Pre-Treatment Protocol
- Conduct a thorough otoscopic examination and cytology to identify the presence of bacteria, yeast, inflammatory cells, or parasites.
- Use an ear cleaner to reduce debris, bacterial load, and yeast populations, preparing the ear for further treatment.
- Apply a biofilm disruptor to break down biofilms, ensuring medications can reach bacteria hidden in Pseudomonas and Staphylococcus biofilms.
- After cleaning, apply the relevant medication if applicable.
Product selection for pre-treatment of otitis
Effective pre-treatment for otitis requires products that remove debris, cerumen, and biofilm, using antimicrobial agents and biofilm disruptors to optimize therapy. Lowering bacterial and yeast load helps reduce antibiotic reliance, supporting antimicrobial stewardship. Here are the products to keep on hand:
Otodine, a patented ear-cleansing solution combining chlorhexidine and Tris-EDTA, specifically formulated for dogs and cats.
This synergistic combination exhibits potent antibacterial and antifungal properties, effectively managing microbial overgrowth in the ear canal. Chlorhexidine serves as a broad-spectrum antimicrobial agent, while Tris-EDTA enhances its efficacy by disrupting the integrity of bacterial cell walls and biofilms. Studies have demonstrated Otodine's effectiveness against various pathogens associated with canine otitis, including multi-drug resistant strains.
Ghibaudo G, Cornegliani L, Martino PA. Evaluation of the in vivo effects of Tris‐EDTA and chlorhexidine digluconate 0.15% solution in chronic bacterial otitis externa: 11 cases. Vet Dermatol. 2004 Aug;15(s1):65)
Peptivet, available in drops and gel, is an innovative ear solution that combines chlorhexidine, Tris-EDTA, and a novel antimicrobial peptide (AMP2041). This formulation offers broad-spectrum antimicrobial activity against bacteria and fungi, including resistant strains. The inclusion of Vitamin PP (niacin) and Zinc PCA provides soothing and moisturizing effects, aiding in the restoration of the skin barrier and reducing inflammation.
Tris-NAC, a specialized ear cleanser that combines Tris-EDTA with N-acetylcysteine (NAC). This formulation is particularly effective in disrupting and dissolving biofilms, which are often implicated in chronic and recurrent otic infections. By breaking down these biofilms, Tris-NAC® helps to enhance the penetration and efficacy of antimicrobial agents, facilitating more effective treatment outcomes. Its use is especially beneficial in cases where biofilm-producing bacteria are present, as it aids in reducing microbial load and the potential for antibiotic resistance.
