Surolan is a prescription ear medication for dogs or cats that treats otitis externa, outer ear infection, caused by yeast and bacteria.
Treating canine otitis: So many optionshow do I choose? - dvm360 No toxic side effects have been observed after accidental intake by licking. prednisolone acetate results from its reduction of the permeability of
Polymyxin B sulfate is a broad-spectrum polypeptide antibiotic with activity against both Gram-positive and Gram-negative species. Janssen Pharmaceutica NV My pug always gets dirty ears and infections. SUROLAN- miconazole nitrate, polymyxin b sulfate, prednisolone acetatesolution/ drops I've taken her to the vet twice for ear infection. of yeasts and fungi. Medi-Vet offers pet medications including Comfortis, Rimadyl, Deramaxx, Metacam, Heartgard, Interceptor, Sentinel, Frontline Plus, Frontline Top Spot, Advantage, K9 Advantix and other Flea and Tick products. Administration and Dosage. I founded Medi-Vet back in 1998, because I believe no animal should go without proper healthcare due to inflated costs. If either . Residue build-up was reported in 1 dog and pain upon drug application in another dog. This belief still guides us to this day. Dr. Kent P. Walker, DVM, Founder and CEO. Miconazole nitrate is a synthetic imidazole derivative with antifungal activity and antibacterial activity against Gram-positive bacteria. Wear gloves or wash your hands immediately after handling the medication. Learn More About Surolan From Our Team of Experts. A total of 161 dogs treated with the active control was included in the safety database and adverse reactions were reported in 8 dogs treated with the active control. Rx Medication Sold Only To Licensed Veterinarians & Pharmacies. Surolan, Elanco and the diagonal bar logo are trademarks of Elanco or affiliates. A study performed using an experimentally-induced model of ear inflammation in mice demonstrated the effectiveness of prednisolone acetate in treating ear inflammation either alone or in combination with the other active ingredients of Surolan(2). Do not use in animals with known perforated tympanum. Antifungal agents are used in cases of otitis caused by Malassezia or . Surolan is normally used twice daily for up to 2 weeks. SUROLAN is indicated for the treatment of canine otitis externa associated with susceptible strains of yeast (Malassezia pachydermatis) and bacteria (Staphylococcus pseudintermedius). Instill 5 drops of SUROLAN in the ear canal twice daily and massage the ear. (miconazole nitrate, polymyxin B sulfate, prednisolone acetate suspension). Avoid getting Surolan Otic Suspension in your dog's eyes, nose or mouth. Nothing has helped so far. The usual dose for dogs of any weight is 5 drops placed into the ear canal 2 times a day and massage the ear. You will receive the exact brand that you request. Corticosteroids are not recommended for use in pregnant animals. Please do not hesitate to contact us with questions: Usually ships the same weekday before 3pm CT with veterinary approval. Keep out of reach of children. $23.79 $ 23. absorption of miconazole from the skin or mucous membranes takes place. Available for Android and iOS devices. The safe use of SUROLAN in dogs used for breeding purposes, during pregnancy, or in . Do not use in dogs with known perforated tympanum. prednisolone acetate). An in vitro study of organisms collected from clinical cases of otitis externa at a veterinary teaching hospital and from dogs enrolled in the clinical effectiveness study for SUROLAN determined that polymyxin B sulfate and miconazole nitrate inhibit the growth of bacteria and yeast commonly associated with canine otitis externa. It soothes itching while it treats infections caused by yeast, fungi and gram-positive and gram-negative bacteria. Surolan is non-greasy,
acetate is a glucocorticoid with strong anti-inflammatory and
