{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:02:15Z","timestamp":1790391735051,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015226","name":"Royal Veterinary College","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Small Animal Practice"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Malassezia<\/jats:italic>\n                      dysbiosis commonly occurs after successful piperacillin\u2010tazobactam monotherapy for canine bacterial otitis externa. The study objective was to compare antimicrobial outcomes in dogs with otitis treated with piperacillin\u2010tazobactam in combination with the antifungal drug clotrimazole with a previous cohort treated with piperacillin\u2010tazobactam alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Twenty\u2010one dogs with bacterial otitis were treated topically with piperacillin\u2010tazobactam (1\u2009mL) every 12\u2009hours, although the fourth dose in each 48\u2009hours period was replaced with 1% clotrimazole solution (1\u2009mL). At visits 1 (V1) and 2 (V2), ear swab tips were washed in PBS\u2009+\u2009Triton X\u2010100 and serial dilutions spread\u2010plated onto blood, MacConkey (37\u00b0C, 48\u2009hours) and modified Dixon's agar (32\u00b0C, 14\u2009days) to generate semiquantitative counts. Microbes were identified by phenotype and MALDI\u2010TOF. Outcomes were compared with those of 14 dogs previously treated with piperacillin\u2010tazobactam alone (sequential case\u2010cohort design).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Relative risk of a post\u2010treatment bacterial culture count exceeding zero in dogs treated with piperacillin\u2010tazobactam\u2010clotrimazole (3\/21), when compared to piperacillin\u2010tazobactam treatment alone (2\/14) was 1.00 (95% confidence interval 0.19 to 5.24). Relative risk of an increase in yeast culture count in dogs treated with piperacillin\u2010tazobactam alone (14\/14), when compared to piperacillin\u2010tazobactam\u2010clotrimazole\u2010treated dogs (7\/21), was 3.00 (95% confidence interval 1.64 to 5.49). Relative risk of fungal dysbiosis (V2 yeast count &gt; normal) in dogs treated with piperacillin\u2010tazobactam alone (14\/14), when compared to piperacillin\u2010tazobactam\u2010clotrimazole\u2010treated dogs (4\/21), was 5.25 (95% CI 2.17 to 12.68).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>Piperacillin\u2010tazobactam\u2010clotrimazole is highly efficacious in the treatment of refractory bacterial otitis; incorporation of clotrimazole markedly reduces but does not abrogate fungal dysbiosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jsap.70199","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:32:43Z","timestamp":1790389963000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The addition of clotrimazole reduces but does not abrogate fungal dysbiosis during effective antibacterial therapy for canine otitis externa"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2540-904X","authenticated-orcid":false,"given":"G.","family":"Gallow","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Services Royal Veterinary College  Hatfield Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Juhola","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Services Royal Veterinary College  Hatfield Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5534-9692","authenticated-orcid":false,"given":"E. 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