Allergic reaction to zinacef?

RE: Allergic reaction to zinacef?

Michael Woodhouse — Tue, 21 Jun 2016 22:08:49 GMT

Irrespective - all adverse reactions should be reported to the VMD.

No one has come forwards with any veterinary evidence this is needed or preferable to something given by a different route (Augmentin IV better than SC Synulox etc). That is what we need to be able to justify, and I don't think anyone can.

Anthony Todd there is human evidence supporting single doses of IV 2nd gen cephalosporin preventing post op infections (or repeated dosing for longer Sx). Not done with animals. No comparison with say IV and SC routes etc.

RE: Allergic reaction to zinacef?

Tim Charlesworth — Mon, 20 Jun 2016 14:06:10 GMT

We've seem quite a few reactions to iv co-amoxiclav (Augmentin) recently causing swelling/erythema around the face/extremities but they have settled very quickly with iv promethazine (Phenergan). We haven't had any probs with Zinacef but it's certainly possible. It may well be the carrier rather than the drug itself (or any of the other medications that were used).

RE: Allergic reaction to zinacef?

Will McMullan — Mon, 20 Jun 2016 13:42:41 GMT

I think very few people use them for minor ops like cat spays these days. We don't give them to anything like that, or mass removals (unless huge/infected/grafting). I almost never give them to a dental. I think if entering the GI/urinary/resp tract or leaving implants eg joint replacement you are justified. I have also seen evidence recently that clean orthopaedic surgeries that had prophylactic abs had lower post-op infection rates. I'll try and find the reference. That debate goes back and forth which is why it stuck in my head.

RE: Allergic reaction to zinacef?

Anthony Todd — Mon, 20 Jun 2016 12:41:45 GMT

[quote user="Will McMullan"]Sorry, I'll clarify.[/quote]

Sorry, me too. I meant is there any evidence that perioperative antibiotics of any colour or creed reduces post-op infection?

I realise that intra-wound mammary preparations probably wasn't the best way, but does the modern way and modern drugs actually make a difference?

eg post cat spay??

RE: Allergic reaction to zinacef?

Will McMullan — Mon, 20 Jun 2016 12:19:14 GMT

Sorry, I'll clarify. I meant if you choose to use antibiotics then using them in the manner the OP did is routine. Not for every surgery. And I think the best evidence suggests perioperative IV use is better in terms of preventing resistance than giving a prophylactic course starting on the day of the op. I don't have specific references to hand but have heard the same in many CPD courses and am pretty sure this is the BSAVA position. I think Zinacef is a 2nd-generation cephalosporin and so many people consider it ok to use whereas the 3rd or 4th generation ones would still be kept in reserve.

RE: Allergic reaction to zinacef?

Anthony Todd — Mon, 20 Jun 2016 12:05:40 GMT

[quote user="Will McMullan"]I think it's justified. Perioperative IV antibiosis is pretty much routine these days and is considered the best way to use antibiotics in terms of resistance development. [/quote]

Must be some evidence that their perioperative use has a benefit, even though it is "routine"?

Or is it just ass-covering?

Just because a drug is licensed surely doesn't mean it can't give an allergic or untoward reaction, even if rarely?

RE: Allergic reaction to zinacef?

Gillian Mostyn — Mon, 20 Jun 2016 11:43:06 GMT

[quote user="Will McMullan"]Perioperative IV antibiosis is pretty much routine these days and is considered the best way to use antibiotics in terms of resistance development.[/quote]

Really? In 'routine' gastrotomies/enterotomies? That genuinely surprises me. Anyway, if we're talking about resistance, I thought that, in general, it is better not to use cephalosporins for routine prophylaxis?

[quote user="Will McMullan"] If you are under scrutiny for a decision you make you are judged against what your peers would do in a similar situation and thousands of vets would have done the same thing so no worries there. [/quote]

Maybe. I really don't know. But I was under the impression that if possible, we should use an antibiotic that is licensed. I wouldn't see how prophylactic use, without a specific culture and sensitivity panel, to be good enough reason to deviate. But until there is a test case, I guess many people will continue to ignore the cascade.

RE: Allergic reaction to zinacef?

Will McMullan — Mon, 20 Jun 2016 08:57:51 GMT

I think it's justified. Perioperative IV antibiosis is pretty much routine these days and is considered the best way to use antibiotics in terms of resistance development. If you are under scrutiny for a decision you make you are judged against what your peers would do in a similar situation and thousands of vets would have done the same thing so no worries there.

RE: Allergic reaction to zinacef?

Gillian Mostyn — Sun, 19 Jun 2016 21:43:06 GMT

Agree with Michael. I can't understand why you used an off-license antibiotic in this case, nor the decision not to use NSAIDS?

I guess the zinacef probably caused the reaction - but I don't know if you could justify its use if the reaction had been worse???

RE: Allergic reaction to zinacef?

Francisco Gomez — Sun, 19 Jun 2016 21:40:43 GMT

I'm a bit unsure about blaming the non-licensed drug for this. I agree that licensed drugs have been extensively (some) researched but?? Can you really be sure that the licensed stuff did't cause this? You do use other drugs in gastrotomies, from pain relief to anaesthetics inductions and maintenance. I've used zinacef and augmentin many times, only reaction I've seen has been vomiting shortly after administration.

RE: Allergic reaction to zinacef?

Michael Woodhouse — Sun, 19 Jun 2016 21:22:03 GMT

Maybe if we stick to licensed vet medicines we wouldn't need to worry.

Do we have a single scrap of evidence in our veterinary patients that they 'need' human IV antibiotics? Anecdotally I am not convinced, and I did look a few years ago and found not a scrap of supportive evidence.

Not supportive of no NSAIDs in such a case either.

I trust you reported this to the VMD?

RE: Allergic reaction to zinacef?

Thomas Johnson — Sat, 18 Jun 2016 12:23:34 GMT

[quote user="Edward Jones"]

The dog had a single dose of zinacef administered during the anaesthetic, slow i/v. Is this likely to have caused the allergic reaction-type signs? Co-amoxyclav is tolerated fine. No NSAIDs were used. Comments and criticisms would be grateful received, thank you!

[/quote]

We had a dog that was given i/v Augmentin by our local Vets Now that had a similar reaction, so it could be the Zinacef, and it could be one of the other ingredients not the antibiotic that caused the reaction.