Long-lasting otic solution containing mometasone furoate can influence intradermal testing in dogs with healthy ears and otitis externa.

BACKGROUND: Topical therapy is preferred for otitis externa (OE) in dogs. Otic products commonly contain glucocorticoids that can be systemically absorbed and possibly interfere with diagnostic tests such as intradermal testing (IDT). HYPOTHESIS/OBJECTIVES: To determine the effect of a long-lasting otic solution containing mometasone furoate (MF) on IDT immediate reactions and to determine withdrawal time before IDT. ANIMALS: Seventeen dogs with healthy ears (Group 1) and 12 with OE (Group 2). MATERIALS AND METHODS: Intradermal injections of histamine, anticanine-immunoglobulin (Ig)E and saline were subjectively and objectively evaluated before treatment and weekly for 6 weeks, after a single application of a long-lasting otic solution containing MF. RESULTS: Statistically significant reductions in the mean subjective histamine scores after application of MF were observed at Weeks 1 (p = 0.012) and 2 (p = 0.028) in Group 1, and Weeks 1 (p = 0.00066), 2 (p = 0.02) and 4 (p = 0.034) in Group 2. Mean histamine objective scores were significantly reduced in Weeks 1 (p = 0.042), 2 (p = 0.0009), 3 (p = 0.001) and 5 (p = 0.018) in Group 1 only. The mean subjective anticanine-IgE scores were significantly reduced in Week 1 in both groups (p = 0.003, p = 0.0066), respectively. There were no significant changes in the mean anticanine-IgE objective score in either group. CONCLUSIONS AND CLINICAL RELEVANCE: Application of a long-lasting otic solution containing MF can interfere with IDT immediate reactions in healthy and OE dogs. Based on the subjective evaluation, IDT can be performed ≥2 weeks after application of the otic solution in healthy dogs, and ≥4 weeks in dogs with OE.

Efficacy and safety of 1.5% levofloxacin otic solution for the treatment of otitis media in a multicenter, randomized, double-blind, parallel-group, placebo-controlled, phase III study.

OBJECTIVE: The present study aimed to evaluate the efficacy and safety of 1.5% levofloxacin (LVFX) otic solution for the treatment of patients with otitis media. METHODS: This multicenter, randomized, double-blind, parallel-group, placebo-controlled phase 3 trial was conducted at 34 institutions in Japan. A total of 202 patients with chronic suppurative otitis media (CSOM) or acute otitis media (AOM) were randomized into either the LVFX group or placebo group. A total of 6-10 drops of 1.5% otic solution of LVFX or its matching placebo were administered in the diseased ear twice daily, in the morning and evening for up to 10 days. Images corresponding to three clinical findings-purulent otorrhea, hyperemia (redness), and granulation tissue formation in the middle ear and tympanic membrane-for each diseased ear were evaluated using digital endoscopy by a blinded central independent review committee (BICRC) at each visit after treatment administration. RESULTS: In total, the data of 201 participants (LVFX group, 99; placebo group, 102) were analyzed. The proportion of patients with disappearance (improvement rate) of all three clinical findings at the end of treatment or discontinuation by the BICRC was 46.5% (46/99) in the LVFX group and 23.5% (24/102) in the placebo group, and the difference (95% confidence interval) between the groups was 22.0% (8.7, 34.2), with a significantly higher improvement rate in the LVFX group than in the placebo group (p = 0.001; Cochran-Mantel-Haenszel test), demonstrating the efficacy of LVFX. The bacterial eradication rates were 93.9% (77/82) and 12.5% (11/88) in the LVFX and placebo groups, respectively, and the rate was significantly higher in the LVFX group than in the placebo group (p < 0.001). Treatment-related adverse events (AEs) occurred in 5.1% (5/99) and 7.8% (8/102) of the patients in the LVFX and placebo groups, respectively, and no significant difference was noted in incidence rate between the groups. CONCLUSION: The clinical efficacy of 1.5% LVFX otic solution for CSOM and AOM was demonstrated by the resolution of inflammation in the middle ear and tympanic membrane as well as through the high bacterial eradication rate observed. No deaths or serious treatment-related AEs were observed. The study provided confirmation that 1.5% LVFX otic solution is a safe, well-tolerated, and effective treatment for CSOM and AOM.

Repair of large traumatic tympanic membrane perforation using ofloxacin otic solution and gelatin sponge.

