When Amoxicillin Doesn’t Work Anymore
You prescribe a trusted antibiotic for a routine skin infection, expecting improvement in a week. Instead, the dog comes back worse, the owner frustrated, and you facing questions: “Doc, bakit hindi gumana yung gamot?” This is no longer rare—it’s the everyday reality of antimicrobial resistance (AMR).
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Understanding the Enemy
Antimicrobial resistance happens when bacteria adapt and no longer respond to drugs designed to kill them. In veterinary practice, we see this in:
- Recurrent pyoderma cases in dogs where Staphylococcus pseudintermedius becomes methicillin-resistant (MRSP).
- Chronic otitis externa, where multiple courses of antibiotics select for resistant strains.
- Urinary tract infections, often with resistant E. coli.
These resistant infections are harder, longer, and more expensive to treat—and they endanger both pets and people because resistant bacteria can spread across species.
Why Resistance Is Rising in Small Animal Practice
Several factors drive this trend:
- Empirical prescribing without culture and sensitivity testing.
- Incomplete treatment courses when owners stop medication early.
- Over-the-counter or leftover antibiotic use without veterinary supervision.
- Widespread broad-spectrum use when narrow-spectrum options would suffice.
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What Vets Can Do Today
Follow Antibiotic Stewardship Principles
- Use culture and sensitivity whenever possible.
- Select the right drug, at the right dose, for the right duration.
Educate Pet Owners
- Emphasize completing full treatment courses.
- Explain why antibiotics are not for every cough, sneeze, or itch.
Consider Alternatives First
- Topical therapies for skin and ear infections can reduce systemic use.
- Supportive care (anti-inflammatory, wound management, diet) often helps resolve without systemic antibiotics.
Document and Monitor
- Keep track of resistance trends in your clinic.
- Share case data with colleagues to strengthen local surveillance.
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Clinical Pearl
The most powerful tool is not a stronger antibiotic—it’s better decision-making. Each prescription is an opportunity to either slow down or speed up antimicrobial resistance.
Closing Reflection
Antibiotics transformed veterinary medicine, but their power is fading. As gatekeepers of animal and public health, we hold the responsibility to use them wisely. Stewardship isn’t just science—it’s professional ethics.
Dr. Geoff Carullo is a Fellow and the current President of the Philippine College of Canine Practitioners.
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