Reação farmacodérmica em um Yorkshire Terrier após administração de metronidazol com amoxicilina clavulanato de potássio / Pharmacodermic reaction in a Yorkshire Terrier after administration of metronidazole with amoxillin-clavulanate potassium

A administração de fármacos para tratamento, prevenção e diagnóstico de doenças é amplamente utilizada na medicina veterinária; porém, esta prática pode provocar reações indesejadas em alguns casos, mesmo quando empregados nas doses, vias de administração e intervalos recomendados. Com relação às manifestações clínicas, essas podem envolver qualquer órgão ou sistema, mas a pele é o órgão mais frequentemente acometido, classificando-se então como uma farmacodermia. Uma farmacodermia, embora seja considerada uma afecção de rara ocorrência em cães, é extremamente importante na rotina veterinária, dada a sua gravidade e difícil diagnóstico decorrente da inespecificidade de sinais clínicos. O presente relato de caso teve como objetivo descrever o caso de uma cadela de onze anos de idade, da raça Yorkshire Terrier. O animal foi tratado com amoxicilina + clavulanato de potássio via subcutânea na dose de 20mg/mL, a cada 8 horas e metronidazol via intravenosa na dose de 15mg/mL, a cada 12 horas. Após o tratamento, este apresentou lesões cutâneas necróticas no dorso, demonstrando melhora clínica e regressão das lesões, após a suspensão imediata dos medicamentos. Assim, foi definido como diagnóstico presuntivo a farmacodermia do tipo necrólise epidermal tóxica. Desta forma, o presente trabalho visa difundir informações sobre a farmacodermia, buscando orientar na conduta terapêutica de pacientes com essa afecção, pelo fato de se tratar de uma doença pouco relatada na medicina veterinária.

The administration of drugs for the treatment, prevention, and diagnosis of diseases is widely used in veterinary medicine; however, this practice may cause unwanted reactions in some cases, even when used at the recommended doses, routes of administration, and intervals. Regarding the clinical manifestations, these can involve any organ or system, but the skin is the most frequently affected organ, classifying it as a pharmacoderma. Pharmacoderma, although considered a rare condition in dogs, is extremely important in the veterinary routine, given its severity and difficult diagnosis due to the non-specificity of clinical signs. The present case report aimed to describe the case of an eleven-year-old female Yorkshire Terrier. The animal was treated with amoxicillin + potassium clavulanate subcutaneously at a dose of 20mg/mL every 8 hours and intravenous metronidazole at a dose of 15mg/mL, every 12 hours. After the treatment, it presented necrotic skin lesions on the back, showing clinical improvement and regression of lesions after immediate suspension of medication. Thus, the pharmacoderma of toxic epidermal necrolysis type was defined as the presumptive diagnosis. In this way, Therefore, the present work aims to disseminate information about pharmacodermia, seeking to guide the therapeutic conduct of patients with this condition since it is a disease that is rarely reported in veterinary medicine.

Avaliação do uso de antimicrobianos e suas interações medicamentosas em cães e gatos hospitalizados / Evaluation of antimicrobial use and their drug interactions in hospitalized dogs and cats

Os antimicrobianos são amplamente utilizados na medicina veterinária, portanto são necessários critérios na hora da prescrição desses fármacos a fim de evitar a resistência bacteriana que se tornou uma grande preocupação tanto para a saúde humana quanto para a medicina veterinária, devido ao seu uso indiscriminado. Uma técnica muito utilizada na rotina, são as associações entre antimicrobianos, que combinam o mecanismo de ação de cada fármaco para se obter os efeitos desejados, acarretando nas interações medicamentosas. Porém, se utilizado de forma incorreta, essas interações podem ser prejudiciais para a saúde dos pacientes. O objetivo desse estudo foi analisar prontuários de pacientes caninos e felinos hospitalizados afim de avaliar os critérios de seleção para o uso de antimicrobianos e suas associações. Foram analisados 112 prontuários, sendo eles 24 felinos e 88 caninos atendidos e hospitalizados no Hospital Veterinário "Prof. Ricardo Alexandre Rippler" da Universidade Vila Velha-UVV. O estudo demonstrou que o metronidazol foi o antimicrobiano mais utilizado em cães e a amoxicilina com clavulanato de potássio foi o mais utilizado nos felinos, além disso, a amoxicilina com clavulanato de potássio e metronidazol foi a associação mais observada em cães e gatos. A maior parte dos pacientes fizeram uso dos antibióticos de forma empírica, o que pode contribuir para a resistência microbiana. Além disso, foram encontradas algumas interações entre antimicrobianos de efeitos antagônicos, porém a maioria das associações foram realizadas de forma correta provocando efeito sinérgico no organismo dos pacientes. Conclui-se que o conhecimento sobre a utilização dos antimicrobianos na rotina da internação de cães e gatos é importante e com base nesses conhecimentos podemos aplicar medidas para atenuar a resistência aos antimicrobianos.

