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May/June 2014 Today's Veterinary Practice 49 TreaTing resisTanT skin infecTions in Dogs DermaTology DeTails | tvpjournal.com antibiotic therapy for dogs with surface or superficial pyoderma caused by methicillin-resistant staphylococci (MRS) and, instead, focus on aggressive topical therapy. Diagnosis To diagnose methicillin resistance, culture and sensitivity testing is needed. It is no longer acceptable for a labora- tory to report coagulase-positive Staphylococcus species as the final diagnosis—the Staphylococcus species should be determined to allow clinicians to appropriately coun- sel clients as to risk of contagion. It is very important to provide precise terminology: • MRSA refers specifically to methicillin-resistant S aure- us, the human pathogen. • MRSP is not more contagious or virulent than methicil- lin-susceptible S pseudintermedius (MSSP); just simply harder to treat. HOW DO WE TREAT METHICILLIN-RESISTANT PYODERMA IN DOGS? Systemic antibiotic therapy for dogs with MRS should not be selected empirically—culture and sensitivity is required to identify the antibiotic most likely to be effective. Given that systemic antibiotic therapy drives retention of resis- tance factors, clinicians should consider topical antiseptic therapy for superficial pyoderma. Topical Therapy It has been hypothesized that topical therapy may give bacteria time and opportunity to eject the resistance genes and become susceptible again (see Topical Thera- py: A Stand-Alone Treatment?). Shampoos containing 2% to 4% chlorhexidine are best, 25-28 and use of only shampoos produced by quality veterinary pharmaceutical companies is recommended, as careful formulation is critical to maintain the activity of chlorhexidine. Shampoos improve skin and coat quality as infection is resolved, and are considered superior to other topical therapies because many shampoos contain: Topical Therapy: A Stand-Alone Treatment? in 2010, a randomized, double-blinded, controlled study tested the hypothesis that topical therapy alone could treat dogs with methicillin-resistant superficial pyodermas. 28 • Ten dogs with mrsP were bathed daily with a surgical scrub containing 2% chlorhexidine. • a scoring system graded the following components—based on severity—on a scale of 0 to 3: pruritus, erythema, crusting, and hair loss. • at 2 weeks, all dogs demonstrated 50% or greater improvement, with 3 dogs experiencing complete resolution. • at 4 weeks, pyoderma lesions had resolved in all dogs but one, whose pruritus was due to uncontrolled atopic dermatitis. • all dogs were cleared of clinically observable infection within 30 days (Figure 2). Oxygen Solutions for Veterinarians Excellence through Experience AirSep is world-renowned as a premier manufactur medical and industrial applications. Oxygen Generation Systems: • Reliable • Cost Effective • Easy to Install & Maintain CONTACT US TODAY! 1.800.320.0303 | cpd@airsep.com www.airsepcpd.com TVP_2014-0506_DermDetails_Infections.indd 49 5/23/2014 3:24:57 PM