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Treatment of Ciprofloxacin-resistant Ear Infections

Kathryn Y Noonan1, Soo Yeon Kim2, Lye Yeng Wong2

  • 1House Ear Clinic.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|September 11, 2018
PubMed
Abstract

Insights

Topical ciprofloxacin is ineffective for treating ciprofloxacin-resistant otologic infections. Alternative therapies, including non-ciprofloxacin drops, significantly improve patient outcomes, demonstrating resistance relevance even with high topical concentrations.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pharmacology

Background:

  • Ciprofloxacin resistance in otorrhea is increasing.
  • Fluoroquinolones are FDA-approved for topical otologic therapy due to ototoxicity concerns with other agents.
  • High topical antibiotic concentrations are often assumed to overcome resistance.

Purpose of the Study:

  • To investigate the effectiveness of ciprofloxacin treatment for ciprofloxacin-resistant otologic infections.
  • To understand treatment options and outcomes for these resistant infections.

Main Methods:

  • Retrospective review of 141 patients with culture-proven ciprofloxacin-resistant otologic infections.
  • Analysis of bacteriology and treatment effectiveness for various antibiotic regimens.

Main Results:

  • Methicillin-resistant Staphylococcus aureus, Corynebacterium striatum, and non-MRSA were the most frequent resistant pathogens.
  • Topical ciprofloxacin monotherapy had a 2.7% success rate, while combined with oral antibiotics it was 64.7%.
  • Non-ciprofloxacin drops achieved a 70% cure rate, significantly outperforming ciprofloxacin drops.

Conclusions:

  • Topical ciprofloxacin is ineffective against ciprofloxacin-resistant bacteria in otologic infections.
  • Alternative therapies, particularly non-ciprofloxacin options, are significantly more effective.
  • High topical concentrations do not overcome antibiotic resistance in these cases.

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