Treatment Choices for Acute Canine Otitis Externa in Sweden, Finland and Norway: A Comparative Study With a Focus on Antibiotic Use.

Most acute canine otitis externa managed successfully without antibiotics; significant geographic practice variation exists.

This multicentre cross-sectional study examined treatment approaches for acute canine otitis externa (COE) across Sweden, Finland, and Norway, involving 1,060 dogs with disease duration ≤4 weeks. Overall, antibiotics were used in only 18% of cases, predominantly topical formulations, with systemic antibiotics in just six cases. Significant geographic variation existed, with antibiotic use at 2% in Sweden versus 28-29% in Norway and Finland (p<0.001). Polymyxin B was the most frequently prescribed antibiotic. Notably, antibiotic use correlated more strongly with cytological findings—particularly neutrophil and rod-shaped bacteria presence—than with clinical signs alone. Glucocorticoids were employed in 94% of cases and ear cleaners in 89%, demonstrating that most acute COE cases were successfully managed without antibiotics. These findings highlight significant differences in antibiotic stewardship practices among Nordic countries and suggest that Swedish practitioners' minimal antibiotic use (2%) may represent a model for judicious antimicrobial prescribing in acute COE management.

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