Zymox Otic Plus Alternative: Why Vetified Is the Steroid-Free Choice

By Emiel Maddens  ·  Reviewed in consultation with licensed veterinary professionals  ·  Updated April 2026  ·  8 min read

Photo by Tima Miroshnichenko on Pexels

Zymox is one of the most recognizable ear care brands in the U.S. pet market. Its enzymatic approach has a loyal customer base, and the "Otic Plus" formulation sold in most retail channels contains hydrocortisone for rapid inflammation control. That steroid is also the reason a growing number of owners are looking for a steroid-free alternative, either because their dog cannot tolerate topical corticosteroids, their veterinarian has advised against chronic steroid exposure, or because they want an active-ingredient approach that treats the infection itself rather than suppressing the inflammatory response.

Vetified Ear Cleaner & Infection Relief was formulated specifically for that need. This page walks through the direct ingredient-by-ingredient comparison, the clinical rationale for each active, and the cases where one approach is preferable to the other.

Ingredient Comparison: Side-by-Side

2-in-1 Formula: One Bottle for Maintenance AND Infection Relief

One of the most practical differences between Vetified and Zymox is how the product fits into your routine. Zymox Otic Plus is a treatment-only formulation, you stop using it once the infection resolves, and you still need a separate cleaner for weekly or monthly maintenance. Vetified Ear Cleaner & Infection Relief is built to do both jobs in a single bottle.

For active infections: Apply twice daily for 7 days, then once daily for another 7 to 10 days, following the full dog ear infection treatment protocol. The 0.2% chlorhexidine and 0.2% ketoconazole combination delivers direct antimicrobial action against both yeast and bacteria.

For ongoing maintenance: Use 1 to 2 times weekly (weekly for floppy-eared breeds, after swimming, or for dogs with a history of recurrent otitis; every 2 to 4 weeks for low-risk breeds). The same formulation that clears infections also prevents them by maintaining the antimicrobial environment in the canal, removing wax accumulation, and keeping yeast and bacterial populations below the threshold where they produce symptoms.

The 12 fl oz (355 mL) bottle is 3× the typical size of treatment-only products, which is deliberate, sustained maintenance use requires meaningful volume. A single Vetified bottle covers roughly 6 months of twice-weekly maintenance for a medium-sized dog, or the full 21-day treatment course for an active infection plus 3 to 4 months of follow-on maintenance to prevent relapse.

Why Steroid-Free Matters for Dog Ear Infections

Hydrocortisone is a topical corticosteroid that suppresses the local inflammatory response. In the ear canal, this produces rapid visible improvement: redness fades, swelling reduces, and itching stops within 24 to 48 hours. Owners reasonably interpret this as the product "working." The complication is that hydrocortisone does not kill yeast or bacteria, it simply turns off the immune system's response to them. The yeast and bacterial populations can continue to grow while the dog appears better.

When the steroid is stopped, the suppressed inflammatory response reactivates against whatever pathogen load remains, and symptoms often rebound rapidly. For dogs with chronic or recurrent otitis, repeated hydrocortisone exposure also carries documented downsides: thinning of the canal epithelium, suppression of local immune defenses, and in some cases systemic absorption with measurable effects on adrenal cortisol production (Ghubash et al., 2004).

The steroid-free approach, relying on direct antimicrobial action from chlorhexidine and ketoconazole, treats the infection at the cause. Inflammation resolves naturally as the pathogen load drops. This takes slightly longer to show visible improvement (typically 2 to 3 days rather than 24 hours) but does not mask ongoing infection and does not carry the cumulative steroid-exposure concerns for chronic-use dogs.

When Vetified Is the Better Choice

• Chronic or recurrent otitis, dogs with 3+ ear infections per year should avoid cumulative topical steroid exposure
• Concurrent steroid therapy, dogs already on oral Apoquel, prednisone, or other systemic corticosteroids for allergies
• Diabetic dogs, topical steroids can complicate glucose control
• Owners who want a single product that cleans and treats simultaneously (no separate cleaner needed)
• Cases where the underlying infection matters, if you want to know whether the infection is truly resolving, you need a formulation that isn't masking it
• Value conscious, 3× the volume per bottle at comparable pricing

When Zymox May Be Appropriate

• Severe acute inflammation where rapid symptom relief is the primary clinical priority
• Owners who prefer an enzymatic rather than active-pharmaceutical approach
• First-episode mild otitis under veterinary direction

Clinical Evidence for Chlorhexidine + Ketoconazole

The combination of chlorhexidine and ketoconazole has been studied extensively in canine dermatology. Chlorhexidine gluconate at 0.2% demonstrates reliable antibacterial activity against Staphylococcus pseudintermedius, methicillin-resistant staph strains, and many Pseudomonas isolates (Young et al., 2012). Ketoconazole at 0.2% is effective against Malassezia pachydermatis, the yeast organism responsible for the vast majority of canine ear infections (Bond et al., 2010). Because most chronic canine otitis involves mixed yeast and bacterial populations, dual-agent therapy substantially outperforms single-agent approaches in clinical practice.

For the full evidence base and treatment protocol, see our dog ear infection treatment guide and chlorhexidine in veterinary medicine overview.

Frequently Asked Questions

Related Resources

• Dog Ear Infection Treatment: Complete Guide
• Canine Ear Infections (Otitis): Clinical Overview
• Yeast Infections in Dog Ears: Malassezia Guide
• Chlorhexidine in Veterinary Medicine
• Ketoconazole Mechanism of Action
• Chronic Ear Infections: Underlying Drivers

References

1. Young R, Buckley L, McEwan N, Nuttall T. "Comparative in vitro efficacy of antimicrobial shampoos: a pilot study." Veterinary Dermatology. 2012;23(1):36-e8. doi: 10.1111/j.1365-3164.2011.00992.x
2. Bond R, Guillot J, Cabañes FJ. "Malassezia yeasts in animal disease." Malassezia and the Skin. Springer. 2010:271-299. doi: 10.1007/978-3-642-03616-3_10
3. Ghubash R, Marsella R, Kunkle G. "Evaluation of adrenal function in small-breed dogs receiving otic glucocorticoids." Veterinary Dermatology. 2004;15(6):363-368. doi: 10.1111/j.1365-3164.2004.00410.x
4. Nuttall T, Cole LK. "Evidence-based veterinary dermatology: a systematic review of interventions for treatment of Pseudomonas otitis in dogs." Veterinary Dermatology. 2007;18(2):69-77.
5. Saridomichelakis MN, Farmaki R, Leontides LS, Koutinas AF. "Aetiology of canine otitis externa: a retrospective study of 100 cases." Veterinary Dermatology. 2007;18(5):341-347.

Emiel Maddens

Founder of Vetified. Develops topical antifungal and antimicrobial formulations for companion animals. Vetified products are listed on DailyMed and manufactured through FDA-registered facilities in the United States.

Veterinary review: All Vetified content is developed in consultation with licensed veterinary professionals and references peer-reviewed research published in journals including Veterinary Dermatology, JAVMA, and Journal of Small Animal Practice.