Antimicrobials are widely used in veterinary medicine, so criteria are needed when prescribing these drugs in order to avoid bacterial resistance, which has become a major concern for both human health and veterinary medicine, due to its indiscriminate use. A technique widely used in routine is the association between antimicrobials, which combine the mechanism of action of each drug to obtain the desired effects, resulting in drug interactions. However, if used incorrectly, these interactions can be harmful to the health of patients. The aim of this study was to analyze the medical records of hospitalized canine and feline patients in order to assess the selection criteria for the use of antimicrobials and their associations. 112 medical records were analyzed, of which 24 were cats and 88 canines treated and hospitalized at the "Prof. Ricardo Alexandre Rippler" from Universidade Vila Velha-UVV. The study showed that metronidazole was the most used antimicrobial in dogs and amoxicillin with potassium clavulanate was the most used in felines. Furthermore, amoxicillin with potassium clavolanate and metronidazole was the most observed association in dogs and cats. Most patients used antibiotics empirically, which may contribute to microbial resistance. In addition, some interactions were found between antimicrobials with antagonistic effects, but most associations were correctly performed, causing a synergistic effect in the patients' bodies. It is concluded that knowledge about the use of antimicrobials in the routine hospitalization of dogs and cats is important and based on this knowledge we can apply measures to mitigate antimicrobial resistance.

Caseous stomatitis caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral’s boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...

Caseous stomatitis caused by Pseudomonas aeruginosa in Boa constrictor amarali

Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amarals boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...(AU)

Clostridioides (Clostridium) difficile-associated diarrhea in equine in Minas Gerais, Brazil: clinical and microbiological characterization of six cases / Diarreia por Clostridioides (Clostridium) difficile em equinos em Minas Gerais, Brasil: caracterização clínica e microbiológica de seis casos

Clostridioides (Clostridium) difficile is the main causative agent of antimicrobial-related diarrhea in humans and a major pathogen-associated enteric disorder in foals and adult horses. Moreover, studies have suggested that animals are a possible reservoir of toxigenic C. difficile strains for humans. Despite this known importance, the epidemiology of C. difficile infection (CDI) in equine is still largely unknown. Therefore, this study described six cases of equine CDI occurring in Minas Gerais, Brazil, including the characterization of the isolates. All but one equine included in this research developed CDI after antimicrobial therapy, three of which occurred during hospitalization. Coinfection with Salmonella Heidelberg and S. Infantis was detected in three cases, making the antimicrobial treatment challenging. All animals recovered after metronidazole administration. All C. difficile isolates were susceptible to metronidazole and vancomycin, while three were resistant to moxifloxacin and two were resistant to clindamycin. The isolates were classified as RT126 (n = 4), RT078 (n = 1), and RT014/020 (n = 1), all previously reported infecting humans and animals worldwide.

Clostridioides (Clostridium) difficile é o principal agente envolvido em diarreias associadas ao uso de antimicrobianos em seres humanos e um enteropatógeno de grande relevância em quadros de diarreia em potros e equinos adultos. Em adição, estudos tem sugerido que animais são possíveis reservatórios de estirpes toxigênicas de C. difficile para humanos. Apesar da importância na saúde animal e humana, a epidemiologia da infecção por C. difficile (ICD) é ainda pouco conhecida. Dessa forma, o presente estudo tem como objetivo caracterizar seis casos de diarreia por C. difficile ocorridos em Minas Gerais, Brasil. Com exceção de um animal, todos os equinos incluídos no presente estudo desenvolveram ICD após antibioticoterapia, três dos quais durante a hospitalização. Coinfecção por Salmonella Heidelberg e S. Infantis foi detectada em três casos, tornando o tratamento antimicrobiano desafiador. Todos os animais recuperaram após administração de metronidazol. Os isolados obtidos no presente estudo foram sensíveis a metronidazol e vancomicina, porém três estirpes foram resistentes a moxifloxacina e duas a clindamicina. Os isolados foram classificados como ribotipos 126 (n=4), 078 (n=1) e 014/020 (n=1), todos previamente relatados em seres humanos com ICD no Brasil e em outros países.

