OTIC FORMULATIONS, METHODS AND DEVICES

Abstract

The present invention relates to a formulation and method for treating an ear infection, especially otomycosis and otitis externa, by administering a one-time only treatment comprising an antibiotic, antifungal, and an anti-inflammatory in a thick, otic carrier. In one embodiment, the formulation comprises a therapeutically effective amount of active ingredients including a marbofloxacin, terbinafine and/or clotrimazole and dexamethasone.

Claims

1. An otic formulation comprising: a) therapeutic agents comprising: i) marbofloxacin; ii) terbinafine, clotrimazole, or a combination thereof; and iii) a corticosteroid; and b) a carrier.

2. The formulation of claim 1, wherein the formulation is capable of delivery to the ear canal of a mammal in a flowable fluid form.

3. The formulation of claim 2, wherein the carrier includes a thickener so that upon introduction into the ear canal the formulation remains in the ear canal for at least 3 days releasing the therapeutic agents.

4. The formulation of claim 3, wherein the carrier comprises about 10 to 90% w/w of the thickener.

5. The formulation of claim 4, wherein the carrier comprises about 10 to 50% w/w of the thickener and about 50 to 90% w/w of mineral oil.

6. The formulation of claim 5, wherein the thickener is wax.

7. The formulation of claim 6, wherein the carrier comprises about 60 to 80% w/w of mineral oil and about 10 to 30% of wax.

8. The formulation of claim 7, wherein the wax is paraffin.

9. The formulation of claim 8, wherein the carrier comprises about 65 to 75% w/w of mineral oil and about 20 to 30% w/w of paraffin.

10. The formulation of claim 1, wherein the formulation comprises about 0.1% to 3% w/w of marbofloxacin and about 0.1% to 5% w/w of terbinafine, clotrimazole or combinations thereof.

11. The formulation of claim 10, wherein the formulation comprises about 0.01 to 2.5% w/w of corticosteroid.

12. The formulation of claim 11, wherein the carrier comprises about 65 to 75% w/w of mineral oil and about 20 to 30% w/w of paraffin.

13. The formulation of claim 12, wherein the corticosteroid is selected from the group consisting of amcinonide, betamethasone benzoate, betamethasone dipropionate, betamethasone valerate, clobetasol propionate, clocortolone pivalate, desonide, desoximetasone, dexamethasone, dexamethasone sodium phosphate, diflorasone diacetate, fluocinonide, fluocinolone acetonide, flurandrenolide, fluticasone propionate, halcinonide, halobetasol propionate, hydrocortisone, hydrocortisone butyrate, hydrocortisone valerate, mometasonefuroate, prednisolone acetate, triamcinolone acetonide, and combinations thereof.

14. The formulation of claim 13, wherein the corticosteroid is dexamethasone, hydrocortisone, or the combination thereof.

15. The formulation of claim 1, wherein the formulation comprises about 0.1% to 3% w/w of marbofloxacin, about 0.1% to 5% w/w of terbinafine, about 0.01 to 2.5% w/w of corticosteroid, about 65 to 75% w/w of mineral oil and about 20 to 30% w/w of paraffin.

16. The formulation of claim 15, wherein the corticosteroid is dexamethasone, hydrocortisone, or the combination thereof.

17. The formulation of claim 1, wherein the formulation has a viscosity of about 10-80,000 cPs at 37 or about 60,000-65,000 cPs at 37 C.

18. An otic formulation, comprising: a) therapeutic agents for treating fungal and bacterial infection comprising: i) about 1.5 to 2.0% w/w of marbofloxacin; ii) about 1.0 to 5.0% w/w of terbinafine, clotrimazole, or a combination thereof; and iii) about 0.1 to 0.3% w/w of dexamethasone; and b) about 20 to 30% w/w of wax; and c) about 65 to 75% w/w of mineral oil.

19. The formulation of claim 18, wherein the formulation comprises about 1.0 to 5.0% w/w of terbinafine.

20. The formulation of claim 20, wherein after applying to the ear canal of a mammal having an ear infection, the formulation remains in the ear canal and has a viscosity of about 10-80,000 cPs at 37 C., about 10,000-80,000 cPs at 37 C., about 20,000-80,000 cPs at 37 C., about 30,000-80,000 cPs at 37 C., or about 40,000-80,000 cPs at 37 C.

