Research Article

Efficacies of 11% Lactoferricin and 0.05% Chlorhexidine Otological Solution compared, in the treatment of microbial otic overgrowth: A randomized single blinded study

Luisa Cornegliani*, Federico Leone, Francesco Albanese, Mauro Bigliati, Natalia Fanton and Antonella Vercelli

Published: 04 October, 2017 | Volume 1 - Issue 1 | Pages: 032-041

Background:Topical therapy with antimicrobial agents is used in otitis treatment. Due to increase of antibiotic resistance, new strategies are needed. Antiseptics are used but they may induce contact dermatitis. Natural antimicrobial peptides may represent future effective drugs.

Objectives:The objectives were to test the efficacy of an 11% lactoferricin otological solution (LCF) in bacterial and yeasts otic overgrowth and compare LCF with a commercial one containing chlorhexidine (CLX) 0.05%.

Materials and methods:Forty-one dogs diagnosed with bacterial or yeasts otitis overgrowths were included according to general good practice. They were randomly assigned to lactoferricin or chlorhexidine group for treatment. Otological solution were applied twice a day for a week and then daily for another week. Clinical and cytological score was assessed at day 1 and day 14. At the end of the study, the owners had to express an opinion on the overall efficacy of the products. Statistical analyses were performed using Wilkoxon’s test and T test for paired samples. Results in lesional and cytological score were significative with a p<0.05.

Results:Forty dogs completed the study. All cases, receiving lactoferricin or chlorhexidine, were successfully treated with clinical signs remission and regression of infection (p<0.05). The owners’ judgment was good in 87%, mild in 13% for LCF group. For CLX they scored good in 41%, mild in 24% and unuseful in 35% of cases.

Conclusions:Lactoferricin, an antimicrobial natural peptide, showed the same efficacy of chlorhexidine in the treatment of otitis characterized by bacterial or/and yeast overgrowth.

Read Full Article HTML DOI: 10.29328/journal.ivs.1001004 Cite this Article Read Full Article PDF


