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Thread: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

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    Default DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Actually this will be life threatening IF I can not find a medication that is here in Costa Rica
    and easily administered.

    Rama Rota will be 12yrs Dec 9th. Lives in Costa Rica - limited resources.

    He has had sinus infections off and on for yrs due to Odontoma.

    Recent test results - Serratia marcescens -- is the bacteria.

    Results for medications antibiotics -- has any one ever used any of these meds? Know
    a squirrel vet who can advise ? ? ? Can't do injections. Thanks so much. RamaMama

    Serratia marcescens

    Amikacina -S
    Ampicilina -R
    Ampicilina/sulbactam -R
    Aztreonam -S
    Cefazolina -R
    Cefepime -S
    Cefotaxime -S
    Cefoxitin -R
    Ceftazidime -S
    Ceftriaxone -S
    Cefuroxime - Sodio -R
    Ciprofloxacina -R
    Ertapenem -S
    Gentamicina -S
    Levofloxacina -R
    Meropenem -S
    Piperacilina/tazobactam -S
    Tetraciclina -R
    Tobramicina -S
    Trimetropim/Sulfa -R
    A

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Quote Originally Posted by RamaMama View Post
    Actually this will be life threatening IF I can not find a medication that is here in Costa Rica
    and easily administered.

    Rama Rota will be 12yrs Dec 9th. Lives in Costa Rica - limited resources.

    He has had sinus infections off and on for yrs due to Odontoma.

    Recent test results - Serratia marcescens -- is the bacteria.

    Results for medications antibiotics -- has any one ever used any of these meds? Know
    a squirrel vet who can advise ? ? ? Can't do injections. Thanks so much. RamaMama

    Serratia marcescens

    Amikacina -S
    Ampicilina -R
    Ampicilina/sulbactam -R
    Aztreonam -S
    Cefazolina -R
    Cefepime -S
    Cefotaxime -S
    Cefoxitin -R
    Ceftazidime -S
    Ceftriaxone -S
    Cefuroxime - Sodio -R
    Ciprofloxacina -R
    Ertapenem -S
    Gentamicina -S
    Levofloxacina -R
    Meropenem -S
    Piperacilina/tazobactam -S
    Tetraciclina -R
    Tobramicina -S
    Trimetropim/Sulfa -R
    A

    Ciprofloxacin is Cipro, which of course we use all the tme and you may have some of. Trimeth/Sulfa is another name for SMZ-TMP which you may also have - sent you some several years ago is you still have some... Tetracyclina is tetracycline which we use but I doubt you have...

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Pretty much all of the viable antibiotics on that list are injectables. I have not used any of these ABs. All of the normal ones we typically use Clindamycin, clavamox, cipro, SMZ-TMP etc will probably not work.

    Are Rama Rotas symptoms worse now? I think this organism is pretty common. I would ask HRT, she might have a suggestion.

    Twelve years old! Wow!







    Quote Originally Posted by RamaMama View Post
    Actually this will be life threatening IF I can not find a medication that is here in Costa Rica
    and easily administered.

    Rama Rota will be 12yrs Dec 9th. Lives in Costa Rica - limited resources.

    He has had sinus infections off and on for yrs due to Odontoma.

    Recent test results - Serratia marcescens -- is the bacteria.

    Results for medications antibiotics -- has any one ever used any of these meds? Know
    a squirrel vet who can advise ? ? ? Can't do injections. Thanks so much. RamaMama

    Serratia marcescens

    Amikacina -S
    Ampicilina -R
    Ampicilina/sulbactam -R
    Aztreonam -S
    Cefazolina -R
    Cefepime -S
    Cefotaxime -S
    Cefoxitin -R
    Ceftazidime -S
    Ceftriaxone -S
    Cefuroxime - Sodio -R
    Ciprofloxacina -R
    Ertapenem -S
    Gentamicina -S
    Levofloxacina -R
    Meropenem -S
    Piperacilina/tazobactam -S
    Tetraciclina -R
    Tobramicina -S
    Trimetropim/Sulfa -R
    A
    See my wild squirrel adventures in the thread "Squirtle's yard!":
    https://thesquirrelboard.com/forums/...quirtle-s-Yard!

    Loving dad to Sir Max, 2017-2018. There is no foot so small that it cannot leave an imprint on this world.

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    I believe that report lists "resistant" to the med with -R, so only the drugs listed as -S (susceptible) will potentially work.


    Quote Originally Posted by CritterMom View Post
    Ciprofloxacin is Cipro, which of course we use all the tme and you may have some of. Trimeth/Sulfa is another name for SMZ-TMP which you may also have - sent you some several years ago is you still have some... Tetracyclina is tetracycline which we use but I doubt you have...
    See my wild squirrel adventures in the thread "Squirtle's yard!":
    https://thesquirrelboard.com/forums/...quirtle-s-Yard!