. Skip to the beginning of the images gallery. Verify that the eardrum is intact. VetLabel.com provides the full animal health subset of the FDA's repository. Within the Veterinary Product and Label Information section: VetLabel.com provides trustworthy package insert and label information about marketed drugs as submitted by manufacturers to the U.S. Food and Drug Administration. Please note on the outside of box near the label why the product is being returned. Surolan is made by the manufacturer Elanco. Your pet's veterinarian will provide directions for use. For otic use in dogs only. Available for Android and iOS devices. Buster Complete Elizabethan Collar For X-Large Breeds 30cm (12" Depth), Yummy Combs Flossing Dental Treats For Dogs, Small 13-25 lbs, 21 Count Bag, Pivetal Porous Tape 1" x 10 Yards, 12 Rolls, Universal Animal Antidote (UAA Gel), 300 ml (10 fl oz), Covetrus Behavior Powder For Dogs Probiotic Supplement, 45 Packets, CeraSoothe SA AntiSeborrheic Shampoo, 16 oz, PetArmor Plus For Dogs 23-44 lbs. Direction and dosage information for Surolan. The addition of prednisolone acetate to the combination did not impair antimicrobial activity to any clinically-significant extent. Elanco US Inc. Antifungal, antibacterial and anti-inflammatory. Two dogs experienced reduced hearing at the end of treatment; on follow-up one dog had normal hearing capacity while the other case was lost for follow-up. Talk to your veterinarian or pharmacist before taking or using any other prescription or over the counter medicines, including vitamins, minerals, and herbal products. Do not use in dogs with perforated ear drums. Even Lilly knows it works! Verify that the eardrum is intact. Do not use with other drugs known to cause ear damage (ototoxicity). THIS SERVICE AND DATA ARE PROVIDED "AS IS". Federal (USA) law Do not use with drugs known to induce ototoxicity. Before instilling any medication into the ear, examine the external ear canal thoroughly to be certain the tympanic membranes are not ruptured. Our team of vets are available to answer any questions that you may have about your pet's health, behaviour, feeding habits or simply to help you pick the best product for your pet. Prednisolone acetate is a glucocorticoid with anti-inflammatory activity. Not for use in humans. Possible side effects may include a stinging sensation, especially on the open or broken skin and an oyster-like or garlic breath and taste in the mouth. Shop Veterinary Diet Food, Supplements, Dental Care & More. Ears: After cleaning the ear canal, apply Surolan and ensure an adequate distribution of the preparation by massaging the ear base. The external ear should be thoroughly cleaned and dried before the initiation of treatment.
Amazon.com: Surolan Ear Drops For Dogs Possible side effects of the ear medication can include loss of hearing, loss of balance and diarrhea, while side effects of the topical medication can include enzyme elevations, weight loss and anorexia. My dog had perfect hearing prior to this medication and now she can NOT hear at all!! SUROLAN is available in 15 mL and 30 mL plastic dispensing bottles with applicator tip for otic use. It is available in a 15 ml plastic dropper bottle. To prevent reinfestation, treatment should be continued for the entire life cycle of the mite (approximately 21 days). Age: 12. Current License Must Be On File Prior To Shipping. You should hear a 'squishing' sound as you massage the medication deep into the ear canal. When your order is complete, well quickly confirm new prescriptions, and existing prescriptions without refills, with your veterinarian. Breed: German shepherd mix.
Surolan Ear Drops - 15ml - 365 Vet The external ear should be thoroughly cleaned and dried before the initiation of treatment. Surolan Otic Suspension is a prescription medication FDA approved for use in dogs only. Long-term use of topical otic corticosteroids has been associated with adrenocortical suppression and iatrogenic hypoadrenalcorticism in dogs. Surolan Otic Suspension is an effective treatment for common and recurring cases of otitis externa and dermatitis in dogs. The safe use of Surolan in dogs used for breeding purposes, during pregnancy, or in lactating dogs has not been evaluated. Keep this and all drugs out of reach of children. Surolan kills the yeast and bacteria causing the infection and has a steroid to treat swelling and redness. It is a proven product with 30+ years of clinical experience. There are many other drugs to use why prescribe something that may cause hearing loss??? Surolan is a prescription product and must be used according to the instructions of your veterinary surgeon. polymyxin B sulfate, What problems could my dog or cat have with Surolan?
