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Ciprofloxacin in the treatment of malignant external otitis
1Otorhinolaryngology Department, Bichat Hospital, Paris, France.
Abstract:
Malignant external otitis is a serious infection most frequently caused by Pseudomonas aeruginosa. Because of its antipseudomonal activity and good tissue penetration, ciprofloxacin is an antibiotic which should, in theory, be effective in the treatment of this type of infection. Publications on the use of ciprofloxacin in the treatment of malignant external otitis are analysed below. This paper analyses 84 clinical case studies collected from 13 publications: ciprofloxacin, administered for the most part orally, was given in a dosage of 750 mg twice daily, apart from three studies where a lower dosage of 500 mg twice daily was used. When the drug was administered parenterally, the dosage was 200 mg b.i.d. In one publication, ciprofloxacin was used in combination with rifampicin. The average duration of treatment was 3 months. Ps. aeruginosa was isolated in 82 patients and sensitivity tests were carried out on 47 strains, none of which was resistant to ciprofloxacin. The clinical cure rate was 96.4% (84 patients). The rate of bacteriological eradication was close to 100% in the 76 evaluable patients. Long-term follow-up (between 2 and 44 months) showed that clinical and bacteriological cure was maintained in all but two patients. Ciprofloxacin thus seems to be a particularly useful antibiotic for the treatment of malignant external otitis, both because of its clinical and bacteriological efficacy and because it is well tolerated.
Insights
Ciprofloxacin effectively treats malignant external otitis, a serious Pseudomonas aeruginosa infection. This antibiotic demonstrates high clinical cure rates and bacteriological eradication, offering a well-tolerated treatment option.
Area of Science:
- Infectious Diseases
- Pharmacology
- Otolaryngology
Background:
- Malignant external otitis is a severe infection, often caused by Pseudomonas aeruginosa.
- Ciprofloxacin possesses antipseudomonal activity and good tissue penetration, suggesting its potential efficacy.
Purpose of the Study:
- To analyze clinical case studies on ciprofloxacin use for malignant external otitis.
- To evaluate the efficacy and tolerability of ciprofloxacin in treating this infection.
Main Methods:
- Analysis of 84 clinical case studies from 13 publications.
- Review of ciprofloxacin dosages (oral 750 mg BID, 500 mg BID; parenteral 200 mg BID) and treatment duration (average 3 months).
- Inclusion of studies using ciprofloxacin with rifampicin and assessment of Pseudomonas aeruginosa sensitivity.
Main Results:
- High clinical cure rate of 96.4% across 84 patients.
- Bacteriological eradication rate near 100% in 76 evaluable patients.
- Long-term follow-up confirmed sustained clinical and bacteriological cure in most patients.
Conclusions:
- Ciprofloxacin is a highly effective antibiotic for malignant external otitis.
- Its clinical and bacteriological efficacy, coupled with good tolerability, makes it a valuable treatment choice.
- The study supports the use of ciprofloxacin in managing this serious infection.