Veterinary Antibiotic Stewardship Guide

Need the textbook behind the tool? 2 books = 15% off automatically. Best Of shelves

Study reference · not a prescription

Veterinary Antibiotic Stewardship Guide

A tight reminder for clinicians and students: culture when it will change the drug, start narrow, and do not treat “just in case.” Doses below are typical published ranges — confirm species, renal/hepatic function and the current formulary (Plumb, BSAVA, ISCAID) before you write.

Do not start antibiotics for: acute uncomplicated diarrhoea in a bright dog or cat; feline viral upper-respiratory disease without bacterial pneumonia; kennel cough without fever, lethargy or radiographic pneumonia; “the wound looks a bit red” with no cellulitis. Those cases need support, hygiene and a recheck — not a fluoroquinolone.

Urinary tract

Confirm infection (sediment ± culture). Most feline “cystitis” is sterile FIC — antibiotics will not help. Recurrent or pyelonephritis: culture first; do not escalate to a fluoroquinolone empirically.

Scenario Usual first choice Typical dose Stop / think
Sporadic canine cystitis (culture pending or confirmed susceptible) Amoxicillin (plain) 11–15 mg/kg PO q8h (dog) 3–5 days if simple; reculture if it fails
Complicated UTI / pyelonephritis Guided by culture. Pending: amoxi-clav is reasonable only if the patient is stable 12.5–25 mg/kg PO q12h (check label) Hospitalise if febrile, azotaemic or obstructed
Recurrent / resistant Culture and MIC — not a default enrofloxacin script — Fluoroquinolones are last-line. Cats: retinal risk with enro; stay at labelled 5 mg/kg if you must use it

Skin

Superficial pyoderma is usually Staphylococcus. Treat the infection and the itch/allergy underneath or it will bounce.

Condition Usual first choice Typical dose Stop / think
Superficial canine pyoderma Cefalexin or amoxi-clav; topical chlorhexidine as well Cefalexin 22–30 mg/kg PO q12h Treat 7 days past clinical cure, then recheck. Not a 3-week autopilot
Deep pyoderma / furunculosis Same class after cytology ± culture Upper end of range Weeks, not days. Look for demodicosis, allergy, endocrine disease
MRSP / multi-resistant Culture. Chloramphenicol is a last resort in dogs 40–50 mg/kg PO q8h (dog) Human aplastic-anaemia risk — warn owners. Avoid in cats

Respiratory

Condition Usual first choice Typical dose Stop / think
Canine infectious respiratory disease (CIRDC), well dog None — Isolation, rest, cough control. Antibiotics if fever, productive cough, or pneumonia on films
Bacterial pneumonia Hospital + IV. Common empiric pair: ampicillin plus a fluoroquinolone after samples Per ICU protocol Oxygen, fluids, culture. Do not send home on “a week of baytril”
Feline bacterial component of URI (purulent, febrile, or after viral week) Doxycycline 5–10 mg/kg PO q12–24h Follow every tablet with water / food. Dry doxy = oesophageal stricture in cats

Gut and mouth

Condition Usual first choice Typical dose Stop / think
Acute non-septic diarrhoea Diet, deworm, probiotics — not metronidazole first — Metro does not improve most simple colitis and disrupts flora. Reserve for documented giardia protocol or anaerobic sepsis
Periodontal infection / dental abscess Clindamycin or amoxi-clav — plus the extraction / scale Clindamycin 5.5–11 mg/kg PO q12h Antibiotics without dentistry fail
Sepsis / septic abdomen IV broad cover in hospital e.g. ampicillin + enrofloxacin IV Not an outpatient script. Source control wins

Hard rules

  • Fluoroquinolones: last-line, not “stronger amoxicillin.” Growing dogs: cartilage. Cats: retina (enrofloxacin).
  • Never give a dry doxycycline tablet to a cat.
  • Chloramphenicol: gloves, no casual use, avoid cats.
  • Write a stop date. Recheck. Do not refill “because it almost worked.”

Confirm every dose in a current formulary. This page is a teaching checklist for people who already have the books — not a licence to treat a pet without an examination.

← All free tools · Pharmacology books →