Sue Paterson is President of the European Society of Dermatology and an RCVS Specialist
Treat Otitis Right First Time To Beat Antimicrobial Resistance (AMR), Says Top Referral Dermatologist
7 years ago 
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Leading veterinary dermatologist Sue Paterson has called for vets to prescribe narrow spectrum, long-acting antibiotics for first line cases of otitis externa (OE) to reduce the concerning levels of multiple-resistant, chronic infections.
Sue, who is President of the European Society of Dermatology and an RCVS Specialist, described how antimicrobial resistance (AMR) is making otitis externa cases difficult to resolve and how vets can help overcome the problem by rethinking their first line prescription choices in a video interview created in conjunction with Elanco Animal Health, makers of Osurnia®.
“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,” Sue explained.
“Many of the cases I see as a referral clinician are longstanding cases with very severe, multiple-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 vets 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.
Sue outlined: “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 highlighted 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 by the vet, 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 right first time, watch the video here – www.osurnia.co.uk
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