Neptra Ear Drops: The Right Treatment For You to Prescribe?
Neptra Ear Drops: The Right Treatment For You to Prescribe?
Neptra ear drops solution is a prescription-only product for dogs. It is one of many ear drop products on the veterinary medicines market that contain an antibiotic together with an antifungal and a corticosteroid.
What are Neptra ear drops used for?
Neptra ear drops contain the antibiotic florfenicol, plus the antifungal terbinafine, plus the corticosteroid mometasone. Neptra ear drops is licensed for the treatment of acute canine otitis externa or acute exacerbations of recurrent otitis caused by mixed infections of susceptible strains of bacteria sensitive to florfenicol (Staphylococcus pseudintermedius), and fungi sensitive to terbinafine (Malassezia pachydermatis). You can find the product information on Neptra ear drops in the Veterinary Medicines Directorate’s Product Information Database and in NOAH’s Datasheet Compendium.
Otitis externa is one of the most common canine disorders seen in primary care veterinary practice. There can be many contributing factors in the development of canine otitis externa that are commonly divided into: predisposing (e.g. conformation of the ear canal), primary (e.g. allergic skin disease, ear mites), secondary (e.g. bacterial and yeast overgrowth) and perpetuating (e.g. stenosis and ulceration of the ear canal). It is therefore important that the vet assesses the patient thoroughly and addresses all potential contributing factors. This will help resolve otitis externa and prevent recurrence. Repeated cycles of infection, inflammation and treatment lead to chronic changes and select for antimicrobial resistance, making management much more challenging.
Some cases of acute otitis externa require antimicrobial therapy with ear drops.
A wealth of choice
When a combination of antibiotic, antifungal and anti-inflammatory effects is needed in the treatment of canine otitis externa, Neptra ear drops is just one of the many options to choose from. With more than ten products on the market authorised for the treatment of canine otitis externa, there is a wealth of choice for the prescribing vet.
Factors that influence choice
Antimicrobial spectrum. The range of products contains different combinations of antibiotics, antifungals and corticosteroids. Choice from the range will primarily depend on the antibiotic ingredient in the ear drops. Wherever possible this should be guided by the type of bacteria found in the ear on cytology.
Antimicrobial stewardship. It is important to make antibacterial choices for otitis externa that respects responsible antibiotic use. The quinolone antibiotics are on the list of ‘Restricted antibiotics’ because they are among the highest priority . It follows that they should only be used when other antibacterials are inappropriate or ineffective, and culture and sensitivity testing indicates they will be effective.
Adverse effects. As for all medicines, there is a need to consider the potential for adverse effects in the treated animal.
Convenience. Many of the ear drop preparations need to be dosed daily for several days, which will normally require the dog owner to administer drops. Now there are three single dose options. Neptra ear drops is one of these single-dose options. The other two are Osurnia and Mometamax Ultra. It means that a treatment for otitis externa can be administered in the veterinary practice without the requirement for the client/pet owner to administer the treatment. Provided the treatment is the most appropriate in terms of the microbiology of the case, this is an obvious advantage.
Cost is an additional consideration.
Helping vets and practices make a selection
With so many options to choose from, including Neptra among a wide choice of single-dose treatments, making a prescribing choice for the patient or a purchasing choice for the practice obviously requires careful comparison and consideration.
Veterinary Prescriber’s unbiased comparative reviews are created to help decision makers make the best choices. And the Monthly Medicines News makes it easy to keep up to date. It highlights new products, changes to product information, new adverse effects and reclassifications together with commentary on the practical implications of the changes. It also includes a critical appraisal of promotional claims in ADVET - what the adverts say, and what they’re not telling you!
Module on Antimicrobial Ear Products for Dogs
Veterinary Prescriber has a specific module on ear products for treating otitis externa in dogs. It is dedicated to making sense of the factors that go into making a rational treatment choice in otitis externa. By doing the module you will:
Understand the aetiology of microbial infections in canine otitis externa,
Know the available topical antimicrobial preparations for treating canine otitis externa,
Know the available evidence on the comparative efficacies of topical antimicrobial preparations,
Be able to make a rational choice from the range of topical preparations.
By doing this module, you will clearly see where Neptra ear drops fit in the choice of treatment options for canine otitis externa.
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