  1. Miller WH, Griffin CE, Campbell KL. Diseases of the eyelids, claws, anal sacs and ears. In Muller and Kirk’s small animal dermatology. Elsevier Mosby. St Luis, VII ed. 2013; 724.
  2. Jacobson LS. Diagnosis and medical treatment of otitis externa in the dog and cat. J S Afr Vet Assoc. 2002; 73: 162-170. Ref.: https://goo.gl/EHxjCX
  3. Nuttal T. Successful management of otitis externa. In Pract. 2016; 38: 17-21.
  4. Guardabassi L, Houser GA, Frank LA. Guidelines for antimicrobial use in small animals. In: Guardabassi L, Jensen LB, Hilde K. eds. Guide to Antimicrobial Use in Animals. Oxford: Blackwell Publishing. 2008; 183-120.
  5. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, et al. Antibiotic resistance-the need for global solutions. Lancet.2013; 13: 1057-1098. Ref.: https://goo.gl/PP9GN9
  6. Loeffler A, Linek M, Moodley A, Guardabassi L, Sung JM, et al. First report of multiresistant, mecA-positive Staphylococcus intermedius in Europe: 12 cases from a veterinary dermatology referral clinic in Germany. Vet Dermatol. 2007; 18: 412-421. Ref.: https://goo.gl/9BCjjR
  7. Morris DO. Medical therapy of otitis externa and otitis media. Vet Clin North Am Small Anim Pract. 2004; 34: 541-545. Ref.: https://goo.gl/Zvdkaf
  8. Kuyyakanond T, Quesnel LB. The mechanism of action of chlorhexidine. FEMS Microbiol Lett. 1992; 79: 211-215. Ref.: https://goo.gl/owfTXg
  9. Guardabassi L, Ghibaudo G, Damborg P. In vitro antimicrobial activity of a commercial ear antiseptic containing chlorhexidine and Tris-EDTA. Vet Dermatol. 2010; 21: 282-286. Ref.: https://goo.gl/THzmS9
  10. Galle HG, Venker-van Haagen, A J. Ototoxicity of the antiseptic combination chlorhexidine/cetrimide (Savlon): effects on equilibrium and hearing. Vet Q. 1986; 8: 56-60. Ref: https://goo.gl/JDPC1r
  11. Igarashi Y, Oka Y. Vestibular ototoxicity following intratympanic applications of chlorhexidine gluconate in the cat. Arch Otorhinolaryngol. 1988; 245: 210-217. Ref.: https://goo.gl/z14mq5
  12. Abdallah C. Perioperative chlorhexidine allergy: Is it serious? J Anaesthesiol Clin Pharmacol. 2015; 31: 152-154. Ref.: https://goo.gl/hUvJdr
  13. Opstrup MS, Johansen JD, Zachariae C, Garvey LH. Contact allergy to chlorhexidine in a tertiary dermatology clinic in Denmark. Contact Dermatitis. 2016; 74: 29-36. Ref.: https://goo.gl/h5EEJn
  14. Lachapelle JM. A comparison of the irritant and allergenic properties of antiseptics. Eur J Dermatol. 2014; 24: 3-9. Ref.: https://goo.gl/GkSS7U
  15. Colagiuri GF, Di Leo E, Trautmann N, Ferrannini A, Vacca A. Chlorhexidine hypersensitivity: a critical and updated review. J Allergy Ther. 2013; 4: 4-10. Ref.: https://goo.gl/jNzJMK
  16. Bruni N, Capucchio MT, Biasiletti E, Enrica Pessione, Simona Cirrincione, et al. Antimicrobial activity of lactoferricin-related peptides and applications in human and veterinary medicine. Molecules. 2016; 21: 752. Ref.: https://goo.gl/LTKwZH
  17. Cafarchia C, Immediato D, Di Paola G, Magliani W, Ciociola T, et al. In vitro and in vivo activity of a killer peptide against Malassezia pachydermatis causing otitis in dog. Med Mycol. 2014; 52: 350-355. Ref.: https://goo.gl/MMSu9K
  18. Yin C, Wong Jh, Ng TB. Recent studies on antimicrobial peptides lactoferricin and lactoferrampin. Curr Mol Med. 2014; 4: 1139-1154. Ref.: https://goo.gl/H1zGLv
  19. Vercelli A, Fanton N, Bruni N, Vergano D, Bigliati M, et al. Use of lactoferricin, verbascoside and glycerophosphoinositol emulsion in otitis externa treatment: a pilot study. Veterinaria. 2015; 29: 49-57. Ref.: https://goo.gl/UbnT6p
  20. Nuttall T, Bensignor E. A pilot study to develop an objective clinical score for canine otitis externa. Vet Dermatol. 2014; 25: 530-537. Ref.: https://goo.gl/Uo1QFu
  21. Ginel JP, Lucena R, Rodriguez JC, Ortega J. A semiquantitative cytological evaluation of normal and pathological samples from the external ear canal of dog and cats. Vet Dermatol. 2002; 13: 151-156. Ref.: https://goo.gl/PLPfmb
  22. Negre A, Bensignor E, Guillot J. Evidence-based veterinary dermatology: a systematic review of interventions for Malassezia dermatitis in dogs. Vet Dermatol. 2009; 20: 1-12. Ref.: https://goo.gl/bTURvp
  23. Calnan CD. Contact Dermatitis from drugs. Proc R Soc Med.1962; 55: 39-42. Ref.: https://goo.gl/QfkijD
  24. Porter BJ, Acharya U, Ormerod AD, Herriot R. Latex/chlorhexidine-induced anaphylaxis in pregnancy. Allergy. 1998; 53: 455-457. Ref.: https://goo.gl/rtijXc
  25. Dashper SG, Liu SW, Reynolds EC. Antimicrobial peptides and their potential as oral therapeutic agents. Int J Pept Res Ther 2007; 13: 505-516. Ref.: https://goo.gl/yZnzfm
  26. Guilhelmelli F, Vilela N, Albuquerque P, Derengowski Lda S, Silva-Pereira I, et al. Antibiotic development challenges: the various mechanisms of action of antimicrobial peptides and of bacterial resistance. Front Microbiol. 2013; 4: 1-12. Ref.: https://goo.gl/jT2WSY
  27. Brandenburg K, Schürholz T. Lack of new anti-infective agents: Passing into the pre-antibiotic age? World J Biol Chem. 2015; 26: 71-77. Ref.: https://goo.gl/Qk6MNe
  28. Corona A, Vercelli A, Bruni N, Cornegliani L. In vitro bactericidal activity of lactoferricin and other enzymes on bacteria selected from dogs with pyoderma. Vete Dermatol. 2016; 27: 54.
  29. Cornegliani L, Corona A, Vercelli A: Use of lactoferricin, verbascoside and glycerophosphoinositole lysine emulsion in bacterial and yeast overgrowth treatment: a pilot study in ten dogs. Vet Dermat. 2016; 27: 72.
  30. Afanasev IB. Superoxide and nitric oxide in pathological conditions associated with iron overload: the effects of antioxidants and chelators. Curr Med Chem. 2005; 12: 2731-2739. Ref.: https://goo.gl/UDCHY3
  31. Vertuani S, Beghelli E, La Scalambra E, Malisardi G, Copetti S, et al. Activity and stability studies of verbascoside, a novel antioxidant, in dermo-cosmetic and pharmaceutical topical formulations. Molecules. 2011; 16: 7068-7080. Ref.: https://goo.gl/isMrk4


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