Moxalactam therapy. Its use in chronic suppurative otitis media and malignant external otitis

Moxalactam disodium is a new broad-spectrum antibiotic structurally related to the cephalosporins. Eleven patients with chronic suppurative otitis media with mastoiditis and four patients with malignant external otitis were treated with moxalactam. Pseudomonas aeruginosa was isolated from external ear or mastoid in all patients. Twelve of 15 patients had undergone prior surgical procedures and 11 of 15 had failed recent antibiotic therapy. Three patients with malignant external otitis did not respond to parenteral carboxypenicillin and aminoglycoside therapy. Success rate for chronic suppurative otitis media was 73% as judged by eradication of P aeruginosa and resolution of symptoms 30 days after moxalactam therapy. Two patients with malignant external otitis were cured, and two were unevaluable since they may have died of noninfectious causes. Moxalactam disodium, at a dosage of 9 g/day, may be useful for serious Pseudomonas ear infections, including those refractory to other antibiotic therapy.