Otitis externa (OE) is a common, debilitating condition affecting up to 1 in 5 dogs in their lifetime and is seen on a daily basis in first opinion practice.^1,2

Otitis is always painful and usually pruritic and has been shown to affect both the quality of life of owners and their dogs who develop it.³ Whilst the development of otitis externa is not an emergency, it is a potentially urgent problem that could lead to significant welfare compromise if left untreated - https://www.bsava.com/TriageTool.

Otitis has been shown to have an impact on dogs’ sleep and playing behaviours, and cause their owners physical or emotional disturbances.³ Where otitis is not addressed adequately, a dramatic deterioration of the dog-owner relationship has been shown to occur, leading to low treatment compliance and the development of ear phobias in affected dogs.⁴ The key to therapy should be early intervention and based on recent quality of life studies, this should be with a veterinary directed treatment rather than an owner directed treatment.⁵

Neptra^® is a one dose solution licensed for the treatment of the most common pathogens seen in 70-80% of OE cases (Staphylococcus pseudintermedius and Malassezia pachydermatis).

It contains a first line antibiotic (florfenicol) which is not on the WHO list of critically important antibiotics, improving antibiotic stewardship, as well as an antifungal (terbinafine) and a potent corticosteroid (mometasone furoate). This highly potent, but “soft” ⁹ corticosteroid acts rapidly and effectively at a local level to reduce inflammation within the ear canal, with minimal systemic absorption. Neptra improves comfort and there is no need for owners to treat their dog at home – reducing stress for everyone and improving compliance.

Dr Sue Paterson MA VetMB DVD DipECVD FRCVS, RCVS and European Specialist in Veterinary Dermatology

Neptra is an effective option 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).

The ONLY first-line treatment available in ONE vet-administered dose.

Offering complete control over compliance in the treatment of otitis externa, Neptra removes the owner responsibility, stress and uncertainty of repeated at-home treatments.

Ideal for first-line use and effective against the most common pathogens* - associated with 70-80% of OE cases, make Neptra your first choice for OE treatment.

Neptra contains a unique combination of three active ingredients that work together to be effective against the most common pathogens associated with otitis externa, as well as providing potent anti-inflammatory and anti-pruritic action, giving welcome relief from the discomfort of OE.

• Highly lipophilic corticosteroid
• Reduces swelling, improving comfort
• Stronger anti-inflammatory activity and longer duration of action than the glucocorticoid betamethasone⁷

• Not a World Health Organization (WHO) critically important antibiotic for human use⁸
• Highly effective against S. pseudintermedius commonly found in otitis externa

• Selectively inhibits ergosterol production in fungi, leading to fungal cell death
• Penetrates keratinised tissues, entering the stratum corneum and sebum via direct diffusion through skin

* Staphylococcus pseudintermedius and Malassezia pachydermatis.

1. Angus J. C. Vet Clinics of North America: Small Animal Practice. 2004 Mar;34(2):411-24.
2. Hill PB, Lo A, Eden CA, Huntley S, Morey V, Ramsey S, et al. Survey of the prevalence, diagnosis and treatment of dermatological conditions in small animals in general practice. Vet Rec. 2006;158(16):533-9.
3. Jamet J-F, Marignac G, Petit JY. Prospective study of the effect of otitis externa before and after treatment on 20 owners' assessment of their and their dog's quality of life Vet Dermatol. 2016;27:45 (abstract).
4. Boda C, Liege P, Reme CA. Evaluation of owner compliance with topical treatment of acute otitis externa in dogs: a comparative study of two auricular formulations. Int J Appl Res Vet Med. 2011;9:157-65.
5. Noli C, Sartori R, Cena T. Impact of a terbinafine-florfenicol-betamethasone acetate otic gel on the quality of life of dogs with acute otitis externa and their owners. Vet Dermatol. 2017;28(4):386-e90.
6. Dog Owner Compliance Evaluation, June 2019, n=2000 dog owners from FR/IT/ES/DE/NL/BE/UK/AU.
7. Spada, F. et al. (2018) Australasian Journal of Dermatology 59(3): e168-e174.
8. World Health Organization (WHO). (2011). Critically important antimicrobials for human medicine. 3rd Revision. Available at: http://www.who.int/iris/handle/10665/77376 Accessed March 20, 2019.
9. Blake J, Keil D, Kwochka K, et al. Evaluation of a single-administration ototopical treatment for canine otitis externa: a randomised trial. Veterinary Record Open 2017;4:e000219. doi:10.1136/vetreco-2017-000219

Neptra POM-V (UK) and POM (Ireland) contains 16.7 mg florfenicol, 16.7 mg terbinafine hydrochloride, equivalent to terbinafine base: 14.9 mg, and 2.2 mg mometasone furoate.

Further information is available from the SPC. Advice should be sought from the Medicine Prescriber. Refer to the product packaging and leaflets for information about side effects, precautions, warnings and contra-indications. Contact Elanco Animal Health for further information on 01256 353131 or email elancovets@elanco.com, or write to: Elanco Animal Health, Form 2, Bartley Way, Bartley Wood Business Park, Hook, RG27 9XA.

Neptra, Elanco and the diagonal bar logo are trademarks of Elanco or its affiliates.

© 2021 Elanco or its affiliates. PM-UK-21-0256. Date of preparation: 03/21.