Use of a Compounded Poloxamer 407 Antibiotic Topical Therapy as Part of the Successful Management of Chronic Ulcerative Dermatitis in a Congo African Grey Parrot ( Psittacus erithacus).

Abstract

A 23-year-old, 425-g male African grey parrot ( Psittacus erithacus) was evaluated for chronic ulcerative dermatitis of the axillary regions under both wings. Initial swab cultures of the sites had revealed a coagulase-positive methicillin-resistant Staphylococcus aureas (MRSA) with marked antibiotic resistance. A second swab culture obtained 8 weeks after the initial culture showed heavy growth of a coagulase-positive Staphylococcus species, which could not be speciated, but showed the same sensitivity as the previous culture. Previous treatment included systemic antibiotics and a topical antimicrobial cream, with variable response and only temporary resolution. On examination, full-thickness, ulcerative, necrotic dermatitis was present under both wings with intermittent bleeding and subdermal tissue exposure. Initial treatment included wound debridement, oral antibiotics, topical therapy, analgesics, and bandages. After a relapse, a poloxamer gel containing 2% doxycycline, 1% chloramphenicol, and 0.5% mupirocin was used in combination with oral antibiotics and analgesics. On follow-up examination, the skin lesions had completely resolved and the patient was doing well and remains normal 4 years later. This report emphasizes the importance of prompt, aggressive multi-modal therapy for MRSA and other dermal bacterial infections in pet birds that may represent zoonoses or have carrier-state zoonotic potential. Preparation by a compounding pharmacy of a transdermal poloxamer gel containing antibiotics shows promise for severe, infected, ulcerative skin lesions in birds when other therapies fail to achieve a cure.