Sue, who is President of the European Society of Dermatology and an RCVS Specialist, says in a video interview that antimicrobial resistance (AMR) is making otitis externa cases difficult to resolve and that vets can help overcome the problem by rethinking their first line prescription choices.
In the video, created in conjunction with Elanco Animal Health (maker of Osurnia), Sue said: "It’s a sad thing to say but if everybody did manage cases of otitis externa appropriately first time, I probably wouldn’t have a job at all."
"Many of the cases I see as a referral clinician are longstanding cases with very severe, multiply-resistant infections. If we get these cases right on the first occasion with appropriate prescription of drugs, and we don’t hurt dogs so we can give ongoing treatment, then we’d never ever see pseudomonas infection again."
Sue believes part of the problem is that veterinary surgeons are incorrectly saving some of their best first-line treatments for difficult cases. This is perpetuating the antimicrobial resistance problem as cases are being inadvertently mismanaged.
She said: "Florfenicol, which is the active antibiotic in Osurnia, has excellent gram positive activity which makes it an ideal first line choice. However, there’s a misconception that florfenicol is a fluoroquinolone - which it isn’t - so vets are incorrectly ‘saving it’ rather than using it on the first occasion."
Sue also highlights that poor compliance, resulting from the patient’s behavioural problems associated with ear phobia, also has a long-term impact:
"We’ve seen many 'well behaved' dogs that have bitten their owners as a result of fear aggression; we’ve had dogs that have pinned their owners against the wall. I would argue very strongly that if you use long-acting products in dogs on the first occasion then you avoid creating that problem and these dogs don’t become difficult to medicate on a long-term basis."
Sue summarised two factors that vets need to consider when deciding on the appropriate treatment: the right active ingredients to target common first-line pathogens; and the method of application. She urged vets to consider using a long-acting product applied within the practice, removing the need for home treatment to reduce stress for both owner and the dog, improve long-term compliance and maximise clinical outcomes.
To hear Sue’s tips on how to treat cases of otitis, watch the video here – www.osurnia.co.uk
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