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Drug | Dose | Comments |
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Amoxicillin | 11–15 mg/kg PO q8h | Good first-line option for UTIs. Excreted in urine predominantly in active form if normal renal function is present. Ineffective against beta-lactamase-producing bacteria. |
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Amikacin | Dogs: 15–30 mg/kg IV/IM/SC q24h Cats: 10–14 mg/kg IV/IM/SC q24h | Not recommended for routine use but may be useful for treatment of multidrug resistant organisms. Potentially nephrotoxic. Avoid in animals with renal insufficiency. |
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Amoxicillin/clavulanate | 12.5–25 mg/kg PO q8h (dose based on combination of amoxicillin + clavulanate) | Not established whether there is any advantage over amoxicillin alone. |
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Ampicillin | | Not recommended because of poor oral bioavailability. Amoxicillin is preferred. |
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Cephalexin, Cefadroxil | 12–25 mg/kg PO q12h | Enterococci are resistant. Resistance may be common in Enterobacteriaceae in some regions. |
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Cefovecin | 8 mg/kg single SC injection. Can be repeated once after 7–14 days. | Should only be used in situations where oral treatment is problematic. Enterococci are resistant. Pharmacokinetic data are available to support the use in dogs and cats, with a duration of 14 days (dogs) and 21 days (cats). The long duration of excretion in the urine makes it difficult to interpret posttreatment culture results. |
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Cefpodoxime proxetil | 5 to 10 mg/kg q24h PO | Enterococci are resistant. |
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Ceftiofur | 2 mg/kg q12-24h SC | Approved for treatment of UTIs in dogs in some regions. Enterococci are resistant. |
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Chloramphenicol | Dogs: 40–50 mg/kg PO q8hCats: 12.5–20 mg/kg PO q12h | Reserved for multidrug resistant infections with few other options. Myelosuppression can occur, particularly with long-term therapy. Avoid contact by humans because of rare idiosyncratic aplastic anemia. |
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Ciprofloxacin | 30 mg/kg PO q24h | Sometimes used because of lower cost than enrofloxacin. Lower and more variable oral bioavailability than enrofloxacin, marbofloxacin, and orbifloxacin. Difficult to justify over approved fluoroquinolones. Dosing recommendations are empirical. |
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Doxycycline | 3–5 mg/kg PO q12h | Highly metabolized and excreted through intestinal tract, so urine levels may be low. Not recommended for routine uses. |
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Enrofloxacin | 5 mg/kg PO q24h (cats)10–20 mg/kg q24h (dogs) | Excreted in urine predominantly in active form. Reserve for documented resistant UTIs but good First-line choice for pyelonephritis (20 mg/kg PO q24h). Limited efficacy against enterococci. Associated with risk of retinopathy in cats. Do not exceed 5 mg/kg/d of enrofloxacin in cats. |
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Imipenem-cilastatin | 5 mg/kg IV/IM q6-8h | Reserve for treatment of multidrug-resistant infections, particularly those caused by Enterobacteriaceae or Pseudomonas aeruginosa. Recommend consultation with a urinary or infectious disease veterinary specialist or veterinary pharmacologist prior to use. |
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Marbofloxacin | 2.7–5.5 mg/kg PO q24h | Excreted in urine predominantly in active form. Reserve for documented resistant UTIs but good First-line choice for pyelonephritis. Limited efficacy against enterococci. |
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Meropenem | 8.5 mg/kg SC/IV q 12 (SC) or 8 (IV)h | Reserve for treatment of multidrug-resistant infections, particularly those caused by Enterobacteriaceae or Pseudomonas aeruginosa. Recommend consultation with a urinary or infectious disease veterinary specialist or veterinary pharmacologist prior to use. |
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Nitrofurantoin | 4.4–5 mg/kg PO q8h | Good second-line option for simple uncomplicated UTI, particularly when multidrug-resistant pathogens are involved. |
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Orbifloxacin | Tablets: 2.5–7.5 mg/kg PO q24h; oral suspension: 7.5 mg/kg PO q24h (cats) or 2.5-7.5 mg/kg PO q24h (dogs) | Excreted in urine predominantly in active form. |
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Trimethoprim-sulfadiazine | 15 mg/kg PO q12hNote: dosing is based on total trimethoprim + sulfadiazine concentration | Good first-line option. Concerns regarding idiosyncratic and immune-mediated adverse effects in some patients, especially with prolonged therapy. If prolonged (>7d) therapy is anticipated, baseline Schirmer’s tear testing is recommended, with periodic re-evaluation and owner monitoring for ocular discharge. Avoid in dogs that may be sensitive to potential adverse effects such as KCS, hepatopathy, hypersensitivity, and skin eruptions. |
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