Surolan POM | Hyperdrug Miconazole Nitrate, Polymyxin B Sulfate, Prednisolone Acetate, Paraffin. Accidental spillage on the skin should be washed off immediately with soap and water. is stable and fluid at room temperature. A total of 161 dogs treated with the active control was included in the safety database and adverse reactions were reported in 8 dogs treated with the active control. 4.7 out of 5 stars 68,561. No more fleas, no more ticks. Avoid using any other medications in your pet's ear unless instructed to by your veterinarian. Medi-Vet.com is a wholesale drug distributor for veterinarians, pharmacies and drug companies. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Polymyxin B sulfate is a broad-spectrum polypeptide antibiotic with activity against both Gram-positive and Gram-negative species. 1-48 of 135 results for "surolan ear drops for dogs" Results. If allergic to this medication, some of the signs may include facial swelling, hives, scratching, diarrhea or vomiting. Ears: After cleaning the ear canal, apply Surolan
The following adverse reactions were reported in a study when SUROLAN was administered at 1X, 3X and 5X for 42 consecutive days (6 times the recommended treatment duration) in laboratory Beagles: hypersensitivity reactions which included mild erythema and hyperemia, painful and sensitive ear canals on examination, changes in hematology, clinical chemistry and urinalysis values consistent with the systemic absorption of topical corticosteroids, and veterinary observations of pale ear canals. Surolan contains polymixin B sulfate, prednisolone acetate, and miconazole nitrate - an antibiotoc, an anti-inflammatory steroid, and an antifungal. Inactive ingredients are colloidal silicon dioxide and liquid paraffin. Foreign market experience: the following adverse events were reported voluntarily during post-approval use of the product in foreign markets: deafness, reduced hearing, topical hypersensitivity reactions and red blisters on pinna. At the end of treatment, this dog had normal hearing as assessed by the investigator. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Keep this and all drugs out of reach of children. capillaries and vascular proliferation and from the inhibition of the
Never run out of what your pet needs the most when you sign up for AutoShip. 5. Therapy should continue for 7 consecutive days. including polymyxin B, miconazole and prednisolone. The hair around and on lesion should be clipped at the start of
Avoid getting this medication in your pet's eyes, nose or mouth. Shake well before use. 1 BOTTLE, WITH APPLICATOR (BOTTLE) in 1 BOX. Clinical evaluations of otitis externa included pain/discomfort, swelling, redness, and exudate. She has just been examined by the vet . Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 4 drops per ear for dogs < 30 lbs. 6. Other side effects may also occur. Surolan is available in 15 mL and 30 mL plastic dispensing bottles with applicator tip for otic use. The inflammation is cleared up and the constant itching. Of 337 dogs enrolled in the field study, 176 dogs were included in the effectiveness database; 91 were treated with SUROLAN and 85 were treated with an FDA-approved active control. B-2340 Beerse What is Surolan? We comply with the HONcode standard for trustworthy health information. Store Surolan Otic Suspension at or below 77 F. Apply the missed dose as soon as you remember. The usual dose for dogs of any weight is 5 drops placed into the ear canal 2 times a day and massage the ear. However, if it is almost time for the next dose, skip the dose you missed and apply the next regularly scheduled dose. A non-inferiority evaluation was used to compare SUROLAN with the active control with respect to each clinical sign of otitis externa and overall clinical improvement. Prevention that's tough on fleas & ticks. Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. DOSAGE AND ADMINISTRATION . At the end of treatment, this dog had normal hearing as assessed by the investigator. Ear Care Otic Suspension for Dogs and Cats - 15 ml Ear Drops and Cutaneous Suspension.
Surolan Ear drops for dogs and cats 15mL / gocce auricolari per cani e The following adverse reactions were reported in a study when SUROLAN was administered at 1X, 3X and 5X for 42 consecutive days (6 times the recommended treatment duration) in laboratory Beagles: hypersensitivity reactions which included mild erythema and hyperemia, painful and sensitive ear canals on examination, changes in hematology, clinical chemistry and urinalysis values consistent with the systemic absorption of topical corticosteroids, and veterinary observations of pale ear canals. it goes in the dogs ears & was much cheaper than at the vets. Side effects that may occur include topical sensitivity and reduced hearing or deafness. Zymox Otic Enzymatic Solution for Dogs and Cats to Soothe Ear Infections with 1% Hydrocortisone for Itch Relief, 1.25oz. otitis externa and dermatitis in dogs. It soothes itching while it treats infections caused by yeast, fungi and gram-positive and gram-negative bacteria.
Cat shakes head after ear drops | TheCatSite Instill 5 drops of Surolan in the ear canal twice daily and massage the ear. This product has helped our golden retriever with ear infections. Proudly sourced directly from the manufacturer or their approved distributor. Do not use in dogs with a perforated ear drum.
