Claphoran (cefotaxime) in rabbits

Question
Hi Dana, My bunny, Piggles, had a C&S done of his sinuses after he lost his upper left molars to the infection. We have been fighting this infection for over a year and this is the third C&S. This latest C&S taken from the fistula showed pseudomonas, e.Coli, and strep. My vet says that the best antibiotic that the culture shows sensitivity to is Claphoran but we can't find much information of its use in rabbits. They are going to sew up the fistula next week, but would like to start the antibiotics tomorrow. We see it is used in horses, but do you have any information about its use and safety in rabbits? Many thanks! Megan

Answer
Dear Megan,

I would be very cautious about using this drug.  It is a cephalosporin, a class of drugs not considered "first choice" for rabbits because of the danger of triggering cecal dysbiosis.  Because it is very broad spectrum against both Gram positive and negative bacteria, it could have an adverse effect on the normal, healthy flora of the bunny's GI tract, allowing overgrowth of potentially very harmful bacteria.

I'm sure your vet is aware of this.  I've never heard of cefotaxime used in rabbits, but will ask around.

Is there any possibility of opening the fistula and infusing it with a powerful disinfectant, such as Technicare (a proprietary mix of chlorhexidene and other napalm-like disinfectants)?  In a case like this, often all you can hope to do is keep the opportunistic pathogens at bay.  The fistula is not likely to be highly vascularized, so systemic antibiotics might have limited efficacy.  

If the various "bugs" show sensitivity to fluoroquinolones and aminoglycosides, you might ask the vet about injecting antibiotic impregnated gel into the capsule that will slowly dissolve away over the course of a couple of weeks.  If you are interested, I can ask my vet if it's okay to share his contact information with your vet.  He's done this on many exotics with good success.

Dana