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Antimicrobial selection and dosage in the treatment of equine bacterial infections
Abstract:
The success of antimicrobial therapy depends on administration of an agent to which the pathogenic microorganisms are susceptible at the concentrations attained at the site of infection. The route of administration, size of the dose and dosing interval must be appropriate for the drug preparation selected. With penicillins in particular, dosage can be tailored to the severity of the infection and quantitative susceptibility of the microorganism. This approach cannot be applied to aminoglycosides because their relatively narrow margin of safety limits the amount which can be administered. In severe infections it is important quickly to establish effective antimicrobial concentrations, which means that the choice of drug must be based on experience in treating the particular type of infection (empiric selection) and its dosage be adequate to produce a high peak concentration in the plasma. In treating septicaemic conditions of neonatal foals the deficit in serum immunoglobulins should be corrected, and it is advisable to administer antimicrobial agents or combinations that produce a bactericidal effect at dosages modified for immature physiological processes.
Insights
Optimizing antimicrobial therapy requires matching drug susceptibility to infection site concentrations. Dosage adjustments are crucial for penicillins and aminoglycosides, especially in severe infections and neonatal foals requiring bactericidal effects.
Area of Science:
- Veterinary Medicine
- Pharmacology
- Infectious Diseases
Background:
- Antimicrobial therapy success hinges on susceptible pathogens at infection sites.
- Drug administration route, dose, and interval are critical for efficacy.
- Penicillins allow tailored dosing based on infection severity and microbial susceptibility.
Purpose of the Study:
- To outline principles for effective antimicrobial therapy selection and dosing.
- To highlight challenges with aminoglycoside dosing due to narrow safety margins.
- To provide guidance on treating severe infections and neonatal foal septicaemia.
Main Methods:
- Review of pharmacokinetic and pharmacodynamic principles in antimicrobial therapy.
- Analysis of dosing strategies for different antimicrobial classes (penicillins, aminoglycosides).
- Consideration of specific patient populations, including neonatal foals with septicaemia.
Main Results:
- Dosage tailoring is feasible for penicillins but limited for aminoglycosides.
- Empiric selection and high peak plasma concentrations are vital for severe infections.
- Neonatal foal septicaemia requires immunoglobulin correction and bactericidal antimicrobials adjusted for immature physiology.
Conclusions:
- Effective antimicrobial therapy necessitates matching drug properties to infection characteristics.
- Dosing strategies must account for drug safety profiles and patient-specific factors.
- Specialized approaches are needed for severe infections and vulnerable populations like neonatal foals.