Surolan antibiotic ear drops for dogs and cats 15 ml - My Blog by or on the order of a She is in a daily dose which the vet says is safe. Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Four dogs vomited during treatment, 1 dog showed red pustules on the pinna and head shaking was observed in another dog. CONTRAINDICATIONS SUROLAN is contraindicated in dogs with suspected or known hypersensitivity to miconazole nitrate, polymyxin B sulfate, or prednisolone acetate.
Surolan Ear Drops for Cats & Dogs 15ml - dogtor.vet Wash hands after use. Surolan is contraindicated in dogs with suspected or known hypersensitivity to miconazole nitrate, polymyxin B sulfate, or prednisolone acetate. Surolan Otic Suspension is used to treat otitis externa and dermatitis in dogs caused by yeasts, fungi, bacteria and ear mites. Miconazole nitrate is a synthetic imidazole derivative with antifungal activity and antibacterial activity against Gram-positive bacteria. This item requires prescription approval. known to be a potential ototoxic agent.
Surolan: Package Insert - Drugs.com The anti-inflammatory action of
Surolan is a combination of medications with antibacterial, anti-inflammatory, and antifungal properties. Both times they gave me Surolan drops-the moment her 10 days of those drops were done she started scratching again. We require a valid written veterinary prescription prior to dispatch. Dosage: For 5-15 lbs, use 4-5 drops in each ear daily for 7-10 days; For 15-30 lbs, use 5-10 drops; For over 30 lbs, use 10-15 drops. administered more comfortably and precisely to infected ears because it
The safe use of Surolan in dogs used for breeding purposes, during pregnancy, or in lactating bitches has not been evaluated. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Treat twice daily until symptoms subside, or until infecting organism is completely eradicated as indicated by appropriate clinical or laboratory examination. Ordered Friday, Delivered Sunday! This product worked for me. Avoid getting this medication in your pet's eyes, nose or mouth. I am very satisfied with the surolan and Piddles is too. Not for use in humans.
SUROLAN (miconazole nitrate, polymyxin B sulfate - Chewy.com Mean Percentage of Improvement in Clinical Signs of Otitis Externa, miconazole nitrate, polymyxin b sulfate, prednisolone acetate solution/ drops. Table 1. The safe use of SUROLAN in dogs used for breeding purposes, during pregnancy, or in lactating bitches, has not been evaluated. The owner of another dog reported that on day 4 of treatment, build-up of the medication decreased the dogs hearing. 8 drops per ear for dogs = or > 30 lbs. History: She had a bad ear infection and got Surolan ear drops prescribed for two weeks. 75% of respondents would recommend this to a friend. Do not allow the suspension to get into your pet's eyes or mouth. Miconazole nitrate is a synthetic imidazole derivative with antifungal activity and antibacterial activity against Gram-positive bacteria. Resistance is a major concern when using antibiotics and antifungals. What does it mean to be a .Pharmacy-Verified Website? Gram-negative bacteria Escherichia coli and Pseudomonas aeruginosa. antifungal activity and a potent activity against Gram-positive
This formulation gives Surolan broad effectiveness against the pathogens that
The usual dose for dogs of any weight is 5 drops placed into the ear canal 2 times a day and massage the ear. The anti-inflammatory and antipruritic properties of prednisolone are well-known. licensed veterinarian. Polymyxin B sulfate is a polypeptide antibiotic with bactericidal activity against Gram-negative bacteria. Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Corticosteroids may produce irreversible effects in the skin. 5500 IU (= 0.696 mg). The vet prescribed an ear drop called Surolan, and applied it for him. Membranes of the liposomes are stabilized against
Instill 3-5 drops twice daily for 7consecutive days. For treatment of ear mites in dogs and cats over 12 weeks of age. The compatibility and additive effect of each of the components in SUROLAN was demonstrated in a component effectiveness and non-interference study. Instill 5 drops of SUROLAN in the ear canal twice daily and massage the ear. For great pet advice and healthcare tips, check out our blog, written by our very own vets, on all things furry, feathery and scaly.
