Antibiotics- yay/nay

Re: Antibiotics- yay/nay

Siobhan Steven — Wed, 14 Dec 2011 11:21:07 GMT

Exactly Robert...

Re: Antibiotics- yay/nay

Rob Watkins — Wed, 14 Dec 2011 11:05:32 GMT

Using antibiotics as a preventative is masking underlying failings elsewhere and contributes to the growing problem with MRSA/MRSP.

Re: Antibiotics- yay/nay

Siobhan Steven — Wed, 14 Dec 2011 10:58:32 GMT

Are you guys doing skin sutures? We have found the patients don't lick if there are no skin sutures, and if they prep is well done. Sharp clipper blades, good technique. Gentle prep, not 'scrub', cotton wool initially, swabs for final prep. And impeccable surgical technique and asepsis. There has to be acknowledgement that overuse of A.B's can cause more problems then they fix, in the long run, MRSA etc...Whose to say that all the clinics that use them 'just in case' wouldn't have any problems if they didn't use them at all?

Re: Antibiotics- yay/nay

thebeestingbutterfly — Wed, 14 Dec 2011 10:30:49 GMT

This is my point, we cant control home scenarios.

suture reactions mixed with licking, poor home hygiene possibly even poor theatre hygiene -would we prevent it with the use of an antibiotic, prevent rather than treat??

Re: Antibiotics- yay/nay

Rob Watkins — Wed, 14 Dec 2011 09:36:49 GMT

Certainly the greatest challenge to the surgical site is the home environment. My guess is that the pet's "favourite blanket" harbours more problems than it's tongue!

But how do you identify if it is the pet licking or and underlying issue in the practice or protocol?

Re: Antibiotics- yay/nay

thebeestingbutterfly — Tue, 13 Dec 2011 23:28:49 GMT

well i always presumed an antibiotic injection was more for the post op period given the patient is likely to lick op site- rather than preventing a horrible peritonitis- as surgery should be sterile, unlike the patients grotty chops.

plus pre op we are clipping fur, scrubbing skin bathing patients if necessary, they are being housed in clean kennels (hopefully) and providing your practice isn't harbouring MRSA or something nasty, this period in time should be the least likely time to have issues????

compared to when they get home and go have a lie down on the garden and have a little lick after licking their bums

Re: Antibiotics- yay/nay

Rob Watkins — Mon, 12 Dec 2011 10:08:06 GMT

[quote user="thebeestingbutterfly"]

i know we have seen wound break downs post op from various contributing factors, whether it is lack of ab coverage or poor post op care i don't know. but surely they go hand in hand?

[/quote]

I'm not sure these go hand in hand. Post op environments in the owner's home are always going to be challenging. Therefore surely the only factors you can influence are the pre operative preparation?

Re: Antibiotics- yay/nay

Hannah25uk — Sun, 11 Dec 2011 14:45:12 GMT

We don't use prophylactic antibiotics for routine either and v.rarely have any issues. If we do its generally because of lack of owner compliance i.e licking of wound. Our post op checksare generally at day 5, and we have an audit system in place in which post op complications are recorded.

Re: Antibiotics- yay/nay

Mrs Dot Dot — Sun, 11 Dec 2011 12:45:00 GMT

We don't routinely for routine ops, but will, especially for bitch spays, if there is a skin problem uncovered when clipping eg rash, spots etc. Always try and get pre-op ab's given for anything orthopaedic, and dentals - have looked at our scrubbing technique and we always wear gloves for scrubbing and use almost neat hibi. We see everything 2-3 days post op for a chk and if any licking etc / poss wound infn give 5 days a/b's but this isn't for the majority.

Re: Antibiotics- yay/nay

thebeestingbutterfly — Sun, 11 Dec 2011 11:43:49 GMT

i know we have seen wound break downs post op from various contributing factors, whether it is lack of ab coverage or poor post op care i don't know. but surely they go hand in hand?

Re: Antibiotics- yay/nay

Rob Watkins — Wed, 07 Dec 2011 10:08:33 GMT

Interesting comments... Are all of you running clinical audits to measure outcomes?

Re: Antibiotics- yay/nay

Nicola Smith — Wed, 07 Dec 2011 09:33:59 GMT

We dont use abs for any electives and have had no problems touch wood x

Re: Antibiotics- yay/nay

thebeestingbutterfly — Tue, 06 Dec 2011 23:12:31 GMT

sounds about right Phrin!

I'd love to say i thought everything was tip top clean and sterile in all practices, but there are a lot of establishments that aren't! :(

Re: Antibiotics- yay/nay

Phrin Vernon RVN — Tue, 06 Dec 2011 22:58:45 GMT

Ideally there should be no reason to give abcs for routine elective surgery.

However in my last practice (mixed) abcs were given to everything. The nurses tried their best for sterility in theatre, (and then tried some more!), but at the end of the day when farm vets tromp into theatre in their wellies on a regular basis there's not much you can do.... especially if said farm vets happen to be the boss :(

Re: Antibiotics- yay/nay

Gemma Burden RVN — Tue, 06 Dec 2011 22:38:35 GMT

We haven't given routine antibiotics for elective surgery in either practice I have worked at. The only reason we have given them for ops such as neuters is because there was a reason to, such as those lovely cat castrates that decided to have diarrhoea just as the vet finishes the op,. We very rarely experience any post operative complications, and often they are actually due to the owners not following the discharge instructions and letting their pet lick their wound etc, so actually need a longer course anyway. I don't see that there is any need to give pre op antibiotics if you are happy with the sterility of the equipment and theatre practice.