Table: Antimicrobial Drugs Used in Reptiles-MSD Veterinary Manual

Antimicrobial Drugs Used in Reptiles

Drug	Dosage	Comments
Acyclovir	80 mg/kg every 8 hours or 240 mg/kg/day, PO; topical cream every 12 hours	Antiviral
Amikacin	Corn snake: loading dose 1.7 mg/kg, IM, followed by 26 mcg/kg/hr via osmotic infusion-pump implant Gopher snake: initial dose 5 mg/kg, IM, then 2.5 mg/kg, IM, every 3 days Gopher tortoise: 5 mg/kg, IM, on alternate days American alligator (juvenile): 2.25 mg/kg, IM, every 3–4 days Ball python: 3.5 mg/kg, IM, every 4–5 days 50 mg/10 mL saline × 30 min nebulization bid	Maintain hydration
Amphotericin B	0.5–1 mg/kg, intracoelomic, IV, 1–3 days for 14–28 days	Aspergillosis; fluid therapy recommended
	Tortoise: 0.1 mg/kg/day, intrapulmonary, for 28 days 5 mg/150 mL saline for 1 hour of nebulization, twice daily for 7 days	Pulmonary candidiasis
Ampicillin	Most species: 10–20 mg/kg, SC, IM, twice daily Tortoises: 50 mg/kg, IM, twice daily
Azithromycin	Ball python: 10 mg/kg, PO, every 3–7 days (3 days for skin infections, 5 days for respiratory tract, 7 days for liver and kidneys)
Carbenicillin	200–400 mg/kg/day, IM
Ceftazidime	20–40 mg/kg, SC, IM, IV, every 2–3 days
Ceftiofur	Tortoises: 2.2–4 mg/kg/day, IM Snakes: 2.2 mg/kg, IM, on alternate days Lizards: 5 mg/kg/day, IM, SC
Cefuroxime	100 mg/kg/day, IM, for 10 days at 30°C
Chloramphenicol	Indigo, rat, king snakes: 50 mg/kg, SC, twice daily
	Boids, moccasins: 50 mg/kg/day, SC Rattlesnakes: 50 mg/kg, SC, every 2 days Red-bellied water snakes: 50 mg/kg, SC, every 3 days
	Most species: 20–40 mg/kg, IM, every day
Ciprofloxacin	Most species: 10 mg/kg, PO, on alternate days Pythons: 11 mg/kg, PO, every 2–3 days
Clarithromycin	Desert tortoise: 15 mg/kg, PO, every 2–3 days	Mycoplasma
Clindamycin	5 mg/kg, PO, twice daily
Clotrimazole	Topical	Fungal dermatitis
Doxycycline	Most species: 5–10 mg/kg/day, PO Hermann's tortoises: 50 mg/kg, IM, then 25 mg/kg, every 3 days
Enrofloxacin	Most species: 5-10 mg/kg/day, IM, PO	IM injection causes necrosis, and after a single injection, oral therapy is required.
	Nasal flush 50 mg/250 mL sterile water; 1–3 mL/nares daily to every other day
	Burmese python (juvenile): 10 mg/kg, IM, initial dosage, then 5 mg/kg, IM, every 48 hours. Pseudomonas: 10 mg/kg, IM, every 48 hours	IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration
	Hermann’s tortoise: 10 mg/kg/day, IM	IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration
	Monitor lizards: 10 mg/kg, IM, every 5 days
	Indian star tortoise: 5 mg/kg, IM, once to twice daily	IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration
	Crocodilians: 5 mg/kg, IV, every 2–3 days
Fluconazole	Lizards: 5 mg/kg/day, PO Sea turtles: 21 mg/kg, SC, once; then 10 mg/kg, SC, 5 days later
	Sea turtles: 21 mg/kg, SC, once; then 10 mg/kg, SC, 5 days later
Gentamicin	American alligator: 1.75 mg/kg, IM, every 3–4 days at 22° C	Maintain hydration, nephrotoxicity reported
	Painted turtle: 10 mg/kg, IM, on alternate days at 26° C	Maintain hydration, nephrotoxicity reported
	Red-eared terrapins: 6 mg/kg, IM, every 25 days	Maintain hydration, nephrotoxicity reported
	Gopher snakes: 2.5 mg/kg, IM, every 3 days at 24° C	Maintain hydration, nephrotoxicity reported
Itraconazole	Chameleons: 5-10 mg/kg, PO, every 1-2 days	Fungal dermatitis
	Spiny lizards: 23.5 mg/kg/day, PO, for 3 days, with persistent drug concentration for 6 days
	Snakes: 10 mg/kg/day, PO
	Sea turtles: 5 mg/kg/day, PO, or 15 mg/kg, PO, every 72 hours
Ketoconazole	Crocodilians: 50 mg/kg/day, PO
	Most species: 15–30 mg/kg/day, PO, for 14–28 days
Lincomycin	10 mg/kg/day, PO; 5 mg/kg, IM, once to twice daily
Marbofloxacin	Ball python: 10 mg/kg, PO, every 48 hours
Metronidazole	Bacterial infections, 20–50 mg/kg, PO, every 1–2 days	Maximal dose for tricolor snake, king snake, indigo snake, or Uracoan rattlesnake, is 40 mg/kg
Neomycin	10 mg/kg/day, PO	Oral only, not to be given systemically
Nystatin	Enteric fungal conditions in turtles: 100,000 U/kg/day, PO, for 10 days
Oxytetracycline	Most species: 5–10 mg/kg/day, IM, PO	Pain, irritation, and inflammation at injection site
	American alligator: 10 mg/kg, IV, IM, every 4–5 days	Mycoplasmosis
Piperacillin	50–100 mg/kg, IM, every 12 days	Fluid therapy recommended
Polymixin B	Topical	Abrasions, wounds
Sulfamethoxydiazine	80 mg/kg, SC, IM, then 40 mg/kg/day, for 5–7 days	Coccidial infections
Tobramycin	Chelonians: 10 mg/kg, IM, every 1–2 days Most species: 2.5 mg/kg, IM, every 1–3 days	Potentially nephrotoxic, fluid therapy recommended
Trimethoprim-sulfa	30 mg/kg/day, PO, IM, IV
Tylosin	5 mg/kg/day, IM	Mycoplasmosis
Voriconazole	10 mg/kg, PO