We had gotten a prescription from our vet for his infected ears. Surolan is contraindicated in dogs with suspected or known hypersensitivity to miconazole nitrate, polymyxin B sulfate, or prednisolone acetate. Surolan is a prescription ear medication for dogs or cats that treats otitis externa, outer ear infection, caused by yeast and bacteria. Is it important for my dog or cat to finish all of the Surolan? Moreover, synergistic effects between miconazole nitrate and polymyxin B sulfate have been demonstrated in an in vitro study(1). The external ear should be thoroughly cleaned and dried before the initiation of treatment. This is a POM-V Product (Prescription Only Medication-Veterinary). Save 35% on first AutoShip with code SAVE35, This number represents the amount of PetMeds Points you will receive by purchasing this item. fibroblast action. non-staining and causes no irritation or toxic effects when applied topically. Delivery fee as low as 1 on most orders, or take advantage of our FREE local 'Click & Collect' service. When her ears are bothering her she will come and sit at my feet with her head tilted to the side of the problem ear. The external ear should be thoroughly cleaned and dried before the initiation of treatment. Shop Now. If your dog or cat has been diagnosed with otitis externa or an ear infection, your veterinarian may prescribe a suspension such as Surolan. Ear mites; Otodectes cynotis; Surolan also has anti-inflammatory and antipruritic activity. Instill 5 drops of Surolan in the ear canal twice daily and massage the ear.
Surolan Ear Drops for Cats and Dogs | The PharmPet Co Malassezia pachydermatis and Staphylococcus pseudintermedius were identified pre-treatment in at least 10 cases that were clinically responsive to Surolan. Always consult a veterinarian about your pets health needs. Do not use in dogs with known perforated tympanum. Clean and dry the ears before application. See the Terms of Use for further details. Symptoms may improve before the infection is completely healed. Some cats may not allow you to do this. Be the first to know. Surolan petmeds are effective against infections caused by yeast, fungi, and gram-positive and gram-negative bacteria. SUROLAN is contraindicated in dogs with suspected or known hypersensitivity to miconazole nitrate, polymyxin B sulfate, or prednisolone acetate. Made me feel like I was more than just a customer.
Surolan Ear Drops for Dogs & Cats - VioVet There are numerous products containing Tris-EDTA: TrizEDTA (Dechra), TrizUltra + Keto (with ketoconazole) (Dechra), TrizChlor (with chlorhexidine) (Dechra), Mal-A-Ket Plus TrizEDTA Flush (with ketoconazole and chlorhexidine) (Dechra), and T8 Keto (with ketoconazole) (Bayer). If you do not understand these directions ask your pharmacist or veterinarian to explain them to you. An overdose of Surolan Otic Suspension is unlikely to occur. Verify that the eardrum is intact. How does Surolan Otic Suspension, 15 mL work? Some exclusions apply. Residue build-up was noted in 1 dog. This results in lysis of the bacteria. wounds is negligible. His allergies are the biggest cause. Package information is not reviewed or updated separately by VetLabel.com. bacteria. Schedule, update or cancel anytime, Reliable Keep this and all drugs out of reach of children. Shake well before use. Press the space key then arrow keys to make a selection.
Amazon.ca: Surolan Ear Drops For Dogs In the field study, 161 dogs treated with SUROLAN were included in the safety database. Generic name: miconazole nitrate, polymyxin b sulfate, and prednisolone acetate and . You will not be disappointed!! If overgrowth of non-susceptible bacteria or fungi occurs, treatment should be discontinued and appropriate therapy instituted. * Excludes AK, HI, and PR shipping addresses. Avoid contact with eyes since irritation may result. 1 Van Cutsem JM, Thienpont D. Miconazole, a broad spectrum antimycotic agent with antibacterial activity. Surolan is dispensed as drops to
minimal.
Surolan Otic Suspension 15ml | On Sale | EntirelyPets Rx This was given to my dog who had an ear infection, she lost her hearing. junction with longterm depot formation in the upper epidermal layers without
Topical and otic antifungal, antibacterial and anti-inflammatory for dogs and cats. I do find that I have to use it twice daily for at least week however, other dogs may not need it that long. That's pretty fast service!!!! Tell your veterinarian if your pet has ever had an allergic reaction to this medication or any of the individual ingredients. Are you sure you want to add just 1 tablet to your cart, or would you like to change the quantity? All Rights Reserved. Verify that the eardrum is intact. I've tried many ear medications and Surolan has been the only product that has provided relief.