    Loving dad to Sir Max, 2017-2018. There is no foot so small that it cannot leave an imprint on this world.

    "Once in a while you get shown the light, In the strangest of places if you look at it right."
    -Grateful Dead

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Quote Originally Posted by CritterMom View Post
    Ciprofloxacin is Cipro, which of course we use all the tme and you may have some of. Trimeth/Sulfa is another name for SMZ-TMP which you may also have - sent you some several years ago is you still have some... Tetracyclina is tetracycline which we use but I doubt you have...
    I'm sorry.... I should have made the lab results clearer..... the R after each med means Resistant - cant be used.

    The S means that the bacteria is Sensitive to the medication.

    I should have removed ALL the R's but I was a bit frantic and rushing.

    He is currently on Amoxicillin as it was what I used the last time his sinus infection flared up...... prior to starting the Amox I had been able for the
    first time IN YEARS to get a mucus specimen from his sinus. And the results are listed here. Yes, TD, it seems all the viable meds do not come in
    pill form .... have to wonder why and wish they did.


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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Amoxi is not going to touch Serratia marcescens, it could prevent other infections but won't help with this one. This is a really tough bug to beat.



    Quote Originally Posted by RamaMama View Post
    I'm sorry.... I should have made the lab results clearer..... the R after each med means Resistant - cant be used.

    The S means that the bacteria is Sensitive to the medication.

    I should have removed ALL the R's but I was a bit frantic and rushing.

    He is currently on Amoxicillin as it was what I used the last time his sinus infection flared up...... prior to starting the Amox I had been able for the
    first time IN YEARS to get a mucus specimen from his sinus. And the results are listed here. Yes, TD, it seems all the viable meds do not come in
    pill form .... have to wonder why and wish they did.

    See my wild squirrel adventures in the thread "Squirtle's yard!":
    https://thesquirrelboard.com/forums/...quirtle-s-Yard!

    Loving dad to Sir Max, 2017-2018. There is no foot so small that it cannot leave an imprint on this world.

    "Once in a while you get shown the light, In the strangest of places if you look at it right."
    -Grateful Dead

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Quote Originally Posted by TubeDriver View Post
    Amoxi is not going to touch Serratia marcescens, it could prevent other infections but won't help with this one. This is a really tough bug to beat.
    It is also ONLY given by injection. I will ask local vet but am doubtful this is going to
    happen.

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Just to be sure we are clear, amoxicillin is NOT going to stop Serratia marcescens.

    Quote Originally Posted by RamaMama View Post
    It is also ONLY given by injection. I will ask local vet but am doubtful this is going to
    happen.
    See my wild squirrel adventures in the thread "Squirtle's yard!":
    https://thesquirrelboard.com/forums/...quirtle-s-Yard!

    Loving dad to Sir Max, 2017-2018. There is no foot so small that it cannot leave an imprint on this world.

    "Once in a while you get shown the light, In the strangest of places if you look at it right."
    -Grateful Dead

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    I am exceedingly distraught.

    Stosh went to the local Vet who has helped us over the years.
    He showed the Vet the names of two of the drugs one being Gentamicin and the other is Amikacin.
    Both are ONLT injection or IV.... both and any drugs that are IV can ONLY be received in a hospital.
    Vets and even Reg doctors do not have access to these types of drugs. Not here in CR.

    I had told Stosh to ask if there are any drugs that are similar that can be delivered by a Vet or reg Dr.
    No. There are not.


    TubeDriver..... I hear you about the Amox..... I have no recourse.

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Iím attaching a reply to Rosie in response to an email. Sorry I havenít been around much lately. I just canít get over my current health challenge so Iím pretty worthless.

    Rosie, Serratia isnít a particularly unusual organism but it does tend to be resistant. It is considered an enteric (of GI origin). Itís in the same family (Enterobacteriaceae) as E.coli and Klebsiella like Rama had in the past. It is not more virulent but it is more resistant. Just as a point of interest, 50% of Serratia marcescens are pigment producers. The actual colony is brilliant red. If Rama has a pigment producer you might see red mucous but donít let that upset you. It would be normal for the organism. Itís not blood.

