Comparison of the clinical efficacy of oral terbinafine and ketoconazole combined with cephalexin in the treatment ofMalasseziadermatitis in dogs – a pilot study

Abstract

The purpose of this randomized, single blinded clinical trial was to evaluate cytologically and clinically the efficacy of oral cephalexin alone and its combination with terbinafine or ketoconazole for the treatment of Malassezia dermatitis in dogs. Twenty-two client-owned dogs with Malassezia dermatitis completed the 3-week study. All received cephalexin (generic, 250 mg or 500 mg) at 22-30 mg kg(-1) twice daily. Eight dogs received terbinafine at 30 mg kg(-1) once daily and seven dogs received ketoconazole (generic, 200 mg) at 5-10 mg kg(-1) twice daily. The remaining seven dogs received cephalexin alone. At week 0 (visit 1) and week 3 (visit 2), mean yeast counts were determined from three affected areas using tape-strip cytology, a clinical index score (CIS) was assigned to the affected areas, and owners evaluated pruritus using a visual analogue scale. All groups showed reduction in mean yeast counts, CIS and pruritus. There was an 86.8%, 80.2% and 28.8% reduction in mean yeast counts from visit 1 to visit 2 for the terbinafine, ketoconazole and cephalexin-only groups, respectively. However, within treatment group comparisons a significant reduction in mean yeast count was only evident for the terbinafine (P < 0.002) and ketoconazole (P < 0.01) groups. Pruritus reduction was only significant for the terbinafine group. These preliminary results suggest that terbinafine should be further assessed for the treatment of canine Malassezia dermatitis.

The clinical and histopathological effects of prednisone on acute radiation‐induced dermatitis in dogs: a placebo‐controlled, randomized, double‐blind, prospective clinical trial

“…If there were no dermatological abnormalities, cytology was performed of the normal‐appearing skin. Slides were examined for bacteria and yeast as previously described 25,26 …”

“…Yeast counts of greater than 10 organisms in 15 random oil immersion fields on cytology and clinical signs of excessive scale or exudate were considered indicative of Malassezia spp. dermatitis 26,27 . All affected dogs were treated with ketoconazole (generic, 200 mg) at 10 mg kg −1 or fluconazole at 5 mg kg −1 (generic, 100 mg) once daily.…”

Evaluation of a single‐administration ototopical treatment for canine otitis externa: a randomised trial

“…13 14 Terbinafine has also been used systemically in the treatment of dermatophytosis in dogs and cats, 15 16 as well as in the treatment of canine Malassezia dermatitis. [17][18][19] In addition, topical terbinafine has been used successfully to treat dermatophytosis in mice, 20 and in a guinea pig model. 21 Of note, Sagit and others, 22 report no toxicity to the middle ear of rats when terbinafine was applied intratympanically.…”

Terbinafine pharmacokinetics after single dose oral administration in the dog

“…Reports in dogs focus on treatment of Malassezia spp. dermatitis and dermatophytosis 18–20 . Further unpublished reports and clinical experiences suggest that terbinafine may be an option for treatment of subcutaneous and systemic mycoses as either an adjunctive or primary therapy.…”