Topical ear treatment – options, indications and limitations of current therapy

Paterson, Sue

doi:10.1111/jsap.12583

Cited by 29 publications

(23 citation statements)

References 98 publications

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“…Tris‐EDTA is a common ingredient found in ear cleaners or rinses to remove ear debris, reduce microbial load and increase the susceptibility of otic pathogens to topical antimicrobial therapy for canine OE . There is a significant literature on Tris‐EDTA and disodium EDTA that describes these bacteriostatic agents as potentiating other antimicrobial agents or assesses their antibacterial activity as a part of a formulation or poly‐pharmaceutical commercial product .…”

Section: Discussionmentioning

confidence: 99%

In vitroantimicrobial activity of seven adjuvants against common pathogens associated with canine otitis externa

Chan

Khazandi

Hickey

et al. 2018

Veterinary Dermatology

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Background -An antibiotic adjuvant is a chemical substance used to modify or augment the effectiveness of primary antimicrobial agents against drug-resistant micro-organisms. Its use provides an alternative approach to address the global issue of antimicrobial resistance and enhance antimicrobial stewardship.Hypothesis/Objectives -To determine the antimicrobial activity of a panel of potential antimicrobial adjuvants against common pathogens associated with canine otitis externa (OE).Animals/Isolates -A number of type strains and clinical isolates (n = 110) from canine OE were tested including Staphylococcus pseudintermedius, b-haemolytic Streptococcus spp., Pseudomonas aeruginosa, Proteus mirabilis and Malassezia pachydermatis.Methods and materials -Antimicrobial activities of monolaurin, monocaprin, N-acetylcysteine (NAC), polymyxin B nonapeptide, Tris-EDTA, Tris-HCL and disodium EDTA were tested using microdilution methodology according to CLSI guidelines.Results -N-acetylcysteine, Tris-EDTA and disodium EDTA had antimicrobial activity against both type strains and otic pathogens. The other adjuvants tested had limited to no efficacy. NAC had a minimal inhibitory concentration (MIC) range of 2,500-10,000 lg/mL for the various organisms. Pseudomonas aeruginosa isolates were eight times more susceptible to disodium EDTA in the presence of Tris-HCL in comparison to disodium EDTA alone. Malassezia pachydermatis isolates were most susceptible to Tris-EDTA (MIC 90 = 190/60 lg/mL) and disodium EDTA (MIC 90 = 120 lg/mL).Conclusions and clinical relevance -N-acetylcysteine, Tris-EDTA and disodium EDTA have intrinsic antimicrobial activity and represent promising adjuvants that could be used to enhance the efficacy of existing antibiotics against Gram-negative and multidrug-resistant bacterial infections. These agents could be combined with other antimicrobial agents in a multimodal approach for mixed ear infections in dogs.

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Section: Discussionmentioning

confidence: 99%

In vitroantimicrobial activity of seven adjuvants against common pathogens associated with canine otitis externa

Chan

Khazandi

Hickey

et al. 2018

Veterinary Dermatology

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“…Onset of secondary causes such as bacterial and Malassezia spp. infections is generally associated by the emergence of primary diseases such as canine atopic dermatitis or combined with several predisposing factors (7). The host immune response to microorganisms in the external ear canal likely plays a pivotal role, but few data are available in dogs, except for studies on the immune reaction against Malassezia (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Identification of Altered miRNAs in Cerumen of Dogs Affected by Otitis Externa

et al. 2020

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Otitis externa is one of the most common diseases in dogs. It is associated with bacteria and yeast, which are regarded as secondary causes. Cerumen is a biological substance playing an important role in the protection of ear skin. The involvement of cerumen in immune defense is poorly understood. MicroRNAs can modulate the host immune response and can provide promising biomarkers for several inflammatory and infectious disorder diagnosis. The aims of this study were to profile the cerumen miRNA signature associated with otitis externa in dogs, integrate miRNAs to their target genes related to immune functions, and investigate their potential use as biomarkers. Cerumen was collected from healthy and otitis affected dogs and the expression of miRNAs was profiled by Next Generation Sequencing; the validation of the altered miRNAs was performed using RT-qPCR. The potential ability of miRNAs to modulate immune-related genes was investigated using bioinformatics tools. The results pointed out that 32 miRNAs, of which 14 were up-and 18 down-regulated, were differentially expressed in healthy vs. otitis-affected dogs. These results were verified by RT-qPCR. To assess the diagnostic value of miRNAs, ROC analysis was carried out, highlighting that 4 miRNAs are potential biomarkers to discriminate otitis-affected dogs. Bioinformatics showed that cerumen miRNAs may be involved in the modulation of host immune response. In conclusion, we have demonstrated for the first time that miRNAs can be efficiently extracted and quantified from cerumen, that their profile changes between healthy and otitis affected dogs, and that they may serve as potential biomarkers. Further studies are necessary to confirm their diagnostic value and to investigate their interaction with immune-related genes.

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“…Treatment options for secondary infections are varied and may include mechanical removal of cellular debris and microorganisms with ear flushing, together with topical or even systemic antimicrobials (Morris 2004, Paterson 2016. The use of topical antimicrobial therapy (mainly antibiotics and/or antifungals) for the treatment of OE is widespread among veterinarians, but there is a wide concern about the emergence of antibiotic resistance.…”

Section: Introductionmentioning

confidence: 99%

“…Recent reports suggest that topical administration of antiseptics, generally referred to as ear cleaners, could be a useful sole or adjunctive treatment for canine OE (Paterson 2016). Most products contain one or more ingredients with antimicrobial activity and other components such as ceruminolytics, astringents, stabilisers and surfactants, which increase the solubility and activity of the antiseptic.…”

Section: Introductionmentioning

confidence: 99%

Preliminary evaluation of two commercial ear solutions in the treatment of canine otitis externa

Fregeneda‐Grandes

Nicolás‐González

Rejas

et al. 2020

J of Small Animal Practice

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Objectives Preliminary evaluation of the efficacy of two commercial ear solutions composed of (1) chlorhexidine‐Tris‐ethylenediaminetetraacetic acid (EDTA) or (2) medical grade honey, for the treatment of otitis externa in dogs. Materials and Methods Dogs affected with otitis externa housed in an animal shelter were eligible for inclusion. Treatment was applied daily for 10 days and effect was measured by otitis clinical scores and microbiological counts. One of the treatments was applied to affected left ears, while the other was applied to affected right ears. Results A total of 24 ears from 13 dogs were included in the study. During the treatment period, with both treatments it was observed an improvement in clinical scores and a decrease in microbiological counts. At the end of the study 22 of 24 ears were deemed to have mild (4 ears), or no (18 ears) pain, with only two ears still showing pruritus. Clinical Significance The application of ear solutions composed of chlorhexidine‐Tris‐EDTA or medical grade honey, in the absence of antimicrobial treatment, might be effective for the control of clinical signs and microbial colonisation in dogs with otitis externa. Additional randomised studies on clinical patients are required to validate these findings.

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Topical ear treatment – options, indications and limitations of current therapy

Cited by 29 publications

References 98 publications

In vitroantimicrobial activity of seven adjuvants against common pathogens associated with canine otitis externa

In vitroantimicrobial activity of seven adjuvants against common pathogens associated with canine otitis externa

Identification of Altered miRNAs in Cerumen of Dogs Affected by Otitis Externa

Preliminary evaluation of two commercial ear solutions in the treatment of canine otitis externa

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