Hydrocortisone Aceponate for Chronic Otitis: Long‐Term Efficacy

Abstract

Background: Effective management of otitis externa (OE) requires addressing all contributing factors to prevent chronicityand recurrence. Evidence on the long-term efficacy of topical corticosteroids in preventing recurrence and secondary infectionsremains limited.Objectives: This retrospective noncontrolled study evaluated the efficacy of hydrocortisone aceponate (HCA) in resolving non-infectious chronic or recurrent (CR)- OE with or without proliferative changes, and preventing recurrence of acute episodes andsecondary infections.Animals: A total of 63 owned dogs (115 ears) with unilateral or bilateral non-infectious CR- OE were included. Most ears wereenrolled after resolving infectious otitis, as persistent inflammation or recurrence required further management.Materials and Methods: Clinical records from two dermatology referral centres (February 2022–July 2023) were reviewed.Dogs were included if they had recurrent otitis for over a year (≥ 1 year) or chronic otitis (≥ 1 month). Otitis severity was assessedusing the Otitis Index Score (OTIS3) scale, and by grading stenosis and hyperplasia severity. Enrolled patients received HCA0.584 mg/mL at weight-adjusted doses. A reactive phase continued until OTIS3 < 2, followed by a proactive phase with regimensadapted to otitis severity. Concurrent treatments were recorded.Results: Recurrence was not observed in 79.1% of ears (mean follow-up 202.6 days). Among 24 relapsed ears, 29.17% recurredafter treatment discontinuation. Higher recurrence was associated with stopping therapy (p < 0.001) and recent bacterial otitis(p = 0.015). No adverse effects were noted.Conclusions and Clinical Relevance: The use of HCA appears to be an effective and safe option for reactive and proactivemanagement of non-infectious CRC- OE, reducing recurrences and improving patient and owner quality-of-life

Background: Effective management of otitis externa (OE) requires addressing all contributing factors to prevent chronicityand recurrence. Evidence on the long-term efficacy of topical corticosteroids in preventing recurrence and secondary infectionsremains limited. Objectives: This retrospective noncontrolled study evaluated the efficacy of hydrocortisone aceponate (HCA) in resolving non-infectious chronic or recurrent (CR)- OE with or without proliferative changes, and preventing recurrence of acute episodes andsecondary infections. Animals: A total of 63 owned dogs (115 ears) with unilateral or bilateral non-infectious CR- OE were included. Most ears wereenrolled after resolving infectious otitis, as persistent inflammation or recurrence required further management. Materials and Methods: Clinical records from two dermatology referral centres (February 2022–July 2023) were reviewed.Dogs were included if they had recurrent otitis for over a year (≥ 1 year) or chronic otitis (≥ 1 month). Otitis severity was assessedusing the Otitis Index Score (OTIS3) scale, and by grading stenosis and hyperplasia severity. Enrolled patients received HCA0.584 mg/mL at weight-adjusted doses. A reactive phase continued until OTIS3 < 2, followed by a proactive phase with regimensadapted to otitis severity. Concurrent treatments were recorded. Results: Recurrence was not observed in 79.1% of ears (mean follow-up 202.6 days). Among 24 relapsed ears, 29.17% recurredafter treatment discontinuation. Higher recurrence was associated with stopping therapy (p < 0.001) and recent bacterial otitis(p = 0.015). No adverse effects were noted. Conclusions and Clinical Relevance: The use of HCA appears to be an effective and safe option for reactive and proactivemanagement of non-infectious CRC- OE, reducing recurrences and improving patient and owner quality-of-life