Effective Inexpensive Management of Necrotizing Otitis Externa Is Possible in Resource-Poor Settings

Area of Science:

• Otolaryngology
• Infectious Diseases
• Medical Protocols

Background:

• Necrotizing otitis externa (NOE) requires effective antimicrobial treatment.
• Patient management and resolution monitoring for NOE present challenges.
• A specific protocol developed in Bangalore offers an inexpensive and effective management solution.

Purpose of the Study:

• To evaluate the efficacy of a novel management protocol for necrotizing otitis externa.
• To establish reliable indicators for monitoring NOE resolution.
• To present a cost-effective model for NOE management applicable in resource-limited settings.

Main Methods:

• Patients with NOE were managed using a protocol involving IV ciprofloxacin and meropenem.
• Weekly laboratory tests, physical examinations, and photographic documentation were conducted.
• Patient-reported outcomes and clinical signs were systematically recorded.

Main Results:

• Forty-six out of fifty-one patients achieved complete resolution of NOE.
• Five patients required surgical removal of necrotic bone.
• Improvement in facial nerve function and reduction in pain and inflammation were observed; normalized ESR was a key indicator.

Conclusions:

• Close patient monitoring, including pain assessment, otoscopic examination, ESR, diabetes control, and imaging, is crucial for NOE management.
• The Bangalore protocol demonstrates successful NOE treatment in a resource-poor setting.
• This protocol can serve as a model for managing NOE in diverse healthcare environments.