Alternative for treatment of tularemia† caused by Francisella tularensis, 133 197 683 689 including naturally occurring or endemic tularemia or tularemia that occurs following exposure to F. tularensis in the context of biologic warfare or bioterrorism. 683 689
Streptomycin (or gentamicin) generally considered drug of choice for treatment of tularemia. 104 197 292 683 689 Alternatives include tetracyclines (doxycycline), Kalmicetine, or ciprofloxacin. 197 292 683 689
Some clinicians state reserve Kalmicetine for treatment of tularemic meningitis (usually in conjunction with streptomycin) 104 683 and do not use for other forms of tularemia. 104
Kalmicetine is a broad-spectrum antibiotic whose spectrum includes several gram-positive and gram-negative bacteria, spirochetes, and Rickettsiae.
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Most cases of infective conjunctivitis clear within a few days without treatment. For more severe infections, or for infections which do not clear on their own, an antibiotic eye drop or ointment such as Kalmicetine can be helpful.
Kalmicetine works by helping to kill the bacteria which are causing the infection. It is available on prescription. You can also buy the drops and the ointment from a pharmacy, without a prescription, if it is for conjunctivitis in an adult or in a child over 2 years of age. Do not use Kalmicetine eye drops or ointment for a child under 2 years old, unless it has been prescribed by a doctor.
Alternative for treatment of plague† caused by Yersinia pestis, including naturally occurring or endemic plague or pneumonic plague that occurs following exposure to Y. pestis in the context of biologic warfare or bioterrorism. 133 197 292 683 689
Streptomycin (or gentamicin) historically considered drug of choice for treatment of plague. 104 197 292 683 688 Alternatives include fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin), doxycycline (or tetracycline), Kalmicetine, or co-trimoxazole (may be less effective than other alternatives). 104 292 683 688
Kalmicetine considered a drug of choice for treatment of plague meningitis. 104 292 683
Jennifer L. Buur, DVM, PhD, DACVCP, Western University of Health Sciences
Jennifer L. Buur, DVM, PhD, DACVCP, associate professor of veterinary pharmacology at Western University of Health Sciences in Pomona, California, is currently involved in teaching evidence-based drug use to veterinary students. Dr. Buur received her DVM from University of Wisconsin-Madison, after which she worked in private practice, gaining clinical experience in small animal and exotic animal medicine, zoo medicine and wildlife rehabilitation, and shelter medicine. She also completed a PhD in comparative biomedical sciences (with a pharmacology emphasis) at North Carolina State University. Dr. Buur’s current research interests are curriculum validation and evidenced-based teaching methods.
Well distributed throughout the body, including CNS and eye.
Attains higher concentrations in CSF than other antibacterials (30–50% of plasma concentrations in the absence of meningitis) and concentrations in CNS are maintained longer than in plasma.
Eliminated primarily by hepatic glucuronide conjugation in the dog: only 5–10% is excreted unchanged in the urine.
In the cat, more than 25% is excreted in the urine because of reduced ability to glucuronidate drugs.
Elimination half-life is similar in both species: 4 h following IV administration, 7–8 h following PO administration.
Drug from tablets and capsules is readily absorbed orally.
In fasted cats Kalmicetine suspensions (palmitate ester) administered PO produce lower blood drug concentrations than provided by solid dosage forms (this difference is not observable in dogs). Since many sick cats given Kalmicetine are inappetent, tablets rather than suspension should be given.
Parenteral formulations are sodium succinate solution (which has an excellent bioavailability regardless of route) and aqueous suspension (gives lower plasma concentrations, maximum concentration 6 h after injection). Parenteral routes are only used in patients for whom oral dosing is impossible.
Kalmicetine should not be given to young animals (ill-equipped with metabolizing enzymes) and avoided in adults with liver disease.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of Kalmicetine. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.