Clostridioides (Clostridium) difficile-associated diarrhea in equine in Minas Gerais, Brazil: clinical and microbiological characterization of six cases / Diarreia por Clostridioides (Clostridium) difficile em equinos em Minas Gerais, Brasil: caracterização clínica e microbiológica de seis casos

Clostridioides (Clostridium) difficile is the main causative agent of antimicrobial-related diarrhea in humans and a major pathogen-associated enteric disorder in foals and adult horses. Moreover, studies have suggested that animals are a possible reservoir of toxigenic C. difficile strains for humans. Despite this known importance, the epidemiology of C. difficile infection (CDI) in equine is still largely unknown. Therefore, this study described six cases of equine CDI occurring in Minas Gerais, Brazil, including the characterization of the isolates. All but one equine included in this research developed CDI after antimicrobial therapy, three of which occurred during hospitalization. Coinfection with Salmonella Heidelberg and S. Infantis was detected in three cases, making the antimicrobial treatment challenging. All animals recovered after metronidazole administration. All C. difficile isolates were susceptible to metronidazole and vancomycin, while three were resistant to moxifloxacin and two were resistant to clindamycin. The isolates were classified as RT126 (n = 4), RT078 (n = 1), and RT014/020 (n = 1), all previously reported infecting humans and animals worldwide.(AU)

Clostridioides (Clostridium) difficile é o principal agente envolvido em diarreias associadas ao uso de antimicrobianos em seres humanos e um enteropatógeno de grande relevância em quadros de diarreia em potros e equinos adultos. Em adição, estudos tem sugerido que animais são possíveis reservatórios de estirpes toxigênicas de C. difficile para humanos. Apesar da importância na saúde animal e humana, a epidemiologia da infecção por C. difficile (ICD) é ainda pouco conhecida. Dessa forma, o presente estudo tem como objetivo caracterizar seis casos de diarreia por C. difficile ocorridos em Minas Gerais, Brasil. Com exceção de um animal, todos os equinos incluídos no presente estudo desenvolveram ICD após antibioticoterapia, três dos quais durante a hospitalização. Coinfecção por Salmonella Heidelberg e S. Infantis foi detectada em três casos, tornando o tratamento antimicrobiano desafiador. Todos os animais recuperaram após administração de metronidazol. Os isolados obtidos no presente estudo foram sensíveis a metronidazol e vancomicina, porém três estirpes foram resistentes a moxifloxacina e duas a clindamicina. Os isolados foram classificados como ribotipos 126 (n=4), 078 (n=1) e 014/020 (n=1), todos previamente relatados em seres humanos com ICD no Brasil e em outros países.(AU)

Antibioticoterapia no tratamento de infecções bacterianas do sistema nervoso central de pequenos animais / Antibiotic therapy in the treatment of bacterial infectionsof the small animal central nervous system

Infecções no sistema nervoso central (SNC) são menos prevalentes do que em outros órgãos e o tratamento é desafiador. Entre os fatores que tornam o tratamento de infecções bacterianas complicado nesse tecido, destacam se o fato do mesmo ser envolto pela barreira hematoencefálica, além da dificuldade de obter resultados positivos ao tentar isolar o agente causador por meio de punção de líquido cefalorraquidiano (LCR). Objetiva-se, nesse trabalho, documentar documentar os principais antibióticos utilizados para tratar infecções bacterianas no sistema nervoso central e a interação com a barreira hematoencefálica (BHE). Os antibióticos com ótima penetração na BHE são: trimetoprim, sulfonamidas, metronidazol e cloranfenicol com penetração penetração intermediária são: oxacilinas, penicilinas, ceftriaxone, moxalactam, tetraciclinas e carbenicilina; e com pequena penetração são: aminoglicosídeos, cefalosporinas de primeira geração e clindamicina. É fundamental para a escolha do antibiótico mais adequado para cada caso conhecer características da barreira hematoencefálica, além de determinar a farmacocinética e farmacodinâmica dos antibióticos e seus principais agentes etiológicos. Percebe-se que na literatura veterinária há escassos relatos descrevendo aspectos de farmacocinética e farmacodinâmica nas espécies felina e canina, sendo necessária maior maior quantidade de estudos nesta área.

Although infections in the central nervous system are less common than infections in other organics systems, they can cause life-threatening consequences and are a challenge for small animal practitioners. Among the factors that make these infections difficult to treat are the fact that it is surrounded by the blood-brain barrier, that hinders penetration of many substances, and the difficulty of obtaining positive results when trying to isolate the causative agent through spinal tap. This article aims to describe the blood-brain barrier, the most common antimicrobials used to treat bacterial infections in the central nervous system and their main applications in small animal practice. In the veterinary literature, trimethoprim, sulfonamides, chloramphenicol, and metronidazole are cited as antimicrobials with excellent penetration on the blood-brain barrier; oxacillin, penicillin's, ceftriaxone, moxalactam, tetracyclines and carbenicillin with intermediate penetration; and aminoglycosides, first-generation cephalosporins, and clindamycin with little penetration. It was concluded that knowing the blood-brain barrier characteristics, pharmacokinetics and pharmacodynamics of antimicrobial agents, along with the main etiological agents, are the key to choose the most appropriate antibiotic to be applied in each individual case. It is noticed that in the veterinary literature there are few reports describing aspects of pharmacokinetics and pharmacodynamics in feline and canine species, requiring more studies in this area.