PDF Surolan Ear Drops and Cutaneous Suspension - Evans Pharmacy A non-inferiority evaluation was used to compare SUROLAN with the active control with respect to each clinical sign of otitis externa and overall clinical improvement. For otic use only. SUROLAN was determined to be non-inferior to treatment with the active control for otitis externa. View Manufacturer and/or Label Information: Happy Jack Mitex It is used for the treatment of otitis externa caused by: Gram-positive bacteria e.g. Now he's doing a lot better. Two dogs experienced reduced hearing at the end of treatment; on follow-up one dog had normal hearing capacity while the other case was lost for follow-up. Prednisolone
To check the most up to date information about this product, please read its Summary of Product Characteristics (SPC). Massage the ear and the auditory canal gently but thoroughly to ensure proper distribution. The compatibility and additive effect of each of the components in SUROLAN was demonstrated in a component effectiveness and non-interference study. 5 Hariharan H, McPhee L, Heaney S, Bryenton J. Antimicrobial drug susceptibility of clinical isolates of Pseudomonas aeruginosa. By virtue of its 3 active ingredients, Surolan has antibacterial, antifungal, and anti-inflammatory activity. Be cautious and calm. Apply this medication exactly as directed by your veterinarian.
Surolan Otic Suspension 15 mL for dogs | Buy Surolan ear drops Cancel or update at anytime. Skin: Ensure the wound is well covered with Surolan and rub into the wound with a gloved hand. My dog lost his hearing after this medication!!! Worked perfect to clear up charleighs ear!
Chemotherapy 1972;17:392-404. bactericidal activity against Gram-negative bacteria. The safe use of Surolan in animals used for breeding purposes, during pregnancy, or in lactating animals, has not been evaluated. Special precautions to be taken by the person administering the product to animals. (miconazole nitrate, polymyxin B sulfate, prednisolone acetate), Antifungal, antibacterial and anti-inflammatory wound with a gloved hand. 800+ bought in past week. * Certain products or categories may not be eligible for the discount. Of 337 dogs enrolled in the field study, 176 dogs were included in the effectiveness database; 91 were treated with SUROLAN and 85 were treated with an FDA-approved active control. This is my Go To for everything from now on!
SUROLAN- miconazole nitrate, polymyxin b sulfate and prednisolone acetate solution/ dropsElanco US Inc. Antifungal, antibacterial and anti-inflammatory. Shake well before use. Surolan is an ear drop suspension for the topical treatment of ear infections in cats and dogs. Surolan is appropriate for treating disease conditions such as: otitis externa in dogs By virtue of its 3 active ingredients, SUROLAN has antibacterial, antifungal, and anti-inflammatory activity. Weight. Surolan Otic Suspension is used to treat otitis externa and dermatitis in dogs caused by yeasts, fungi, bacteria and ear mites.
Gentamicin, Otomax, Mometamax, GenOne - Pet, Dog and Cat Medication and SUROLAN was determined to be non-inferior to treatment with the active control for otitis externa. Keep this and all drugs out of reach of children. Chemotherapy 1983;29:419-27. Before instilling any medication into the ear, examine the external ear canal thoroughly to be certain the tympanic membranes are not ruptured. Excretion is almost completely via the kidneys. Unfortunately, our rascal got a hold of the bottle and chewed them up. Other side effects and reactions may occur. Our database mirrors the FDA's central repository of drug labels and package inserts under the Structured Product Labeling standard. Do not use in dogs with known perforated tympanum. General hygienic measures aid in the control of infection and prevent reinfection. Care should be taken as some canine and feline fungal infections are transmissible to humans. Body weight: 31 kg. cytoplasmic membrane, whereby the membrane permeability is disturbed. otitis externa and dermatitis caused by: Surolan also has anti-inflammatory and antipruritic activity. The product is applied topically. If overgrowth of non-susceptible bacteria or fungi occurs, treatment should be discontinued and appropriate therapy instituted. The external ear should be thoroughly cleaned and dried before the initiation of treatment.