개 외이염 치료에서 하이드로코티손 아세포네이트-겐타마이신-미코나졸 국소 혼합제제의 효과

Effect of Hydrocortisone Aceponate - Gentamicin - Miconazole Topical Otic Combination for Treating Canine Otitis Externa

  • 박설희 (서울대학교 수의과대학.수의과학연구소) ;
  • 이용욱 (서울대학교 수의과대학.수의과학연구소) ;
  • 남의화 (서울대학교 수의과대학.수의과학연구소) ;
  • 이학진 (서울대학교 수의과대학.수의과학연구소) ;
  • 정지영 (서울대학교 수의과대학.수의과학연구소) ;
  • 한승희 (서울대학교 수의과대학.수의과학연구소) ;
  • 송치윤 (서울대학교 수의과대학.수의과학연구소) ;
  • 황철용 (서울대학교 수의과대학.수의과학연구소)
  • Park, Seol-Hee (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Lee, Yong-Uk (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Nam, Eui-Hwa (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Yi, Hak-Jin (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Jung, Ji-Young (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Han, Seung-Hee (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Song, Chi-Youn (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Hwang, Cheol-Yong (College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
  • 심사 : 2012.02.14
  • 발행 : 2012.02.29

초록

54 마리의 외이염에 이환된 개에서 하이드로코티손 아세포네이트-겐타마이신-미코나졸 국소 혼합제제인 이소틱($Easotic^{(R)}$, Virbac, Carros, France)의 효과를 평가하였다. 외이염 환자들은 이소틱을 하루 1번 적용하여 5일 동안 치료 받았고 2일 동안 휴약 하였으며 처음 적용일로부터 7일 후 평가되었다. 적용 후에 외이염이 지속되는 경우 추가적으로 이소틱을 하루 1번 5일 동안 사용하고 2일 휴약 후에 처음 적용일로부터 14일 후 평가되었다. 이소틱의 효과를 평가하기 위해 8항목의 임상증상을 증상의 심한 정도로 등급을 매겨 점수화하였고 귀의 도말 표본에서 감염인자들을 준정량적으로 등급을 매겨 점수화하였다. 임상증상점수와 감염인자점수의 합을 전체임상점수로 정의하였다. 이소틱을 5일 동안 적용하였을 때 전체임상점수는 76% 감소하였다. 이소틱을 10일 동안 적용하였을 때 처음 5일 동안 전체임상점수는 46.6% 감소하였다. 추가적인 5일간 적용 후 처음 적용할 때와 비교하여 전체임상점수는 82.2% 감소하였다. 모든 케이스에서 실험 기간 동안 치료제와 관련된 부작용은 나타나지 않았다. 따라서 5일 간 이소틱 치료 및 10일 간 이소틱 치료는 개의 외이염을 치료하는데 있어서 효과적이고 안전한 방법으로 생각된다.

Fifty-four dogs with otitis externa were enrolled in the study for the Evaluation of efficacy of a Hydrocortisone aceponate - Gentamicin - Miconazole otic combination ($Easotic^{(R)}$, Virbac, Carros, France). Otitis externa patients were treated by $Easotic^{(R)}$ once daily for 5 days and 2 days off treatment and evaluated on $7^{th}$ day. If otitis externa persisted, additional $Easotic^{(R)}$ treatment was administered once daily for 5 days and rested 2 days and reevaluated on $14^{th}$ day. For the evaluation of efficacy of $Easotic^{(R)}$, eight clinical signs were scored on a severity scale and infectious agents from ear sample were also graded using semi-quantitative scale at each visit. Sum of clinical scores and cytological scores was defined as Global Clinical Score. When $Easotic^{(R)}$ was applied once daily for 5 days, global clinical score was reduced 76.0%. When $Easotic^{(R)}$ was administered for 10 days, during first 5 days administration, 46.6% reduction of global clinical score was detected. During additional 5 days administration, 82.2% reduction of global clinical score was observed compared with Day 0. Any relevant adverse effect was not reported during the study in all cases. Thus, $Easotic^{(R)}$ treatment once daily for 5 days and 10 days appears to be effective and safe treatment for canine otitis externa.

