In vitro activities of cefcanel and some other cephalosporins against Pasteurella multocida

The efficacy and safety of cefovecin in the treatment of feline abscesses and infected wounds

OBJECTIVES

To determine the efficacy and safety of cefovecin for the treatment of bacterial abscesses and wounds in cats at clinics in Germany, France, Spain and the UK.

METHOD

Cats with abscesses or wounds were enrolled. Cats (217) were randomised to treatment with either cefovecin administered by subcutaneous injection at 14 day intervals or amoxicillin/clavulanic acid as twice-daily oral tablets for 14 days. Treatment courses were repeated at 14 day intervals, when deemed necessary. Clinicians assessing lesions were masked to treatment allocation. Only animals with a confirmed pretreatment bacterial pathogen were included in the efficacy analysis. Cases were evaluated 28 days after initiation of the final course of treatment.

RESULTS

Cefovecin was as efficacious as amoxicillin/clavulanic acid, and efficacy was 100 per cent for both treatments.

CLINICAL SIGNIFICANCE

Cefovecin, administered as a single subcutaneous injection repeated at 14 day intervals as required, was shown to be as efficacious as oral amoxicillin/clavulanic acid in the treatment of abscesses/wounds in cats.

The Management of Dog Bites

Objective

To review the contemporary management of dog bites with an emphasis on clinical presentation, wound care, microbiology, antimicrobial prophylaxis, and treatment.

Data Sources

The published literature was searched by use of MEDLINE (1990-December 2000) and bibliographic reviews of relevant textbooks and review articles.

Data Selection and Extraction

Review articles, case reports, appropriate meta-analyses, and relevant textbook chapters dealing with mammalian bites and their management were evaluated. All pertinent information was synthesized and incorporated into the present review.

Data Synthesis

The incidence of serious and fatal dog bites has increased because of the acquisition of larger, more aggressive breeds. School-age children and young adults are at the highest risk. Most bites occur on the upper extremities, although head and neck bites are also common. The risk of infection is greatest for crush injuries, puncture wounds, and hand wounds. Infection tends to develop within 24–36 hours of the injury. Complications include osteomyelitis, septic arthritis, tenosynovitis, and septicemia. Most infections are polymicrobial and involve organisms isolated from the skin of the patient and the indigenous oral flora of the dog. Bites should be initially managed under accepted wound care protocols. Wound closure remains controversial and should be reserved for facial and head wounds. Immobilization and elevation are essential for therapeutic success. Prophylactic antibiotics should be reserved for bites at high risk for infection and the immunocompromised host. Whether for prophylaxis or treatment, empiric antimicrobial therapy should be directed against the most common bacteria: Pasteurella spp., streptococci, staphylococci, and anaerobes. Duration and route are dependent on the location and severity of the wound.

Conclusions

Dogs remain the major cause of mammalian bites in the US. It is important for clinicians to have an understanding of the contemporary management of dog bites. Good wound care is central to the prevention and treatment of complications. Appropriate antimicrobial therapy should be directed against both aerobic and anaerobic flora. Careful monitoring is imperative, and antibiotic changes should be made based on clinical response and, if appropriate, the results of culture and sensitivity reports.

Severe Pasteurella multocida infections in pregnant women

We report 2 cases of severe infections due to Pasteurella multocida, both occurring during pregnancy in previously healthy women. Both women had contact with animals (dog and cat) but neither of them had been bitten. Apart from a slight decrease in IgG levels, no immunological defects could be detected. Both women had received oral phenoxymethylpenicillin in the early phase of the disease, but still fell ill with severe infections. One woman had meningitis while the other suffered from cellulitis with deep abscess formation.