcus intermedius and Staphylococcus schleiferi isolated from dogs. Res Vet Sci 2009; 87:192-195. 29. Intorre l, vanni M, di Bello d, et al. antimicrobial susceptibility and mechanism of resistance to fluoroquinolones in Staphylococcus intermedius and Staphylococcus schleiferi. J Vet Pharmacol Therap 2007; 30:464-469. 30. Morris do, Boston rc, o'Shea K, et al. The prevalence of carriage of meticillin-resistant staphylococci by veterinary dermatology practice staff and their respective pets. Vet Dermatol 2010; 21:400-407. Today's Veterinary Practice May/June 2013 (References 31-67 continued online at todaysveterinarypractice.com) NADA 141-084, Approved by FDA Brief Summary—For full product information see product insert. Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: SENTINEL® (milbemycin oxime/lufenuron) Flavor Tabs® are available in four tablet sizes in color-coded packages for oral administration to dogs and puppies according to their weight. Milbemycin oxime consists of the oxime derivatives of 5-didehydromilbemycins in the ratio of approximately 80% A4 (C32H45NO7, MW 555.71) and 20% A3 (C31H43NO7, MW 541.68). Milbemycin oxime is classifed as a macrocyclic anthelmintic. Lufenuron is a benzoylphenylurea derivative with the following chemical composition: N-[2,5-dichloro-4-(1,1,2,3,3,3, -hexafuoropropoxy)phenylaminocarbonyl]-2,6- difuorobenzamide (C 17H 8CI2F 8N2O3, MW 511.15). Benzoylphenylurea compounds, including lufenuron, are classifed as insect development inhibitors (IDIs). Indications and Usage: SENTINEL Flavor Tabs are indicated for use in dogs and puppies, four weeks of age and older, and two pounds body weight or greater. SENTINEL Flavor Tabs are also indicated for the prevention of heartworm disease caused by Diroflaria immitis, for the prevention and control of fea populations, the control of adult Ancylostoma caninum (hookworm), and the removal and control of adult Toxocara canis and Toxascaris leonina (roundworm) and Trichuris vulpis (whipworm) infection. Lufenuron controls fea populations by preventing the development of fea eggs and does not kill adult feas. Concurrent use of an adulticide product may be necessary for adequate control of adult feas. Dosage and Administration: SENTINEL Flavor Tabs are given orally, once a month, at the recommended minimum dosage of 0.23 mg/lb (0.5 mg/kg) milbemycin oxime and 4.55 mg/lb (10mg/kg) lufenuron. Dogs over 100 lbs. are provided the appropriate combination of tablets. SENTINEL Flavor Tabs are palatable and most dogs will consume the tablet when offered by the owner. As an alternative to direct dosing, the tablets can be hidden in food. Administer SENTINEL Flavor Tabs to dogs, immediately after or in conjunction with a normal meal. Food is essential for adequate absorption of lufenuron. SENTINEL Flavor Tabs must be administered monthly, preferably on the same date each month. In geographic areas where mosquitoes and feas are seasonal, the treatment schedule should begin one month prior to the expected onset and should continue until the end of "mosquito and fea season." In areas with year-round infestations, treatment should continue through the entire year without interruption. If a dose is missed and a 30-day interval between dosing is exceeded, administer SENTINEL Flavor Tabs immediately and resume the monthly dosing schedule. Warnings: Not for use in humans. Keep this and all drugs out of the reach of children. Precautions: Do not use SENTINEL Flavor Tabs in puppies less than four weeks of age and less than two pounds of body weight. Prior to administration of SENTINEL Flavor Tabs, dogs should be tested for existing heartworm infections. Mild, transient hypersensitivity reactions manifested as labored respiration, vomiting, salivation, and lethargy have been noted in some treated dogs carrying a high number of circulating microflariae. Adverse Reactions: The following adverse reactions have been reported in dogs after giving milbemycin oxime or lufenuron: vomiting, depression/lethargy, pruritus, urticaria, diarrhea, anorexia, skin congestion, ataxia, convulsions, hypersalivation, and weakness. Effcacy: Milbemycin Oxime Milbemycin oxime provided complete protection against heartworm infection in both controlled laboratory and clinical trials. In laboratory studies, a single dose of milbemycin oxime at 0.5 mg/kg was effective in removing roundworm, hookworm, and whipworm. In well-controlled clinical trials, milbemycin oxime was also effective in removing roundworms and whipworms and in controlling hookworms. Effcacy: Lufenuron Lufenuron provided a 99% control of fea egg development for 32 days following a single dose of lufenuron at 10 mg/kg in studies using experimental fea infestations. In well-controlled clinical trials, when treatment with lufenuron tablets was initiated prior to the fea season, mean fea counts were lower in lufenuron-treated dogs versus placebo-treated dogs. After 6 monthly treatments, the mean number of feas on lufenuron-treated dogs was approximately 4 compared to 230 on placebo-treated dogs. When treatment was initiated during the fea season, lufenuron tablets were effective in controlling fea infestations on dogs that completed the study. The mean fea count per lufenuron-treated dog was approximately 74 prior to treatment but had decreased to 4 after six monthly doses of lufenuron. A topical adulticide was used in the frst eight weeks of the study to kill the pre-existing adult feas. For technical assistance or to report suspected adverse events, call 1-800-332-2761. Manufactured for: Novartis Animal Health US, Inc. Greensboro, NC 27408, USA ©2008 Novartis Animal Health US, Inc. SENTINEL and Flavor Tabs are registered trademarks of Novartis AG. NAH/SEN-FCT/BS/6 06/08

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