21. The formulation of claim 20, wherein upon introduction into the ear canal the formulation remains in the ear canal releasing the active ingredients for 2-7 days, and thereafter is not found in the ear.

22. The formulation of claim 21, wherein the formulation comprises about 1.5 to 2.0% w/w of marbofloxacin, about 1.5 to 3.5% w/w of terbinafine, about 0.1 to 0.3% w/w of dexamethasone, about 20 to 30% w/w of wax, and about 65 to 75% w/w of mineral oil.

23. The formulation of claim 22, wherein the formulation is for single treatment and has a clinical cure rate of at least 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or 100% within 2, 14 or 27 days.

24. An otic formulation, comprising marbofloxacin, terbinafine and dexamethasone in an aurally acceptable carrier, the carrier having about 10-80,000 cPs at 37 C., about 10,000-80,000 cPs at 37 C., about 20,000-80,000 cPs at 37 C., about 30,000-80,000 cPs at 37 C. or about 40,000-80,000 cPs at 37 C., wherein the carrier retains the active ingredients in an ear for 2-7 days and then egresses or is absorbed, and wherein the formulation is for single treatment and has a clinical cure rate of at least 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or 100% within 2, 14 or 27 days.

25. An otic formulation comprising: 1.5 to 2.0% w/w of marbofloxacin; 2.0 to 5.0% w/w of terbinafine; 0.1 to 0.3% w/w of dexamethasone; 20 to 30% w/w of paraffin; and 65 to 75% w/w of mineral oil.

26. An otic formulation comprising: 1.5 to 2.0% w/w of marbofloxacin; 1.5 to 5.0% w/w of clotrimazole; 0.1 to 0.3% w/w of dexamethasone; 20 to 30% w/w of paraffin; and 65-75% w/w of mineral oil.

27. A method for treating an infection in an ear canal of a mammal, comprising applying a single dose of the formulation of claim 1 into the ear canal of a mammal with an ear infection.

28. The method of claim 27, wherein the ear infection is clinically resolved within 2, 14 or 27 days.

29. The method of claim 27, wherein the mammal is a human, canine or feline.

30. A therapeutic kit comprising an injection unit comprising a storage compartment fluidly coupled to a delivery component, and a formulation of claim 1 stored within the storage compartment.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0031] The present disclosure provides a novel formulation and method for treating ear fungal infections, especially otitis externa. The formulation and method of the present invention makes it possible to treat and even eradicate the chronic otitis externa by one-time only administration of the formulation to the ear canal.

[0032] The disclosure provides a novel formulation for treating fungal ear infection, comprising an antifungal, an antibiotic and an anti-inflammatory agent in a thick base of 10-80,000 cPs at ear or body temperature.

[0033] As used herein, ear infection means fungal and/or bacterial infection in the ear. The location of the infection is primarily the auditory canal. In an embodiment, the term ear infection includes otomycosis, chronic and acute otitis externa.

[0034] As used herein, active ingredient means the substance of a pharmaceutical drug that has therapeutic effect against the disorder to be treated.

[0035] As used herein, corticosteroid means a class of steroids having anti-inflammatory effect that may include, but are not limited to, amcinonide, betamethasone benzoate, betamethasone dipropionate, betamethasone valerate, clobetasol propionate, clocortolone pivalate, desonide, desoximetasone, dexamethasone, dexamethasone sodium phosphate, diflorasone diacetate, fluocinonide, fluocinolone acetonide, flurandrenolide, fluticasone propionate, halcinonide, halobetasol propionate, hydrocortisone, hydrocortisone butyrate, hydrocortisone valerate, mometasonefuroate, prednisolone acetate, triamcinolone acetonide, and combinations thereof.