Drug

Dosage

Comments

Acyclovir

80 mg/kg every 8 hours or 240 mg/kg/day, PO; topical cream every 12 hours

Antiviral

Amikacin

Corn snake: loading dose 1.7 mg/kg, IM, followed by 26 mcg/kg/hr via osmotic infusion-pump implant

Gopher snake: initial dose 5 mg/kg, IM, then 2.5 mg/kg, IM, every 3 days

Gopher tortoise: 5 mg/kg, IM, on alternate days

American alligator (juvenile): 2.25 mg/kg, IM, every 3–4 days

Ball python: 3.5 mg/kg, IM, every 4–5 days

50 mg/10 mL saline × 30 min nebulization bid

Maintain hydration

Amphotericin B

0.5–1 mg/kg, intracoelomic, IV, 1–3 days for 14–28 days

Aspergillosis; fluid therapy recommended

Tortoise: 0.1 mg/kg/day, intrapulmonary, for 28 days

5 mg/150 mL saline for 1 hour of nebulization, twice daily for 7 days

Pulmonary candidiasis

Ampicillin

Most species: 10–20 mg/kg, SC, IM, twice daily

Tortoises: 50 mg/kg, IM, twice daily

Azithromycin

Ball python: 10 mg/kg, PO, every 3–7 days (3 days for skin infections, 5 days for respiratory tract, 7 days for liver and kidneys)

