Investigation on the clinical efficacy and tolerability of a 0.4% topical stannous fluoride preparation (MedEquine® Gel) for the treatment of bacterial skin infections in horses: a prospective, randomized, double‐blinded, placebo‐controlled clinical trial

Abstract

The purpose of this prospective, double-blinded, placebo-controlled clinical trial was to investigate the efficacy and tolerability of a novel gel containing 0.4% stannous fluoride (MedEquine) for the treatment of cutaneous bacterial infections in horses. Twenty privately owned horses diagnosed with bacterial skin infections based on physical findings and cytology results were enrolled and randomly assigned to either a placebo or an active ingredient treatment group. The product was applied on affected areas daily for 4 weeks. Cytology and clinical evaluations were done by the same investigator at the beginning and at the end of the treatment. Owners scored pruritus weekly. Both owners and investigators were blinded to the allocation to the groups. At the end of the study, stannous fluoride gel treatment significantly decreased the investigator's clinical scores and owners' pruritus scores while no significant changes were detected in the vehicle treatment group. At the end of the trial, none of the horses in the stannous fluoride group required additional therapy while four of ten horses in the vehicle group required systemic therapy to resolve the infection. No adverse effects were detected in any of the groups. The gel formulation made compliance easier for owners compared to the traditional bathing regimen and allowed spot treatment, which was particularly helpful in animals with localized infections. These favourable aspects of the treatment were highlighted by the owners of the horses enrolled in the study. In conclusion, 0.4% stannous fluoride gel (MedEquine) was an effective and safe therapy for the topical management of bacterial skin infections in the horses included in the study.

Bacterial Skin Diseases

“…20 The study was placebo-controlled and double-blinded. 20 The study was placebo-controlled and double-blinded.…”

A review of topical therapy for skin infections with bacteria and yeast

“…In a prospective, double‐blinded study, 20 horses with dermatophilosis ( n = 4) and staphylococcal skin infection ( n = 16) were treated with either 0.4% stannous fluoride gel or placebo. Significant decreases in clinical and pruritus scores were observed in the treatment but not the placebo group 93 . In a similar trial, 0.2% topical stannous fluoride spray was used for the treatment of canine pyoderma.…”

“…Recommendations for all other described ingredients are based only on in vitro studies (such as acetic acid/boric acid 18,19 and phytosphingosines 77,78 ) or on one or a small number of open clinical trials (for example, medical honey 68 and fusidic acid 54 ) or on only one well‐designed clinical trial (stannous fluoride 93,94 and hydrogen peroxide 59 ). Thus, more clinical studies are needed to confirm or refute those results.…”

“…Thus, more clinical studies are needed to confirm or refute those results. The reason for the different efficacy of stannous fluoride in horses 93 and dogs 94 may be the different concentrations used in the studies (0.4 versus 0.2%), species‐specific host differences or the different bacterial strains found on horses and dogs.…”

Investigation of the clinical efficacy of 0.2% topical stannous fluoride for the treatment of canine superficial pyoderma: a prospective, randomized, double-blinded, placebo-controlled trial

“…SF is commonly used in a variety of oral preparations to treat canine and human gingivitis as it is effective against both gram positive and gram negative bacteria 16–19 . 0.4% SF spray and gel formulations are also effective and well‐tolerated in the treatment of bacterial skin infections in horses 20 . Thus, a formulation of SF could be an effective therapy for canine skin infections.…”