Ear wash recipes for Pseudomonas

Re: Ear wash recipes for Pseudomonas

Rob Loxley — Fri, 22 Aug 2014 14:05:29 GMT

[quote user="Iain McAllister"]I would be interested in Tobramycin recipes if anyone has one - you can by 40mg/ml injectable - anyone know of a recipe?[/quote]

If you've the BSAVA 2009 proceedings there's a Tim Nuttall article - he suggests tobramycin 8mg/ml plus dex @ 0.2%

Re: Ear wash recipes for Pseudomonas

Iain McAllister — Wed, 20 Aug 2014 15:28:42 GMT

Regarding licenced preps from the research I've done the feeling is that emulsions don't seem to do the job and the concentrations of the antibiotics are not enough

there is also a school of thought that says that altho there may be invitro resistance to enrofloxacin if you stick enough into the ear wash ie 20 ml of enrofloxacin (100mg/ml) to 80 ml Tris EDTA it will still work

I would be interested in Tobramycin recipes if anyone has one - you can by 40mg/ml injectable - anyone know of a recipe?

Re: Ear wash recipes for Pseudomonas

Matt Hilary — Wed, 20 Aug 2014 10:02:57 GMT

[quote user="Anthony Dennison"]

We've had a few of these where we've made up our own ear preps and once the psuedomonas has been sorted, there is a terrible problem with malasezzia! May be a good idea to add in some canesten.

[/quote]

Thought I'd highlight this as have had similar problems with malassezia overgrowth post-pseudomonas.

Also unsure why licensed topical meds w/ gentamicin aren't appropriate here.

Re: Ear wash recipes for Pseudomonas

Jo Dyer — Wed, 20 Aug 2014 09:04:03 GMT

Flamazine 1:1 in sterile water. Works brilliantly where all else fails, and hits the malassezia as well.

Re: Ear wash recipes for Pseudomonas

emma_j — Wed, 20 Aug 2014 08:38:33 GMT

Agree, it's sensitive to antibiotics available in licenced forms in Surolan, Easotic, Otomax or Canaural? What has it had so far that has not been effective? I'd probably be choosing one of those with TrizAural used as a pre-treatment flush before application.

Re: Ear wash recipes for Pseudomonas

Rob Loxley — Wed, 20 Aug 2014 00:25:17 GMT

[quote user="Iain McAllister"]Gentamicin S [/quote]

Why not Otomax or Easotic?

Re: Ear wash recipes for Pseudomonas

Evelyn Barbour-Hill — Tue, 19 Aug 2014 18:26:16 GMT

[quote user="Rachael Winder"]

This was given me by the derm dept at Liverpool.

Bottle triz crystals . Add 10mls dexadreson, 320mg gentamicin and then enough distilled water to make up to 118mls. I've used it a few times with drug resistant Pseudomonas cases and it seems to work well.

Hope that helps!

[/quote]

If you're going to do that, and then

[quote user="Anthony Dennison"]add in some canesten.[/quote]

ummmm....... why not just use Otomax anyway? but not completely.

(Actually I imagine Iain is after a recipe without a glucocorticoid so I'm just rambling)

Re: Ear wash recipes for Pseudomonas

Anthony Dennison — Tue, 19 Aug 2014 18:18:36 GMT

We've had a few of these where we've made up our own ear preps and once the psuedomonas has been sorted, there is a terrible problem with malasezzia! May be a good idea to add in some canesten.

With regards to the tris-EDTA solution to add things to, we often use Before-X from Vetruus as a base.

Re: Ear wash recipes for Pseudomonas

Hannah Wynne Richards — Tue, 19 Aug 2014 16:35:20 GMT

Dermisol solution to clean once daily It's not ototoxic, and Pseudomonas doesn't like the pH

Wynne

Re: Ear wash recipes for Pseudomonas

Rachael Winder — Tue, 19 Aug 2014 16:23:17 GMT

This was given me by the derm dept at Liverpool.

Hope that helps!