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Treatment of otitis externa with miconazole nitrate. A comparative study involving 85 cases
Abstract:
The hazards of neomycin in local preparations have recently been re-emphasized. Eighty-five patients with otitis externa were treated with one of two preparations between August 1980 and April 1982 -- 54 were treated with a cream containing miconazole nitrate and hydrocortisone (Daktacort; Janssen) and 31 with a preparation containing neomycin (Kenacomb; Squibb); Sixty eight per cent of the patients were cured within 1 week with both preparations. Most treatment failures were due to a resistant Pseudomonas aeruginosa. The miconazole cream proved as effective as the preparation containing neomycin in the first-line treatment of otitis externa. A gentamicin-containing steroid ointment was effective against the Pseudomonas infection.
Insights
Miconazole cream and neomycin preparations effectively treated otitis externa, with similar cure rates. Gentamicin proved effective against resistant Pseudomonas aeruginosa infections.
Area of Science:
- Otolaryngology
- Dermatology
- Infectious Diseases
Background:
- Neomycin's local preparation hazards are a growing concern.
- Otitis externa is a common ear infection requiring effective treatment.
Purpose of the Study:
- To compare the efficacy of miconazole nitrate/hydrocortisone cream versus a neomycin-containing preparation for otitis externa.
- To assess treatment outcomes and identify resistance patterns.
Main Methods:
- A clinical study involving 85 patients with otitis externa.
- Patients received either miconazole/hydrocortisone cream or a neomycin preparation.
- Treatment outcomes were monitored for cure rates and failure causes.
Main Results:
- Both preparations achieved a 68% cure rate within one week.
- Treatment failures were primarily linked to resistant Pseudomonas aeruginosa.
- Miconazole cream demonstrated comparable efficacy to neomycin for initial otitis externa treatment.
Conclusions:
- Miconazole cream is a viable alternative to neomycin for otitis externa.
- Gentamicin-containing ointments are effective against Pseudomonas-related ear infections.
- Careful consideration of antibiotic risks and benefits is crucial in topical treatments.