Skin infections in veterinary patients are commonly treated with systemic antibiotics, but topical therapies can also be used.¹ Topical therapy is available in various formulations (eg, shampoo, spray, mousse, cream, spot-on) and can be tailored to body regions, coat types, and pet owner capabilities. All treatment options for dermatologic disease should be considered to support antimicrobial stewardship and ensure antibiotics remain effective.

Following are the author’s top topical therapies to reduce systemic antibiotic use.

1. Chlorhexidine ± Miconazole

Topical antiseptics can replace systemic antibiotics in dermatology cases, particularly for treatment of superficial pyoderma (Figure 1), and are recommended when impression cytology shows bacteria or yeast (Figure 2). If yeast are the predominant microorganisms on cytology, systemic antibiotics are not indicated. Topical antiseptics alone can be effective for treatment of bacterial pyoderma.^2-6 Chlorhexidine and miconazole are synergistic in vitro against Staphylococcus pseudintermedius, killing bacteria more effectively than either ingredient alone.^7,8 A variety of commercial products containing 2% chlorhexidine and 2% miconazole are available; products with up to 4% chlorhexidine alone are also available.