[0036] As used herein, thickener means optically acceptable additives that increase viscosity of the formulation. The thickener may make the overall formulation as auris-acceptable viscous fluid when the temperature rises to body temperature. Examples of thickeners that can be used in the present invention include, but not limited to, low-density polyethylene, poloxamers, waxes and the combination thereof. Mineral oil can be added to adjust the viscosity of the thickener. The thickener in the present invention preferably provides a formulation with a viscosity of approximately about 10-80,000 cPs at 37 C., about 10,000-80,000 cPs at 37 C., about 20,000-80,000 cPs at 37 C., or about 40,000-80,000 cPs at 37, such as about 50,000-70,000 cPs at 37 C. or about 60,000-62,000 cPs at 37 C.

[0037] As used herein, injection unit means a unit that is capable of storing a therapeutic agent and injecting or delivering the therapeutic agent to a target area of a subject. Typical injection units include, but are not limited to, a syringe coupled with a needle or a tube, e.g., via a standard luer lock or luer connector. The needle or tube can be customized as described herein.

[0038] As used herein, flowable means a fluid having a viscosity less than 100,000 cPs at room temperature.

[0039] The use of the word a or an when used in conjunction with the term comprising in the claims or the specification means one or more than one, unless the context dictates otherwise.

[0040] The term about means the stated value plus or minus the margin of error of measurement or plus or minus 10% if no method of measurement is indicated.

[0041] The use of the term or in the claims is used to mean and/or unless explicitly indicated to refer to alternatives only or if the alternatives are mutually exclusive.

[0042] The terms comprise, have, include (and their variants) are open-ended linking verbs and allow the addition of other elements when used in a claim.

[0043] The phrase consisting of is closed, and excludes all additional elements.

[0044] The phrase consisting essentially of excludes additional material elements, but allows the inclusions of non-material elements that do not substantially change the nature of the invention, such as instructions for use, special packaging, preservatives, antioxidants and the like. The active pharmaceutical ingredients are considered material.

[0045] When a drug is referred to by name herein, all active salts, isomers, and derivatives thereof are considered to be included.

[0046] All percentages are by weight, unless indicated otherwise.

[0047] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 0.01% to 5% by weight of marbofloxacin, 0.01% to 5% by weight of terbinafine and/or clotrimazole, 0.01% to 2.5% by weight of a corticosteroid, 10% to 70% by weight of thickener, and 30% to 90% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0048] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 1% to 3% by weight of terbinafine and/or clotrimazole, 0.1% to 0.3% by weight of a corticosteroid, 15% to 25% by weight of thickener, and 70% to 90% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0049] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 2% by weight of marbofloxacin, 1% to 2% by weight of terbinafine and/or clotrimazole, 0.1% to 0.25% by weight of a corticosteroid, 15% to 25% by weight of thickener, and 70% to 90% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0050] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 1% to 3% by weight of terbinafine and/or clotrimazole, 0.1% to 0.3% by weight of a corticosteroid, 15% to 20% by weight of thickener, and 75% to 80% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0051] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 2% by weight of marbofloxacin, 1% to 2% by weight of terbinafine and/or clotrimazole, 0.1% to 0.25% by weight of a corticosteroid, 15% to 20% by weight of thickener, and 75% to 80% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0052] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 1% to 5% by weight of terbinafine, 0.1% to 0.3% by weight of a corticosteroid, 20% to 30% by weight of thickener, and 65% to 80% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0053] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 2% to 4% by weight of terbinafine, 0.1% to 0.3% by weight of a corticosteroid, 20% to 30% by weight of thickener, and 65% to 80% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0054] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 2% to 4% by weight of terbinafine, 0.1% to 0.3% by weight of a corticosteroid, 20% to 30% by weight of thickener, and 65% to 75% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0055] In an embodiment, the disclosure provides a formulation for treating an ear infection in a mammal, the formulation comprising 1% to 3% by weight of marbofloxacin, 2% to 4% by weight of terbinafine, 0.1% to 0.3% by weight of a dexamethasone, 20% to 30% by weight of paraffin, and 65% to 75% by weight of mineral oil. Other therapeutically appropriate bases can also be utilized in the present invention in place of the thickener without affecting the efficacy of the formulation.