INTRODUCTION: Traumatic large tympanic membrane perforations usually fail to heal and require longer healing times. Few studies have compared the healing and hearing outcomes between gelatin sponge patching and ofloxacin otic solution. OBJECTIVES: To compare the healing outcomes of large traumatic tympanic membrane perforations treated with gelatin sponge, ofloxacin otic solution, and spontaneous healing. METHODS: Traumatic tympanic membrane perforations >50% of the entire eardrum were randomly divided into three groups: ofloxacin otic solution, gelatin sponge patch and spontaneous healing groups. The healing outcome and hearing gain were compared between the three groups at 6 months. RESULTS: A total of 136 patients with large traumatic tympanic membrane perforations were included in analyses. The closure rates were 97.6% (40/41), 87.2% (41/47), and 79.2% (38/48) in the ofloxacin otic solution, gelatin sponge patch, and spontaneous healing groups, respectively (p=0.041). The mean times to closure were 13.12±4.61, 16.47±6.24, and 49.51±18.22 days in these groups, respectively (p<0.001). CONCLUSIONS: Gelatin sponge patch and ofloxacin otic solution may serve as effective and inexpensive treatment strategies for traumatic large tympanic membrane perforations. However, ofloxacin otic solution must be self-applied daily to keep the perforation edge moist, while gelatin sponge patching requires periodic removal and re-patching.

Repair of large traumatic tympanic membrane perforation using ofloxacin otic solution and gelatin sponge / Reparo de grande perfuração da membrana timpânica traumática utilizando solução otológica de ofloxacina e curativo de Gelfoam®

Abstract Introduction Traumatic large tympanic membrane perforations usually fail to heal and require longer healing times. Few studies have compared the healing and hearing outcomes between gelatin sponge patching and ofloxacin otic solution. Objectives To compare the healing outcomes of large traumatic tympanic membrane perforations treated with gelatin sponge, ofloxacin otic solution, and spontaneous healing. Methods Traumatic tympanic membrane perforations >50% of the entire eardrum were randomly divided into three groups: ofloxacin otic solution, gelatin sponge patch and spontaneous healing groups. The healing outcome and hearing gain were compared between the three groups at 6 months. Results A total of 136 patients with large traumatic tympanic membrane perforations were included in analyses. The closure rates were 97.6% (40/41), 87.2% (41/47), and 79.2% (38/48) in the ofloxacin otic solution, gelatin sponge patch, and spontaneous healing groups, respectively (p = 0.041). The mean times to closure were 13.12 ± 4.61, 16.47 ± 6.24, and 49.51 ± 18.22 days in these groups, respectively (p < 0.001). Conclusions Gelatin sponge patch and ofloxacin otic solution may serve as effective and inexpensive treatment strategies for traumatic large tympanic membrane perforations. However, ofloxacin otic solution must be self-applied daily to keep the perforation edge moist, while gelatin sponge patching requires periodic removal and re-patching.

Resumo Introdução As grandes perfurações traumáticas da membrana timpânica geralmente apresentam falha de cicatrização e requerem tempos de cicatrização mais longos; poucos estudos compararam os resultados de cicatrização e a audição dessas perfurações obtidos com curativo de Gelfoam® e solução otológica de ofloxacina. Objetivo Comparar os resultados de cicatrização de grandes perfurações traumáticas da membrana timpânica tratadas com Gelfoam®, solução otológica de ofloxacina e cicatrização espontânea. Método Perfurações traumáticas de > 50% de todo o tímpano foram divididas aleatoriamente em três grupos: tratamento com solução otológica de ofloxacina, com curativo de Gelfoam® e grupo de cicatrização espontânea. O resultado da cicatrização e o ganho auditivo foram comparados entre os três grupos após 6 meses. Resultados Foram incluídos nas análises 136 pacientes com grandes perfurações traumáticas de membrana timpânica. As taxas de cicatrização foram de 97,6% (40/41), 87,2% (41/47) e 79,2% (38/48) com a solução otológica de ofloxacina, curativo de Gelfoam® e grupos de cicatrização espontânea, respectivamente (p = 0,041). O tempo médio de cicatrização foi de 13,12 ± 4,61, 16,47 ± 6,24 e 49,51 ± 18,22 dias nesses grupos, respectivamente (p < 0,001). Conclusões O curativo de Gelfoam® e a solução otológica de ofloxacina podem servir como estratégias de tratamento eficazes e de baixo custo para grandes perfurações traumáticas de membrana timpânica. Entretanto, a solução otológica de ofloxacina deve ser autoaplicada diariamente para manter a borda da perfuração úmida, enquanto o curativo de Gelfoam® requer sua remoção e reaplicação periódicas.