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Progressive necrotizing external otitis: treatment with ticarcillin and tobramycin
The Laryngoscope
|November 1, 1977
Summary
Necrotizing external otitis can progress despite standard treatments, affecting cranial nerves. Investigational antibiotics, ticarcillin and tobramycin, successfully resolved a severe Pseudomonas aeruginosa infection.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Necrotizing external otitis (NEO) is a severe infection of the external ear canal.
- It can progress to involve deeper structures and cranial nerves, posing a significant management challenge.
Observation:
- A case of progressive NEO with facial paralysis is presented.
- The infection involved cranial nerves IX and X, indicating extensive disease spread.
- Pseudomonas aeruginosa demonstrated resistance to standard antibiotics like carbenicillin and gentamicin.
Findings:
- Standard medical and surgical treatments were insufficient to halt disease progression.
- Near-toxic blood levels of conventional antibiotics were required for minimal efficacy.
- Investigational antibiotics, ticarcillin and tobramycin, were successfully employed to eradicate the infection.
Implications:
- This case highlights the potential for severe NEO to resist conventional therapies.
- The successful use of ticarcillin and tobramycin suggests their potential role in managing refractory NEO.
- Further research into novel antibiotic strategies for resistant Pseudomonas aeruginosa in NEO is warranted.