    Both of the antibiotics you inquired about are injectables in a class called (aminoglycosides). There is no oral form of the drugs that Iím aware of. They are also somewhat expensive. I think Amikacin is more expensive than gentamicin. I do have an idea though. Both gentamicin and Amikacin are common ingredients in prescription eye drops or ear drops. Iím sure the vets there treat eye or ear infections in cats or dogs. I would be willing to bet that your vet has access the Gentamycin eye drops. You could use this as a nose drop. It wouldnít be systemic treatment but It would deliver the antibiotic right to the site. DrE uses Amikacin drops in the ports (top of the nose) that access the sinus after she does the odontoma surgery. I think this would be an excellent option. Ask the vet if she can get that. Most gentamycin ear drops have an anti inflammatory and an antifungal as well. This would be fine also. I hope this helps.

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Quote Originally Posted by HRT4SQRLS View Post
    Iím attaching a reply to Rosie in response to an email. Sorry I havenít been around much lately. I just canít get over my current health challenge so Iím pretty worthless.

    Rosie, Serratia isnít a particularly unusual organism but it does tend to be resistant. It is considered an enteric (of GI origin). Itís in the same family (Enterobacteriaceae) as E.coli and Klebsiella like Rama had in the past. It is not more virulent but it is more resistant. Just as a point of interest, 50% of Serratia marcescens are pigment producers. The actual colony is brilliant red. If Rama has a pigment producer you might see red mucous but donít let that upset you. It would be normal for the organism. Itís not blood.

    Both of the antibiotics you inquired about are injectables in a class called (aminoglycosides). There is no oral form of the drugs that Iím aware of. They are also somewhat expensive. I think Amikacin is more expensive than gentamicin. I do have an idea though. Both gentamicin and Amikacin are common ingredients in prescription eye drops or ear drops. Iím sure the vets there treat eye or ear infections in cats or dogs. I would be willing to bet that your vet has access the Gentamycin eye drops. You could use this as a nose drop. It wouldnít be systemic treatment but It would deliver the antibiotic right to the site. DrE uses Amikacin drops in the ports (top of the nose) that access the sinus after she does the odontoma surgery. I think this would be an excellent option. Ask the vet if she can get that. Most gentamycin ear drops have an anti inflammatory and an antifungal as well. This would be fine also. I hope this helps.
    You are NEVER worthless ! ! Stosh will check with the Vet first thing tomorrow. If Vet does not have he will check some of the other pharms around on the off chance they give to people here. CR can be different. Thanks a BUNCH !

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Not much I can help with but please know I'm sending many many prayers to Rama Rota🙏🙏🙏
    Charley Chuckles gone from my arms FOREVER in my heart 8/14/04-3/7/13
    Simon, our time was too short together, but you gave us so much love, be with CC now 3/7/14


    The "CHARLEY CHUCKLES MEMORIAL RAIL TOUR" leaves the station choo chooo
    *Deland,FL. *Washington DC *Boston (Back Bay) *Boston (North Station) *Wells,Maine *Albany,NY *New York (Penn Station) *Back to Deland FL. "July 1- July 22" 2013

    http://thesquirrelboard.com/forums/s...RIAL-RAIL-TOUR Check it out here
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    I'm not poof reading any of this

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    I’m glad HRT posted. I was going to suggest the same thing. Dr. E also routinely uses tobradex, which is tobramycin with dexamethasone as an anti inflammatory, for a variety of issues. It’s an eye drop that is deposited in the nose. The anti inflammatory properties help shrink the swelling and allow easier breathing.

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Stosh checked with local Vet.... they knew the "drops" for eyes and ears with the two drugs HRT mentioned but did
    not have any . . . BUT . . . wrote a script for Stosh to take to a Pharm in town. They had eye drops with Gentamicin.

    Rama is getting one drop in each nostril twice a day for 5 to 7 days.

    Here's hoping !


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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    That was a terrific suggestion from HRT! I hope it does the trick.


    Quote Originally Posted by RamaMama View Post
    Stosh checked with local Vet.... they knew the "drops" for eyes and ears with the two drugs HRT mentioned but did
    not have any . . . BUT . . . wrote a script for Stosh to take to a Pharm in town. They had eye drops with Gentamicin.

    Rama is getting one drop in each nostril twice a day for 5 to 7 days.

    Here's hoping !

    See my wild squirrel adventures in the thread "Squirtle's yard!":
    https://thesquirrelboard.com/forums/...quirtle-s-Yard!

    Loving dad to Sir Max, 2017-2018. There is no foot so small that it cannot leave an imprint on this world.

    "Once in a while you get shown the light, In the strangest of places if you look at it right."
    -Grateful Dead

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    Default Re: DOSING HELP FOR RARE BACTERIAL SINUS INFECTION

    Tobramycin is given for ophthalmic infections with a topical application. I have had that myself for eye infection. Perhaps an ophthalmalogist could be of help.
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