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Necrotizing external otitis treated with ciprofloxacin. A case report
F Sabater1, J Mensa, J Doménech
1Dept. of Otolaryngology, Hospital Clínic of Barcelona.
Abstract:
Necrotizing (malignant) external otitis is a severe infection caused by Pseudomonas aeruginosa which occurs mainly in elderly diabetics or in immuno-depressed patients (Chandler, 1968). The management of this condition requires the association between an aminoglycoside antibiotic and an antipseudomonal beta-lactamic, given parenterally during a 4 to 6 week period. Sometimes it is necessary to continue the therapy for months until there is no evidence of residual disease (Strauss et al., 1982). Ciprofloxacin is a quinolone with antipseudomonal activity which can be taken orally, and it is a useful alternative to the current treatment. The authors report a case of necrotizing external otitis which was successfully treated with ciprofloxacin.
Insights
Necrotizing external otitis, a severe Pseudomonas aeruginosa infection, typically requires prolonged intravenous antibiotics. Oral ciprofloxacin offers a successful alternative treatment for this condition.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Pharmacology
Background:
- Necrotizing external otitis is a severe Pseudomonas aeruginosa infection primarily affecting elderly diabetics and immunocompromised individuals.
- Standard treatment involves prolonged parenteral administration of an aminoglycoside and an antipseudomonal beta-lactam antibiotic.
- Therapy duration can extend for months to ensure complete disease resolution.
Observation:
- This study reports a case of necrotizing external otitis.
- The patient presented with symptoms indicative of this severe infection.
Findings:
- Successful treatment of necrotizing external otitis was achieved using oral ciprofloxacin.
- Ciprofloxacin, a quinolone with antipseudomonal activity, demonstrated efficacy in this case.
Implications:
- Oral ciprofloxacin presents a viable and potentially more convenient alternative to traditional intravenous therapies for necrotizing external otitis.
- This finding may influence future treatment guidelines for this serious infection, particularly for patients who can tolerate oral medication.