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[Combination effect of fosfomycin otic solution and norfloxacin against chronic otitis media]

Insights

This study found that combining fosfomycin (FOM) and norfloxacin (NFLX) is effective for treating chronic otitis media. The combination therapy demonstrated significant antibacterial activity and clinical improvement with no observed adverse effects.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Chronic otitis media (COM) is a persistent middle ear infection.
  • Effective treatment options for COM, especially those involving bacterial resistance, are crucial.
  • Understanding synergistic antibiotic combinations is key to improving COM management.

Purpose of the Study:

  • To evaluate the efficacy and safety of a combination therapy using fosfomycin (FOM) and norfloxacin (NFLX) for chronic otitis media.
  • To assess the in vitro synergistic activity of FOM and NFLX against common pathogens in COM.
  • To determine the clinical outcomes and microbiological eradication rates of this combination treatment.

Main Methods:

  • In vitro susceptibility testing using fractional inhibitory concentration (FIC) index to determine synergy between FOM and NFLX against Staphylococcus aureus and Pseudomonas aeruginosa.
  • Clinical evaluation of patients with chronic otitis media treated with FOM and NFLX otic solution.
  • Monitoring of clinical improvement, bacteriological eradication, and adverse events.

Main Results:

  • Synergistic activity (FIC index ≤ 0.5) was observed in 66.7% of S. aureus and 80.5% of P. aeruginosa isolates.
  • Clinical efficacy was rated as excellent or good in 72.7% of patients.
  • Bacteriological eradication was achieved in 9 out of 11 patients (81.8%), including 5/6 S. aureus and 4/5 P. aeruginosa.
  • No adverse effects or abnormal laboratory findings were reported.

Conclusions:

  • The combination of fosfomycin (FOM) otic solution and norfloxacin (NFLX) demonstrates significant synergistic activity against key pathogens in chronic otitis media.
  • This combination therapy is effective in achieving clinical improvement and high rates of bacterial eradication in patients with chronic otitis media.
  • The FOM and NFLX combination is a safe and promising therapeutic option for managing chronic otitis media.

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