Mycobacterial or resistant staphylococcal combination treatment
10–20 mg/kg
PO
Every 8–12 h
Use with another effective antimicrobial to reduce resistance; monitor hepatic toxicity.
Pyogranulomatous pyoderma combination treatment
5–10 mg/kg
PO
Every 24 h
Up to 56 days; Reported 4-8 weeks with another effective antibiotic.
Actinomycosis
10–20 mg/kg
PO
Every 12 h
Cats
Use / stage
Dose
Route
Schedule
Instructions
Susceptible bacterial infection
5 mg/kg
PO
Every 12 h
Lower divided regimen preferred.
Susceptible bacterial infection
10 mg/kg
PO
Every 24 h
Horses
Use / stage
Dose
Route
Schedule
Instructions
Susceptible bacterial infection
10 mg/kg
PO
Every 24 h
Rhodococcus equi infection
5 mg/kg
PO
Every 12 h
Foals; reported regimen describes possible erythromycin 25 mg/kg PO every 8 hours or another macrolide; combination benefit is not established by this monograph.
Foal proliferative enteropathy adjunct
10 mg/kg
PO
Every 24 h
With erythromycin estolate 25 mg/kg PO every 6-8 hours; at least 21 days.
Cattle
Use / stage
Dose
Route
Schedule
Instructions
Reported susceptible infection treatment
20 mg/kg
PO
Every 24 h
Johne disease discussion includes combination with isoniazid without a complete companion protocol.
Sheep
Use / stage
Dose
Route
Schedule
Instructions
Reported susceptible infection treatment
20 mg/kg
PO
Every 24 h
Johne disease discussion includes combination with isoniazid without a complete companion protocol.
Goat
Use / stage
Dose
Route
Schedule
Instructions
Reported susceptible infection treatment
20 mg/kg
PO
Every 24 h
Johne disease discussion includes combination with isoniazid without a complete companion protocol.
Birds
Use / stage
Dose
Route
Schedule
Instructions
Mycobacteriosis combination treatment
45 mg/kg
PO
Every 24 h
With ethambutol 30 mg/kg PO daily plus clofazimine 6 mg/kg daily or isoniazid 30 mg/kg daily; individualize avian monitoring.
Potently induces hepatic enzymes and P-glycoprotein, lowering exposure to many drugs including macrolides, anticonvulsants, corticosteroids, digoxin and warfarin.
Assess liver enzymes and bilirubin after about 7 days and every 10-14 days thereafter; discontinue if hepatic injury develops. Antibacterial resistance and combination plans require microbiologic assessment.
Light-protected oral syrup preparations have reported stability of 4-6 weeks. Reported reconstituted IV solution 60 mg/mL is stable for 24 hours.
Resistance can emerge rapidly with monotherapy; use another effective antimicrobial when indicated. The comparative benefit of combination treatment for foal R. equi disease remains uncertain. Macrolide-containing foal courses often last 4-9 weeks and can cause hyperthermia and severe enterocolitis in foals or mares.