Antibioticoterapia no tratamento de infecções bacterianas do sistema nervoso central de pequenos animais / Antibiotic therapy in the treatment of bacterial infectionsof the small animal central nervous system

Infecções no sistema nervoso central (SNC) são menos prevalentes do que em outros órgãos e o tratamento é desafiador. Entre os fatores que tornam o tratamento de infecções bacterianas complicado nesse tecido, destacam se o fato do mesmo ser envolto pela barreira hematoencefálica, além da dificuldade de obter resultados positivos ao tentar isolar o agente causador por meio de punção de líquido cefalorraquidiano (LCR). Objetiva-se, nesse trabalho, documentar documentar os principais antibióticos utilizados para tratar infecções bacterianas no sistema nervoso central e a interação com a barreira hematoencefálica (BHE). Os antibióticos com ótima penetração na BHE são: trimetoprim, sulfonamidas, metronidazol e cloranfenicol com penetração penetração intermediária são: oxacilinas, penicilinas, ceftriaxone, moxalactam, tetraciclinas e carbenicilina; e com pequena penetração são: aminoglicosídeos, cefalosporinas de primeira geração e clindamicina. É fundamental para a escolha do antibiótico mais adequado para cada caso conhecer características da barreira hematoencefálica, além de determinar a farmacocinética e farmacodinâmica dos antibióticos e seus principais agentes etiológicos. Percebe-se que na literatura veterinária há escassos relatos descrevendo aspectos de farmacocinética e farmacodinâmica nas espécies felina e canina, sendo necessária maior maior quantidade de estudos nesta área.(AU)

Although infections in the central nervous system are less common than infections in other organics systems, they can cause life-threatening consequences and are a challenge for small animal practitioners. Among the factors that make these infections difficult to treat are the fact that it is surrounded by the blood-brain barrier, that hinders penetration of many substances, and the difficulty of obtaining positive results when trying to isolate the causative agent through spinal tap. This article aims to describe the blood-brain barrier, the most common antimicrobials used to treat bacterial infections in the central nervous system and their main applications in small animal practice. In the veterinary literature, trimethoprim, sulfonamides, chloramphenicol, and metronidazole are cited as antimicrobials with excellent penetration on the blood-brain barrier; oxacillin, penicillin's, ceftriaxone, moxalactam, tetracyclines and carbenicillin with intermediate penetration; and aminoglycosides, first-generation cephalosporins, and clindamycin with little penetration. It was concluded that knowing the blood-brain barrier characteristics, pharmacokinetics and pharmacodynamics of antimicrobial agents, along with the main etiological agents, are the key to choose the most appropriate antibiotic to be applied in each individual case. It is noticed that in the veterinary literature there are few reports describing aspects of pharmacokinetics and pharmacodynamics in feline and canine species, requiring more studies in this area.(AU)

Fecal microbiota transplantation via colonoscopy in a dog with Clostridioides (Clostridium) difficile infection / Transplante de microbiota fecal via colonoscopia em um cão com infecção por Clostridioides (Clostridium) difficile

In dogs, antimicrobial therapy for Clostridioides (Clostridium) difficile infection (CDI) is based solely on metronidazole, leaving limited treatment options in case of recurrent disease. Fecal microbiota transplantation (FMT) has been successfully used in humans with recurrent CDI, whereas the usefulness of this approach is largely unknown in dogs. In the present study, a dog with a chronic-recurring diarrhea was treated with FMT via colonoscopy. CDI was confirmed by A/B toxin detection and isolation of toxigenic C. difficile from ribotype 106, a strain also commonly associated with nosocomial infection in humans. The dog recovered well after the procedure and C. difficile was no longer isolated from its stool sample. The present research suggested that FMT could be a useful tool to treat recurrent CDI in dogs, corroborating the actual protocol in humans.(AU)

Em cães, a terapia antimicrobiana para infecções por Clostridioides (Clostridium) difficile é baseada apenas no uso de metronidazol, limitando as opções de tratamento nos casos de recorrência. O transplante de microbiota fecal (FMT) tem sido utilizado com sucesso em seres humanos com infecções recorrentes por C. difficile, porém a utilidade desse método é ainda amplamente desconhecida em cães. O presente trabalho relata a utilização de FMT para o tratamento de um cão com diarreia crônica-recorrente por C. difficile. A infecção foi confirmada por detecção das toxinas A/B e isolamento de uma estirpe toxigênica do ribotipo 106, linhagem comumente associada a infecção em seres humanos. Após o transplante via colonoscopia, o animal se recuperou do quadro e C. difficile não mais foi encontrado em novas amostras fecais. O presente trabalho sugere que o FMT possa ser útil para o tratamento de quadros de C. difficile em cães, corroborando protocolo atual de tratamento em seres humanos.(AU)

Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse: case report / Associação da ceftriaxona intraperitoneal, gentamicina intravenosa e do metronidazol oral no tratamento de abscesso abdominal e peritonite em equino: relato de um caso

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response.(AU)

O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 12 horas (15 mg/Kg). Em retorno, ao 30° dia, observou-se regressão do tamanho do abscesso, entretanto, não houve resolução, tendo sido mantida a terapia com metronidazol. No 45º dia de tratamento, realizou-se nova avaliação hospitalar, onde foi observada a resolução do abscesso e a admnistração do metronidazol foi suspensa. Destaca-se, que a associação terapêutica utilizada no tratamento de infecção abdominal e abscesso resultou em rápida resposta clínica.(AU)

Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse: case report / Associação da ceftriaxona intraperitoneal, gentamicina intravenosa e do metronidazol oral no tratamento de abscesso abdominal e peritonite em equino: relato de um caso

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response.(AU)

O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 12 horas (15 mg/Kg). Em retorno, ao 30° dia, observou-se regressão do tamanho do abscesso, entretanto, não houve resolução, tendo sido mantida a terapia com metronidazol. No 45º dia de tratamento, realizou-se nova avaliação hospitalar, onde foi observada a resolução do abscesso e a admnistração do metronidazol foi suspensa. Destaca-se, que a associação terapêutica utilizada no tratamento de infecção abdominal e abscesso resultou em rápida resposta clínica.(AU)

Characterization of enteropathy in mice infected with Giardia duodenalis and treated with differing anti-parasite drugs / Caracterização da enteropatia em camundongos infectados com Giardia duodenalis e tratados com diferentes medicamentos antiparasitários

Our aim was to analyze the duodena of mice infected with Giardia duodenalis (assemblage A) after four different types of parasite treatment for enteropathy. Methods: Forty-eight male Swiss mice, 21 days of age, received 1000 parasite cysts orally. The animals were divided into six groups: negative (G1) and positive control (G2), and groups treated with nitazoxanide (G3), albendazole (G4), metronidazole (G5), and secnidazole (G6). After treatment they were sacrificed and the duodena were examined histopathologically. Results: In the positive control group G2, increased levels of neutral and acidic goblet cells, intraepithelial lymphocytes, and Paneth cells were found. There was a reduction in villus height and an increase in villus width; and crypts presented increased widths and depths. Hypertrophy in all layers of the intestinal wall and enterocytes was also observed. Conclusions: Metronidazole was the most effective in attenuating the enteropathy caused by G. duodenalis infection; reversing the increase in intraepithelial lymphocytes and Paneth cells, and attenuating the other elements investigated.(AU)

Nosso objetivo foi analisar a enteropatia do duodeno de camundongos infectados com Giardia duodenalis (assembleia A) e submetê-los a quatro tipos diferentes de tratamento parasitário. Métodos: Quarenta e oito camundongos Swiss machos, com 21 dias de idade, receberam 1000 cistos de parasitas por via oral. Os animais foram divididos em seis grupos: controle negativo (G1), controle positivo (G2) e tratamento com nitazoxanida (G3), albendazol (G4), metronidazol (G5) e secnidazol (G6). Eles foram então sacrificados e o duodeno foi examinado histopatologicamente. Resultados: No grupo G2, foram encontrados níveis aumentados de células caliciformes neutras e ácidas, linfócitos intra-epiteliais e células de Paneth. Houve redução da altura das vilosidades e aumento da largura das vilosidades; as criptas aumentaram em largura e profundidade. Hipertrofia em todas as camadas da parede intestinal e enterócitos também foi observada. Conclusões: O metronidazol foi mais efetivo na atenuação da enteropatia causada pela infecção por G. duodenalis, pois reverteu o aumento dos linfócitos intraepiteliais e das células de Paneth e atenuou os demais elementos investigados. (AU)

Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse / Associação da ceftriaxona intraperitoneal, gentamicina intravenosa e do metronidazol oral no tratamento de abscesso abdominal e peritonite em equino

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the anim

O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 1

Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse: case report / Associação da ceftriaxona intraperitoneal, gentamicina intravenosa e do metronidazol oral no tratamento de abscesso abdominal e peritonite em equino: relato de um caso