[0056] In an embodiment, the corticosteroid is selected from amcinonide, betamethasone benzoate, betamethasone dipropionate, betamethasone valerate, clobetasol propionate, clocortolone pivalate, desonide, desoximetasone, dexamethasone, dexamethasone sodium phosphate, diflorasone diacetate, fluocinonide, fluocinolone acetonide, flurandrenolide, fluticasone propionate, halcinonide, halobetasol propionate, hydrocortisone, hydrocortisone butyrate, hydrocortisone valerate, mometasone furoate, prednisolone acetate, triamcinolone acetonide, and the combination thereof. More preferably, the corticosteroid is dexamethasone, hydrocortisone, triamcinolone acetonide or the combination thereof.

[0057] In an embodiment, the carrier comprises mineral oil and a thickener. In one embodiment the thickener is paraffin and the carrier includes about 11-21% w/w or about 17% or 18% paraffin in mineral oil. In one embodiment the thickener is paraffin and the carrier includes about 20-30% w/w or about 24% or 25% paraffin in mineral oil. In one embodiment the thickener is paraffin and the carrier includes about 20-30% w/w or about 24% or 25% paraffin in about 65-80% w/w or about 71% or 72% mineral oil. In one embodiment the thickener is paraffin and the carrier includes about 22-26% w/w or about 24% or 25% paraffin in about 70-75% w/w or about 71% or 72% mineral oil. In one embodiment the thickener is paraffin and the carrier includes paraffin in about 65-80% w/w or about 70-75% mineral oil.

[0058] In an embodiment, the method for treating ear infection comprises the following steps: applying one time, a formulation of the disclosure into the ear canal of a mammal, wherein the formulation forms a gel after applying to the ear canal of the mammal, and wherein the gel releases the active ingredients continuously for at least 2, 3, 4, 5, 6, 7, 8 or 9 days. In some embodiments, before applying the formulation to the ear canal, the method further comprises the step of debriding infectious and inflammatory debris from the ear canal.

[0059] In another embodiment, the invention is a formulation for treating ear infection, comprising: one or more antifungal agents; one or more anti-bacterial agents; one or more anti-inflammatory agents; and a carrier having about 10-80,000 cPs at 37 C., about 10,000-80,000 cPs at 37 C., about 20,000-80,000 cPs at 37 C., or about 40,000-80,000 cPs at 37 C., wherein the carrier retains the active ingredients in an ear for 2-7 days and then egresses or is absorbed.

[0060] In an embodiment, the otic formulation, comprises marbofloxacin, terbinafine and dexamethasone in an aurally acceptable carrier. Preferably, 0.1-10% marbofloxacin, 0.1-10% terbinafine and 0.01-5% dexamethasone are used, most preferred is 1.5-2.0% marbofloxacin, 1.5-5.0% terbinafine, and 0.1-0.25% dexamethasone in a suitable carrier as described herein.

[0061] In an embodiment, the otic formulation, comprises marbofloxacin, clotrimazole and dexamethasone in an aurally acceptable carrier. Preferably, 0.1-10% marbofloxacin, 0.1-10% clotrimazole and 0.01-5% dexamethasone are used, most preferred is 1.5-2.0% marbofloxacin, 1.0-2.0% clotrimazole, and 0.1-0.25% dexamethasone in a suitable carrier as described herein.

[0062] In an embodiment, the suitable mammal that can be treated with the formulation and method of the present invention includes humans, canines, felines, bovines, ovines, porcines, equines, as well as other mammals commonly treated by veterinarians for ear infections.

[0063] The present disclosure further provides a therapeutic kit for treating ear infections. In one embodiment, the therapeutic kit comprises an injection unit as a syringe, needle or hollow tube, comprising a storage compartment for storing the drug formulation described herein. The tube or needle can be bent to any degree suitable for use, so long as it does not affect the dispensation of the therapeutic formulation.

[0064] The entire kit can be disposable, in which case the storage volume is small to hold the amount suitable for single dosage, for example, 1 to 1.5 ml, in order to prevent waste. Or alternatively, the kit can be used repeatedly until no therapeutic formulation is left, in which case the storage volume is large to hold multiple dosages, for example 10 to 30 ml. Volumes may change if the patients are not human, e.g., a larger dose may be required for dogs.

[0065] Preparing the formulation of the present invention can be performed with various compounding methods, as long as the final product has the desired characteristics, such as remaining flowable at both room temperature and body temperature, while remaining in the ear canal for a prolonged period of time and providing a continuous release of active ingredients.

