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Effect of tympanic cavity evacuation and flushing on microbial isolates during total ear canal ablation with lateral bulla osteotomy in dogs

Bianca F. Hettlich T1, Harry W. Boothe DVM, MS, DACVS2,3, R. Bruce Simpson DVM, MS, DACVM4, Kim A. DuBose MS5, Dawn M. Boothe DVM, PhD, DACVIM, DACVCP6,7, and Mark Carpenter PhD8
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  • 1 Department of Veterinary Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.
  • | 2 Department of Veterinary Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.
  • | 3 Present address Department of Clinical Sciences, Pharmacology, College of Veterinary Medicine, Auburn University, AL 36849.
  • | 4 Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.
  • | 5 Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.
  • | 6 Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843.
  • | 7 Present address is Department of Anatomy, Physiology, and Pharmacology, College of Veterinary Medicine, Auburn University, AL 36849.
  • | 8 Department of Mathematics and Statistics, College of Sciences and Mathematics, Auburn University, AL 36849.

Abstract

Objective—To evaluate differences in bacterial numbers, identity, and susceptibility in samples obtained from the tympanic cavity on entry (preflush) and after evacuation and lavage (postflush) and assess perioperative and empiric antimicrobial selection in dogs that underwent total ear canal ablation (TECA) with lateral bulla osteotomy (LBO) or reoperation LBO.

Design—Prospective clinical study.

Animals—34 dogs.

Procedure—TECA with LBO or reoperation LBO was performed on 47 ears. Pre- and postflush aerobic and anaerobic samples were obtained from the tympanic cavity. Isolates and antimicrobial susceptibility patterns were compared.

Results—Different isolates (31/44 [70%] ears) and susceptibility patterns of isolate pairs (6/44 [14%] ears) were detected in pre- and postflush samples from 84% of ears. Evacuation and lavage of the tympanic cavity decreased the number of bacterial isolates by 33%. In 26% of ears, bacteria were isolated from postflush samples but not preflush samples. Only 26% of isolates tested were susceptible to cefazolin. At least 1 isolate from 53% of dogs that received empirically chosen antimicrobials postoperatively was resistant to the selected drugs. Anaerobic bacteria were recovered from 6 ears.

Conclusions and Clinical Relevance—Accurate microbiologic assessment of the tympanic cavity should be the basis for selection of antimicrobials in dogs undergoing TECA with LBO. Bacteria remain in the tympanic cavity after evacuation and lavage. Cefazolin was a poor choice for dogs that underwent TECA with LBO, as judged on the basis of culture and susceptibility testing results. (J Am Vet Med Assoc 2005;227:748–755)

Abstract

Objective—To evaluate differences in bacterial numbers, identity, and susceptibility in samples obtained from the tympanic cavity on entry (preflush) and after evacuation and lavage (postflush) and assess perioperative and empiric antimicrobial selection in dogs that underwent total ear canal ablation (TECA) with lateral bulla osteotomy (LBO) or reoperation LBO.

Design—Prospective clinical study.

Animals—34 dogs.

Procedure—TECA with LBO or reoperation LBO was performed on 47 ears. Pre- and postflush aerobic and anaerobic samples were obtained from the tympanic cavity. Isolates and antimicrobial susceptibility patterns were compared.

Results—Different isolates (31/44 [70%] ears) and susceptibility patterns of isolate pairs (6/44 [14%] ears) were detected in pre- and postflush samples from 84% of ears. Evacuation and lavage of the tympanic cavity decreased the number of bacterial isolates by 33%. In 26% of ears, bacteria were isolated from postflush samples but not preflush samples. Only 26% of isolates tested were susceptible to cefazolin. At least 1 isolate from 53% of dogs that received empirically chosen antimicrobials postoperatively was resistant to the selected drugs. Anaerobic bacteria were recovered from 6 ears.

Conclusions and Clinical Relevance—Accurate microbiologic assessment of the tympanic cavity should be the basis for selection of antimicrobials in dogs undergoing TECA with LBO. Bacteria remain in the tympanic cavity after evacuation and lavage. Cefazolin was a poor choice for dogs that underwent TECA with LBO, as judged on the basis of culture and susceptibility testing results. (J Am Vet Med Assoc 2005;227:748–755)