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the anim

O tratamento conservativo dos abscessos abdominais em equinos requer antibioticoterapia prolongada e apresenta variadas taxas de sucesso. Foi atendido um cavalo de seis anos de idade, com histórico de cólica e múltiplas punções abdominais por agulha para esvaziamento de gás. Na admissão, foram observados taquicardia, taquipnéia, hipertermia, congestão mucosa, desidratação e marcha rígida. A associação do exame físico, achados laboratoriais e ultrassonográficos permitiu o diagnóstico de peritonite e abscesso abdominal. Foi realizado tratamento suporte e antibioticoterapia de amplo espectro: ceftriaxona intraperitoneal diária (25 mg/kg, 7 dias); gentamicina intravenosa diária (6,6 mg/kg, 7 dias); metronidazol oral três vezes ao dia (15 mg/kg, 12 dias), seguido de mesma dose duas vezes ao dia, por mais 33 dias, totalizando 45 dias de tratamento. O fibrinogênio plasmático e o exame ultrassonográfico foram os recursos mais eficazes para a avaliação da evolução do abscesso. Após 24 horas do início do tratamento foi constatada a normalização do exame fisico, regressão progressiva da contagem de células nucleadas no líquido peritoneal, do fibrinogênio plasmático e do tamanho do abscesso. No 10° dia de tratamento o animal recebeu alta hospitalar, mantendo-se a terapia oral com metronidazol a cada 1

Aplicação intravenosa de metronidazol, ceftriaxona e enrofloxacina em cadelas anestesiadas com isoflurano: repercussão dos parâmetros hemodinâmicos e respiratórios / Intravenous application of metronidazole, ceftriaxone and enrofloxacin in dogs anesthetized with isoflurane: impact of hemodynamic and cardiorespiratory parameters

Background: The prophylactic use of antimicrobials in patients undergoing surgery is widely performed due to its power to reduce and control infections in the surgical site. Metronidazole, ceftriaxone and enrofloxacin are drugs widely used in veterinary medicine, even during anesthesia, either in healthy patients or under critical conditions. Despite several reports on hemodynamic reactions after intravenous application of antimicrobials in dogs, there are few studies on these effects in dogs undergoing anesthesia. The objective of this study was to evaluate the hemodynamic and cardiorespiratory effects of metronidazole, ceftriaxone and enrofloxacin in dogs anesthetized with isoflurane. Materials, Methods & Results: Forty healthy bitches were used, equally divided into four experimental groups of 10 animals each: placebo group (PG), metronidazole group (MG), ceftriaxone group (CG) and enrofloxacin group (EG). After the experimental phase of data collection, all animals were submitted to ovariohysterectomy using the minimally invasive approach. A catheter was placed in the dorsal metatarsal artery for direct blood pressure monitoring, with systolic (SBP), mean (MBP) and diastolic (DBP) blood pressures were continuously monitored by means of a transducer connected to a multiparametric monitor. The others measured data were heart rate (HR), respiratory rate (RR), body temperature (T°C), carbon dioxide expired fraction (ETCO2), oxygen saturation of hemoglobin (SpO2) in T0 (time immediately before performing the treatment), 5 (T5), 10 (T10), 15 (T15), 20 (T20) and 30 (T30) minutes after administration of the antimicrobial. Anesthetic induction was performed with propofol and anesthetic maintenance was performed with isoflurane. After reaching anesthesia with a surgical plan, all parameters were measured before treatments were performed (T0). Then the...

Metronidazole concentration in the bloodstream following its topical application, at different concentration levels, on experimental skin wounds during healing by secondary intention

Purpose:To characterize qualitatively and quantitatively the absorption of metronidazole solution, in greater concentrations and for longer periods, when applied topically to an experimental open skin wound model.Methods:An open skin wound, 2 cm in diameter and total skin thickness was prepared, under anesthetic, in the dorsal region of 108 Wistar rats weighing between 300 and 350 grams. The animals were allocated to groups of 18 animals in accordance with the concentration of metronidazole in the solution to be applied daily to the wound. In the control group (CG), 0.9% sodium chloride solution was used for application, and in the experimental groups (GI, GII, GIII, GIV and GV) metronidazole solution at 4%, 6%, 8%, 10% and 12%, respectively, was applied. After 3, 7 and 14 days of treatment. Blood samples collected through cardiac puncture were examined for the existence or non-existence of metronidazole, using high performance liquid chromatography (HPLC). Detected metronidazole values were compared statistically within each group (temporal analysis 3 days X 7 days X 14 days) and between the groups that used topical metronidazole (4% X 6% X 8% X 10% and 12%) using the Kruskal-Wallis test, considering a statistical significance of 95% (p<0.05).Results:Metronidazole was detected in all the samples at all times in all the groups in which topical metronidazole was applied to the wounds. Characteristically, there was no significant difference between the doses obtained within each group over time (3 days X 7 days X 14 days) GI=0.461; GII=0.154; GIII=0.888; GIV= 0.264 and GV=0.152. In the evaluation between groups, a similar degree of absorption was found after 3 days (p=0.829) and 14 days (p=0.751).Conclusion:The serum concentration of metronidazole that was achieved was not influenced by the concentration of the solution applied to the skin wound, with similar extend, or by the duration of the application.(AU)