[0066] The following ingredients are included in a formulation in one embodiment of the invention.

TABLE-US-00002 TABLE B Active Ingredient Amount (% w/w) Marbofloxacin 1.5-1.9 Terbinafine 1.6-2.0 Dexamethasone (micronized) 0.1-0.25 Mineral Oil 78-80 Paraffin 17-18 100total

[0067] The following ingredients are included in a formulation in one embodiment of the invention.

TABLE-US-00003 TABLE C Active Ingredient Amount (% w/w) Marbofloxacin 1.5-2.0 Clotrimazole 1.0-2.0 Dexamethasone (micronized) 0.1-0.25 Mineral Oil 78-80 Paraffin 17-18 100 total

[0068] The following ingredients are included in a formulation in one embodiment of the invention.

TABLE-US-00004 TABLE D Active Ingredient Amount (% w/w) Marbofloxacin 1.7-1.8 Terbinafine 1.6-2.0 Dexamethasone (micronized) 0.1-0.25 Mineral Oil 78-79 Paraffin 17-18 100tal

TABLE-US-00005 TABLE E Active Ingredient Amount (% w/w) Marbofloxacin 1.5-1.9 Terbinafine 2.7-3.3 Dexamethasone (micronized) 0.1-0.3 Mineral Oil 70-74 Paraffin 22-26 100 total

TABLE-US-00006 TABLE F Active Ingredient Amount (% w/w) Marbofloxacin 1.5-1.9 Terbinafine 2.7-3.3 Dexamethasone (micronized) 0.1-0.3 Mineral Oil 71-72 Paraffin 23-24 100 total

[0069] In manufacture, marbofloxacin powder, clotrimazole or terbinafine powder, and dexamethasone powder may be measured according to respective weight and placed inside a mixing vessel, such as a flask.

[0070] The mineral oil may then be added and the combination mixed well. Finally, the thickener and an additional amount of mineral oil may be added to the vessel to make the final volume and mixed well. Additional mineral oil may be added to adjust the viscosity of the formulation.

[0071] In the methods described herein, an appropriate dosage level of active ingredients will generally be about 0.01 to about 50 mg/kg, such as, for example, about 0.25 to about 15 mg/kg per day, such as about 2.0 to about 14 mg/kg per day. Within this range the dosage of each active ingredient may be about 0.25 to 3.5 mg/kg, 0.25 to 14 mg/kg, 1.0 to 10 mg/kg, 1.5 to 10 mg/kg, 2.0 to 10 mg/kg, 2.5 to 8.0 mg/kg, 2.5 to 8 mg/kg, 2.5 to 7.0 mg/kg, 2.5 to 6.5 mg/kg, 2.5 to 6.0 mg/kg, 2.5 to 5.5 mg/kg, 2.5 to 5.0 mg/kg, 2.5 to 4.0 mg/kg, 2.5 to 3.5 mg/kg (including all intermediate dosages, such as 2.5, 2.6, 2.7, 2.8, 2.9, 3.0, 3.1, 3.2, 3.3, 3.4, 3.5, etc. mg/kg), in a single dosage form. In this form, the composition need only be administered by single application, one time for an entire course of treatment to clinically resolve an infection with up to 100% elimination.

[0072] It is anticipated that the formulations of the disclosure achieve at least 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or 100% cure rate. It is expected that patients administered the formulations will show at least 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or 100% cure in 2-27 days with most being clinically cured under 7, 14 or 27 days, and with complete egress of the base from the ear. Of course, the percentages of base ingredients can vary depending on the wax chosen, softer waxes needing a higher percentage.

[0073] As used herein, clinical cure rate refers to a substantial reduction of symptoms or total elimination of symptoms. In embodiments, an infection is resolved with efficacy greater than 90, 91, 92, 93, 94, 95, 96, 97, 98, 99 or up to 100%, within a duration of less than 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 or 27 days after a single administration.

[0074] It is expected that a 1 ml dose of formulation is sufficient is most cases. It is to be noted that the volume may change as the type of mammal being treated changes, and a person of ordinary skilled in the art can easily adjust the amount to suit the treatment needs. Different amounts of the present formulation may be administered to the mammal's ear canal as readily appreciated by a person skilled in the art.

