Table 15-4.
Antimicrobial Combination Therapies Commonly Used in Exotic Animals.a
| Antimicrobial Agent | Synergistic or Combination Agent |
|---|---|
| Aminoglycosidesb (amikacin, gentamicin) | Cephalosporins, clindamycin, fluoroquinolones, lincomycin, metronidazole, penicillins (amoxicillin, ampicillin, carbenicillin, piperacillin, ticarcillin), trimethoprim/sulfas |
| Amoxicillin | Clavulanate |
| Ampicillin | Sulbactam |
| Cephalosporin | Aminoglycosides,b clindamycin, fluoroquinolones, metronidazole, semi-synthetic penicillins |
| Clindamycin | Aminoglycosides, cephalosporins (third-generation), enrofloxacin, penicillins |
| Fluoroquinolones (enrofloxacin, ciprofloxacin, marbofloxacin) | Aminoglycosides,b cephalosporins (third-generation), clindamycin, metronidazole, penicillins (extended-spectrum) |
| Lincomycin | Aminoglycosides,b spectinomycin |
| Metronidazole | Amikacin, azithromycin, carbenicillin, cefazolin, cefotaxime, chloramphenicol, enrofloxacin, gentamicin, marbofloxacin, others as indicated |
| Ormetoprim | Sulfadimethoxine |
| Penicillins (ampicillin, carbenicillin, piperacillin) | Aminoglycosides,b fluoroquinolones |
| Penicillins, early generation | Aminoglycosides,b third-generation cephalosporins, fluoroquinolones |
| Ticarcillin | Clavulanate |
| Trimethoprim | Sulfadiazine, sulfamethoxazole |
| Tylosin | Oxytetracycline |
a
Indicated when synergy is advantageous in definitive therapy, to treat polymicrobial infections, to broaden empiric coverage, or to attempt to prevent the development of antimicrobial resistance.
b
Generally amikacin, occasionally gentamicin.