In-vivo-Wirksamkeit eines kommerziellen Chlorhexidin und Tris-EDTA enthaltenden Ohrreinigers

C. Bouassiba; W. Osthold; R. S. Mueller

doi:10.1055/s-0038-1623642

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2012; 40(03): 161-170
DOI: 10.1055/s-0038-1623642

Originalartikel

Schattauer GmbH

In-vivo-Wirksamkeit eines kommerziellen Chlorhexidin und Tris-EDTA enthaltenden Ohrreinigers

Eine randomisierte, plazebokontrollierte DoppelblindstudieIn-vivo efficacy of a commercial ear antiseptic containing chlorhexidine and Tris-EDTAA randomised, placebo-controlled, double-blinded comparative trial

Authors

C. Bouassiba

¹Tierärztliche Praxis Dr. Wolfgang Osthold, Schwalmtal
W. Osthold

¹Tierärztliche Praxis Dr. Wolfgang Osthold, Schwalmtal
R. S. Mueller

²Zentrum für klinische Tiermedizin, Ludwig-Maximilians-Universität München

Abstract

Zusammenfassung

Gegenstand und Ziel: Ein wichtiger Aspekt einer erfolgreichen Therapie der Otitis externa (OE) ist die Reinigung des Gehörgangs. Dafür stehen verschiedene Präparate zur Verfügung. Im Hinblick auf steigende Antibiotikaresistenzen wird eine Keimbekämpfung in Kombination mit Antiseptika angestrebt. Die plazebokontrollierte Doppelblindstudie überprüfte die In-vivo-Wirksamkeit eines Chlorhexidin (1500 μg/ml) und Tris-EDTA (48 μg/ml) enthaltenden kommerziellen Ohrreinigers anhand klinischer Symptomatik, zytologischer und bakteriologischer Untersuchung. Material und Methoden: An 64 Hunden mit OE wurde dieser Ohrreiniger (Gruppe A) bzw. das Plazebo (Gruppe B) zweimal täglich angewendet, einmal täglich gefolgt von der Applikation eines Marbofloxacin/Dexamethason/Clotrimazol enthaltenden Ohrmedikaments. Die Kontrolluntersuchung fand nach 14 Tagen statt. Die Auswertung erfolgte klinisch und zytologisch. Ferner wurde zu Beginn sowie nach 14 Tagen aus jedem Ohr eine Tupferprobe entnommen und bakteriologisch untersucht. Ergebnisse: Verglichen mit dem Plazebo kam es bei Anwendung des Ohrreinigers zu einer signifikanten Reduktion der Kokken, Stäbchen und neutrophilen Granulozyten. Die Hefenzahl verringerte sich in beiden Gruppen signifikant. Klinisch bestand kein signifikanter Unterschied zwischen den Gruppen. Die Zahl Marbofloxacinresistenter Bakterien stieg in Gruppe A von 0 auf 44%, in Gruppe B von 8 auf 31%. Schlussfolgerung: Chlorhexidin und Tris-EDTA führten in Kombination mit Marbofloxacin/Dexamethason/Clotrimazol zu einer zytologisch verifizierbaren Keimreduktion. Die Zahl Marbofloxacin-resistenter Bakterien stieg unter dieser Therapie signifikant an. Klinische Relevanz: Die Ergebnisse lassen die Vermutung zu, dass eine Kombination von Chlorhexidin und Tris-EDTA zusammen mit antimikrobiellen Ohrentropfen zur Reduktion der bakteriellen Besiedelung einer bakteriell bedingten OE empfohlen werden kann, doch das Risiko der Resistenzentwicklung besteht. Basierend auf den Resultaten können lokale Nebenwirkungen erwartet werden.

Summary

Aim: The important aspect of a successful therapy for otitis externa is cleaning of the external canal. Several cleaners are available for this purpose. In the light of increasing bacterial resistance against antibiotics a combined therapy with antiseptics is desirable. The aim of this study was to evaluate the efficacy of a cleaner containing chlorhexidine (1500 μg/ml) and Tris-EDTA (48 μg/ml) clinically, cytologically and microbiologically in a placebo-controlled double-blinded trial. Material and methods: In 64 dogs ear cleaner (group A) or placebo (group B) was used twice daily followed by an ear medication containing marbofloxacin/dexamethasone/clotrimazole once daily. After 2 weeks patients were re-evaluated clinically and cytologically. In addition at the beginning and after 14 days an ear swab of each ear underwent a microbiological examination and sensitivity testing. Results: On cytology, there was a significant reduction in the count of cocci (p < 0.0001), rods (p = 0.007) and neutrophils (p = 0.0001) in the treatment compared to the placebo group. Yeasts were significantly reduced in both groups (group A p < 0.0001, group B p < 0.001). Clinical examination did not reveal a significant difference between the two groups (p = 0.59). The number of marbofloxacin-resistant bacteria increased in group A from 0 to 44% (p = 0.0025) and in group B from 8 to 31% (p > 0.05). Conclusion: Chlorhexidine and Tris-EDTA in combination with marbofloxacin/dexamethasone/clotrimazole were effective in cytological reduction of bacteria in canine infectious otitis externa. The number of marbofloxacin-resistant bacteria increased significantly. Clinical relevance: Based on this study, chlorhexidine and Tris-EDTA in combination with antimicrobial ear medication can be assumed to be recommended for the treatment of otitis externa complicated by bacterial infection to reduce bacteria, however the high risk of resistance development exists. Side effects are to be expected.

Schlüsselwörter

Otitis externa - Hund - Antiseptika - Zytologie

Key words

Otitis externa - dog - antiseptics - cytology

Full Text

References

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