Effect of metronidazole on placental and fetal development in albino rats

Metronidazole is an antiprotozoal and antibacterial used in gynecology and obstetrics for the treatment of parasitic infections. However, despite having clinical use for more than three decades, questions about the safety of its use during pregnancy is not well understood. Thus, the present study evaluated the effect of metronidazole on placental and fetal development in pregnant rats. Metronidazole was orally administered by gavage at a dosage of 130 mg/kg for 7 and 14 days. Morphological analysis, morphometry and immunohistochemistry were performed at the implantation sites and placentas with 14 days of development. The results showed that in the treated group there was a significant reduction in the number of implantation sites, total placental disc area and constituent elements of the labyrinth and spongiotrophoblast layers. Histochemical analysis revealed no significant changes in the content of collagen, elastic and reticular fibers. The TUNEL test showed apoptotic activity in the implantation sites and placentas with 14 days of development independent of the treatment. There was no evidence of malformation in the neonates. However, there was a significant reduction in the number and weight of neonates in the group treated with metronidazole when compared to the control group. Thus, it is concluded that the administration of 130 mg/kg of metronidazole during pregnancy in rats, in addition to interfering with the number of implanted embryos, promotes changes in placental structure and interferes with fetal development. This suggests that this drug should be used with caution during pregnancy

Effect of metronidazole on placental and fetal development in albino rats

Metronidazole is an antiprotozoal and antibacterial used in gynecology and obstetrics for the treatment of parasitic infections. However, despite having clinical use for more than three decades, questions about the safety of its use during pregnancy is not well understood. Thus, the present study evaluated the effect of metronidazole on placental and fetal development in pregnant rats. Metronidazole was orally administered by gavage at a dosage of 130 mg/kg for 7 and 14 days. Morphological analysis, morphometry and immunohistochemistry were performed at the implantation sites and placentas with 14 days of development. The results showed that in the treated group there was a significant reduction in the number of implantation sites, total placental disc area and constituent elements of the labyrinth and spongiotrophoblast layers. Histochemical analysis revealed no significant changes in the content of collagen, elastic and reticular fibers. The TUNEL test showed apoptotic activity in the implantation sites and placentas with 14 days of development independent of the treatment. There was no evidence of malformation in the neonates. However, there was a significant reduction in the number and weight of neonates in the group treated with metronidazole when compared to the control group. Thus, it is concluded that the administration of 130 mg/kg of metronidazole during pregnancy in rats, in addition to interfering with the number of implanted embryos, promotes changes in placental structure and interferes with fetal development. This suggests that this drug should be used with caution during pregnancy(AU)

Perfil de resistência antimicrobiana de Klebsiella pneumoniae isoladas de animais domésticos e silvestres / Antimicrobial resistance profile of Klebsiella pneumoniae isolated from domestic and wild animals

Klebsiella pneumoniae é um patógeno oportunista, responsável por diversos tipos de infecções nosocomiais, e é considerado um microrganismo multirresistente. Dados na literatura que forneçam informações a respeito da resistência desse microrganismo a antimicrobianos em amostras de animais são escassos. Dessa forma, o objetivo deste trabalho foi avaliar o perfil e o seu aumento das resistências a antimicrobianos dentro da medicina veterinária. Um total de 67 isolados de K. pneumoniae, provenientes de diferentes sítios de isolamento de animais domésticos (39/67) e silvestres (28/67), foi confirmado por sequenciamento do gene 16S rRNA. O maior percentual de isolamento de K. pneumoniae foi de amostras de urina, com 16% (11/67), fezes, com 15% (10/67), e pulmão, com 13,5% (09/67). No perfil de resistência, foram testadas 11 categorias de antibióticos, sendo a maior taxa de resistência ao metronidazol 97% (65/67), à ampicilina 94% (63/67), à amoxicilina 93% (62/67), às sulfonamidas 93% (62/67), à colistina 93% (62/67) e à nitrofurantoína 88% (59/67). Aqueles que apresentaram menor taxa de resistência foram: meropenem 3% (2/67), imipenem 6% (4/67) e amicacina 16% (11/67). Todos os isolados foram considerados bactérias multirresistentes (MRD), com o índice de resistência múltipla aos antibióticos (IRMA) variando de 0,15 a 0,85 e com 60 tipos de padrões de resistência. O resultado deste estudo reforça que os animais são reservatórios de K. pneumoniae multirresistentes.(AU)