Carbenicillin

200–400 mg/kg/day, IM

Ceftazidime

20–40 mg/kg, SC, IM, IV, every 2–3 days

Ceftiofur

Tortoises: 2.2–4 mg/kg/day, IM

Snakes: 2.2 mg/kg, IM, on alternate days

Lizards: 5 mg/kg/day, IM, SC

Cefuroxime

100 mg/kg/day, IM, for 10 days at 30°C

Chloramphenicol

Indigo, rat, king snakes: 50 mg/kg, SC, twice daily

Boids, moccasins: 50 mg/kg/day, SC

Rattlesnakes: 50 mg/kg, SC, every 2 days

Red-bellied water snakes: 50 mg/kg, SC, every 3 days

Most species: 20–40 mg/kg, IM, every day

Ciprofloxacin

Most species: 10 mg/kg, PO, on alternate days

Pythons: 11 mg/kg, PO, every 2–3 days

Clarithromycin

Desert tortoise: 15 mg/kg, PO, every 2–3 days

Mycoplasma

Clindamycin

5 mg/kg, PO, twice daily

Clotrimazole

Topical

Fungal dermatitis

Doxycycline

Most species: 5–10 mg/kg/day, PO

Hermann's tortoises: 50 mg/kg, IM, then 25 mg/kg, every 3 days

Enrofloxacin

Most species: 5-10 mg/kg/day, IM, PO

IM injection causes necrosis, and after a single injection, oral therapy is required.

Nasal flush 50 mg/250 mL sterile water; 1–3 mL/nares daily to every other day

Burmese python (juvenile): 10 mg/kg, IM, initial dosage, then 5 mg/kg, IM, every 48 hours. Pseudomonas: 10 mg/kg, IM, every 48 hours

IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration

Hermann’s tortoise: 10 mg/kg/day, IM

IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration

Monitor lizards: 10 mg/kg, IM, every 5 days

Indian star tortoise: 5 mg/kg, IM, once to twice daily

IM injection likely causes necrosis, and consideration should be given to single injection followed by oral administration

Crocodilians: 5 mg/kg, IV, every 2–3 days

Fluconazole

Lizards: 5 mg/kg/day, PO

Sea turtles: 21 mg/kg, SC, once; then 10 mg/kg, SC, 5 days later

Gentamicin

American alligator: 1.75 mg/kg, IM, every 3–4 days at 22° C

Maintain hydration, nephrotoxicity reported

Painted turtle: 10 mg/kg, IM, on alternate days at 26° C

Maintain hydration, nephrotoxicity reported

Red-eared terrapins: 6 mg/kg, IM, every 25 days

Maintain hydration, nephrotoxicity reported

Gopher snakes: 2.5 mg/kg, IM, every 3 days at 24° C

Maintain hydration, nephrotoxicity reported

Itraconazole

Chameleons: 5-10 mg/kg, PO, every 1-2 days

Fungal dermatitis

Spiny lizards: 23.5 mg/kg/day, PO, for 3 days, with persistent drug concentration for 6 days

Snakes: 10 mg/kg/day, PO

Sea turtles: 5 mg/kg/day, PO, or 15 mg/kg, PO, every 72 hours

Ketoconazole

Crocodilians: 50 mg/kg/day, PO

Most species: 15–30 mg/kg/day, PO, for 14–28 days

Lincomycin

10 mg/kg/day, PO; 5 mg/kg, IM, once to twice daily

Marbofloxacin

Ball python: 10 mg/kg, PO, every 48 hours

Metronidazole

Bacterial infections, 20–50 mg/kg, PO, every 1–2 days

Maximal dose for tricolor snake, king snake, indigo snake, or Uracoan rattlesnake, is 40 mg/kg

Neomycin

10 mg/kg/day, PO

Oral only, not to be given systemically

Nystatin

Enteric fungal conditions in turtles: 100,000 U/kg/day, PO, for 10 days

Oxytetracycline

Most species: 5–10 mg/kg/day, IM, PO

Pain, irritation, and inflammation at injection site

American alligator: 10 mg/kg, IV, IM, every 4–5 days

Mycoplasmosis

Piperacillin

50–100 mg/kg, IM, every 12 days

Fluid therapy recommended

Polymixin B

Topical

Abrasions, wounds

Sulfamethoxydiazine

80 mg/kg, SC, IM, then 40 mg/kg/day, for 5–7 days

Coccidial infections

Tobramycin

Chelonians: 10 mg/kg, IM, every 1–2 days

Most species: 2.5 mg/kg, IM, every 1–3 days

Potentially nephrotoxic, fluid therapy recommended

Trimethoprim-sulfa

30 mg/kg/day, PO, IM, IV

Tylosin

5 mg/kg/day, IM

Mycoplasmosis

Voriconazole

10 mg/kg, PO