키워드

참고문헌

  1. Bensignor E, Grandemange E. Comparison of an antifungal agent with a mixture of antifungal, antibiotic and corticosteroid agents for the treatment of Malassezia species otitis in dogs. Vet Rec 2006; 158: 193-195. https://doi.org/10.1136/vr.158.6.193
  2. Bonneau S, Skowronski V, Sanquer A, Maynard L, Eun HM. Therapeuic efficacy of topical hydrocortisone aceponate in experimental flea-allegy dermatitis in dogs. Aust Vet J 2009; 87: 287-291. https://doi.org/10.1111/j.1751-0813.2009.00447.x
  3. Brazzini B, Pimpinelli N. New and established topical corticosteroids in dermatology: clinical pharmacology and therapeutic use. Am J Clin Dermatol 2002; 3: 47-58. https://doi.org/10.2165/00128071-200203010-00005
  4. Cafarchia C, Gallo S, Capelli G, Otranto D. Occurrence and population size of Malassezia spp in the external ear canal of dogs and cats both healthy and with otitis. Mycopathologia 2005; 160: 143-149. https://doi.org/10.1007/s11046-005-0151-x
  5. Coutinho SD, Paula CR. Proteinase, phospholipase, hyaluronidase and chondroitin-sulphatase production by Malassezia pachydermatis. Medical Mycol 2000; 38: 73.
  6. Foster AP, DeBoer DJ. The role of Pseudomonas in canine ear disease. Comp Cont Ed Pract Vet 1998; 20: 909-919
  7. Guedeja-Marron J, Blanco JL, Ruperez C, Garcia ME. Susceptibility of Bacterial Isolates from Chronic Canine Otitis Externa to Twenty Antibiotics. J Vet Med 1998; 45: 507-512. https://doi.org/10.1111/j.1439-0450.1998.tb00821.x
  8. Hammer KA, Carson CF, Riley T.V. In vitro activities of ketoconazole and Melaleuca alternifolia (tea tree) oil against Malassezia species. Antimicrob Agents Chemother 2000; 44: 467-469. https://doi.org/10.1128/AAC.44.2.467-469.2000
  9. Hariharan H, McPhee L, Heaney S, Bryenton J. Antimicrobial drug susceptibility of clinical isolates of Pseudomonas aeruginosa. Can Vet J 1995; 36: 166-168.
  10. Hill PB, Lo A, Aden CA, Huntley S, Morey V, Ramsey S, Richardson C, Smith DJ, Sutton C, Tayler MD, Thrope E, Tidmarsh R, Williams V. Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animal practice. Vet Rec 2006; 158: 533-539. https://doi.org/10.1136/vr.158.16.533
  11. Junco MTT, martin Barrasa JL. Identification and antimicrobial susceptibility of coagulase positive staphylococci isolated from healthy dogs and dogs suffering otitis externa. J Vet Med 2002; 49: 419-423.
  12. Kowalski JJ. The microbial environment of the ear canal in health and disease. Vet Clin North Am Small Anim Pract 1988; 18: 743-754.
  13. Lilenbaum W, Veras M, Blum E, Souza GN, Antimicrobial susceptibility of staphylococci isolated from otitis externa in dogs. Lett Appl Microbiol 2000; 31: 42-45. https://doi.org/10.1046/j.1472-765x.2000.00759.x
  14. Lyskova P, Vydrzalova M, Mazurova J. Identification and Antimicrobial susceptibility of bacteria and yeasts isolated from healthy dogs and dogs with otitis externa. J Vet Med 2007; 54: 559-563. https://doi.org/10.1111/j.1439-0442.2007.00996.x
  15. Martin Barrasa JL, Gomez PL, LamaZG, Junco MTT. Antibacterial Susceptibility Patterns of Pseudomonas Strains Isolated from Chronic Canine Otitis Externa. J Vet Med 2000; 47: 191-196. https://doi.org/10.1046/j.1439-0450.2000.00336.x
  16. Morris DO. Malassezia dermatitis and otitis. Vet Clin North Am Small Anim Pract 1999; 29: 1303.
  17. Nardoni S, Mancianti F, Coraza M, Rum A. Occurrence of Malassezia species in healthy and dermatologically diseases dogs. Mycophthologia 2004; 157: 383-388.
  18. Nuttall T, Mueller R, Bensignor E, Verde M, Noli C, Schmidt V, Reme CA. Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomized, double blind, placebo controlled trial. Vet dermatol 2009; 20: 191-198. https://doi.org/10.1111/j.1365-3164.2009.00756.x
  19. Prado MR, Brilhante RS, Cordeiro RA, Monteiro AJ, Sidrim JJ, Rocha MF, Frequency of yeasts and dermatophytes from healthy and diseased dogs. J Vet Diagn Invest 2008; 20: 197- 202. https://doi.org/10.1177/104063870802000208
  20. Radinsky MA, Mason D. Diseases of the ear. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary Internal medicine, 7th ed, Elsevier, Saintlouis, 2010: 1015-1020.
  21. Rigaut D, Sanquer A, Maynard L, Reme CA, Efficacy of a topical ear formulation with a pump delivery system for the treatment of infectious otitis externa in dogs: a randomized controlled trial. Intern J Appl Res Vet Med 2011; 9: 15-28.
  22. Rougier S, Borell D, Pheulpin S, Woehrle F, Boisrame B. A comparative study of two antimicrobial anti-inflammatory formulations in the treatment of canine otitis externa. Vet Dermatol 2005; 16: 299-307. https://doi.org/10.1111/j.1365-3164.2005.00465.x
  23. Reme CA, Dufour P. Effects of repeated topical application of a 0.0584% hydrocortisone aceponate spray on skin thickness in beagle dogs. Intern J Appl Res Vet Med 2010; 8: 1-6.
  24. Saridomichelakis MN, Farmaki R, Leontides LS, Koutinas AF. Aetiology of canine otitis externa a retrospectivestudy of 100 cases. Vet Dermatol 2007; 18: 341-347. https://doi.org/10.1111/j.1365-3164.2007.00619.x
  25. Scott DW, Miller WH, Griffin CE. External ear disease. In: Small Animal Dermatology, 6th ed. Philadelphia, PA: W.B. Saunders, 2001: 1203-1235.
  26. Seol B, Naglic T, Madic J, Bedekovic M. In vitro antimicrobial susceptibility of 183 Pseudomonas aeruginosa strains isolated from dogs to selected antipseudomonal agents. J Vet med 2002; 49: 188-192. https://doi.org/10.1046/j.1439-0450.2002.00548.x
  27. Tater KC, Scott DW, Miller WH, Erb HN. The cytology of the external ear canal in the normal dogs and cats. J Vet Med 2003; 50: 370-374. https://doi.org/10.1046/j.1439-0442.2003.00548.x
  28. Van Gerven F, Odds FC. The anti-malassezia furfur activity in vitro and in experimental dermatitis of six imidazole antifungal agents: bifonazole, clotrimazole, flutrumazole, miconazole and sertaconazole. Mycoses 1995; 38: 389-393. https://doi.org/10.1111/j.1439-0507.1995.tb00070.x