Klebsiella pneumoniae is an opportunistic pathogen responsible for several types of nosocomial infections and is considered a multiresistant microorganism. Data in the literature that provide information regarding the resistance of this microorganism to antimicrobials in animal samples are scarce. Thus, the objective of this work was to evaluate the profile and its increase of antimicrobial resistance within Veterinary Medicine. A total of 67 K. pneumoniae isolates from different domestic (39/67) and wild (28/67) isolation sites were confirmed by sequencing the 16S rRNA gene. The highest percentage of K. pneumoniae isolation was from urine samples with 16% (11/67), faeces 15% (10/67) and lung 13.5% (09/67). In the resistance profile, 11 categories of antibiotics were tested, with the highest resistance to metronidazole being 97% (65/67), ampicillin 94% (63/67), amoxicillin 93% (62/67), sulfonamides 93% (62 / 67), 93% colistin (62/67), and 88% nitrofurantoin (59/67). The ones with the lowest resistance were: meropenem 3% (2/67), imipenem 6% (4/67) and amikacin 16% (11/67). All isolates were considered multiresistant bacteria (MDR), with the Multiple Resistance to Antibiotics Index (IRMA) ranging from 0.15 to 0.85 and with 60 types of resistance patterns. The result of this study reinforces that the animals are reservoirs of multiresistant K. pneumoniae.(AU)

Perfil de resistência antimicrobiana de Klebsiella pneumoniae isoladas de animais domésticos e silvestres / Antimicrobial resistance profile of Klebsiella pneumoniae isolated from domestic and wild animals

Klebsiella pneumoniae é um patógeno oportunista, responsável por diversos tipos de infecções nosocomiais, e é considerado um microrganismo multirresistente. Dados na literatura que forneçam informações a respeito da resistência desse microrganismo a antimicrobianos em amostras de animais são escassos. Dessa forma, o objetivo deste trabalho foi avaliar o perfil e o seu aumento das resistências a antimicrobianos dentro da medicina veterinária. Um total de 67 isolados de K. pneumoniae, provenientes de diferentes sítios de isolamento de animais domésticos (39/67) e silvestres (28/67), foi confirmado por sequenciamento do gene 16S rRNA. O maior percentual de isolamento de K. pneumoniae foi de amostras de urina, com 16% (11/67), fezes, com 15% (10/67), e pulmão, com 13,5% (09/67). No perfil de resistência, foram testadas 11 categorias de antibióticos, sendo a maior taxa de resistência ao metronidazol 97% (65/67), à ampicilina 94% (63/67), à amoxicilina 93% (62/67), às sulfonamidas 93% (62/67), à colistina 93% (62/67) e à nitrofurantoína 88% (59/67). Aqueles que apresentaram menor taxa de resistência foram: meropenem 3% (2/67), imipenem 6% (4/67) e amicacina 16% (11/67). Todos os isolados foram considerados bactérias multirresistentes (MRD), com o índice de resistência múltipla aos antibióticos (IRMA) variando de 0,15 a 0,85 e com 60 tipos de padrões de resistência. O resultado deste estudo reforça que os animais são reservatórios de K. pneumoniae multirresistentes.(AU)

Klebsiella pneumoniae is an opportunistic pathogen responsible for several types of nosocomial infections and is considered a multiresistant microorganism. Data in the literature that provide information regarding the resistance of this microorganism to antimicrobials in animal samples are scarce. Thus, the objective of this work was to evaluate the profile and its increase of antimicrobial resistance within Veterinary Medicine. A total of 67 K. pneumoniae isolates from different domestic (39/67) and wild (28/67) isolation sites were confirmed by sequencing the 16S rRNA gene. The highest percentage of K. pneumoniae isolation was from urine samples with 16% (11/67), faeces 15% (10/67) and lung 13.5% (09/67). In the resistance profile, 11 categories of antibiotics were tested, with the highest resistance to metronidazole being 97% (65/67), ampicillin 94% (63/67), amoxicillin 93% (62/67), sulfonamides 93% (62 / 67), 93% colistin (62/67), and 88% nitrofurantoin (59/67). The ones with the lowest resistance were: meropenem 3% (2/67), imipenem 6% (4/67) and amikacin 16% (11/67). All isolates were considered multiresistant bacteria (MDR), with the Multiple Resistance to Antibiotics Index (IRMA) ranging from 0.15 to 0.85 and with 60 types of resistance patterns. The result of this study reinforces that the animals are reservoirs of multiresistant K. pneumoniae.(AU)