[0075] After debriding the infectious and/or inflammatory debris from the ear canal, an appropriate amount of a formulation from above may be administered to the infected ear canal such that all available space in the outer ear was filled. The formulations may be stored in a syringe or container before use, and can be stored at room temperature without deteriorating the therapeutic effect.

[0076] The application of the formulation is illustrated as follows. First the ENT doctor carefully places a hollow tube inside the patient's auditory canal. Upon pressing the plunger or storage unit, the therapeutic formulation can be dispensed into the auditory canal and remains therein. In embodiments, the tube is flexible and includes a rounded tip such that doctors can minimize possible scratching when applying the therapeutic formulation. The dispensed thick fluid will fill in the space within the auditory canal, thereby contacting the infected area therein while preventing secondary infection in the ear canal.

[0077] After administration of the formulation, each patient may be examined to ensure that the formulation remained within the ear canal. Cotton balls may be provided at the outer ear canal (conchal bowl) to catch egress, but no attempt was made to plug the ear canal. Follow-up examination may be performed between 7 to 14 days after initial treatment. Residue of the formulation is expected to be observed at day 14, indicating the formulation did maintain within the ear canal for as long as 14 days. Symptoms relief is expected to occur usually within three days, while hearing is expected to return to normal within 5 to 7 days after treatment.

[0078] An ideal anti-inflammatory for use in the formulation is dexamethasone or hydrocortisone.

[0079] The following examples are provided to further illustrate the advantages and features of the present invention, but they are not intended to limit the scope of the invention. While the examples are typical of those that might be used, other procedures, methodologies, or techniques known to those skilled in the art may alternatively be used.

Example I

Treatment of Otitis Externa in Dogs

[0080] This study evaluated the effectiveness and field safety of an otic formulation of the present invention over a period of thirty (30) days for the treatment of otitis externa in dogs. Twenty-four (24) dogs were enrolled in the study from two study sites, and all 24 were treated with a formulation as described in Table B. All 24 dogs were included in the safety evaluation, while 21 dogs were included in the efficacy evaluation.

[0081] Dogs enrolled in the study presented to the clinic with signs of otitis externa. On Day 0, a physical examination, including an aural and otoscopic exam, was conducted in order to verify an intact tympanic membrane, absence of foreign bodies and ear mites, and to assign a clinical score to the study ear based on erythema, exudate, swelling and ulceration. In order to be included in the study, the minimum clinical score had to be greater than or equal to 6. A hearing test was conducted, an ear swab was obtained for bacterial culture and fungal (yeast) identification, and the ear was cleaned with saline. The dogs were dosed by administering 1.0 mL of the IVP per infected ear. If both ears were infected, the right ear was designated as the study ear.

[0082] At the first follow-up visit on Day 7 (+2 days), aural and otoscopic exams were conducted to evaluate the ear and assign a clinical score. In addition, the owner was questioned regarding any adverse events observed.

[0083] At the second follow-up visit on Day 14 (2 days), aural and otoscopic exams were conducted to evaluate the ear and assign a clinical score. In addition, the owner was questioned regarding any adverse events observed.

[0084] At the final follow-up visit on Day 30 (+3 days), a physical examination, including an aural and otoscopic exam, was conducted to evaluate the ear and to assign a clinical score. A hearing test was also conducted. For a case to be considered a clinical cure, the final clinical score had to be less than or equal to 3, along with no individual clinical score getting worse at the final visit. If clinical cure was not achieved, an ear swab was obtained for bacterial culture and fungal (yeast) identification.

[0085] Based on clinical scores, clinical cures were obtained in 13 dogs by day 30 with at least 9 showing clinical cure by day 7. The number of clinical cures is expected to increase with the use of the formulations shown in Table E and Table F. There were both no serious adverse events or adverse events directly attributable to administration of the formulation, which demonstrated the safety of this formulation.

[0086] While preferred embodiments of the present invention have been shown and described herein, such embodiments are provided by way of example only. Various alternatives to the embodiments can be optionally employed without deviating from the spirit of the present invention. The scope of the invention is defined by the following claims.