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Relapsing malignant otitis externa successfully treated with ciprofloxacin

Published online by Cambridge University Press:  29 June 2007

G. A. J. Morrison
Affiliation:
(London)
C. M. Bailey*
Affiliation:
(London)
*
The Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, LondonWC1X 8DA.

Abstract

Two cases are presented, both patients with advanced maligant otitis externa.

The antibiotic ciprofloxacin has strong anti-pseudomonal activity. It was given orally for six months to both patients, following administration of the traditional parenteral antibiotic courses, and in each case the disease has been extinguished. We therefore recommend that the management of patients shown to have malignant otitis externa should include strict diabetic control, regular local aural toilet, gentamicin ear drops and a six week course of parenteral antipseudomonal antibiotic agents (usually gentamicin and azlocillin) together with metronidazole to cover any anaerobic element in the infection. This regimen should be followed by a six month course of oral ciprofloxacin (750 mg b. d.). Indium scans should be used to monitor recovery. We believe that this regimen can significantly reduce the morbidity and mortality of patients suffering from malignant otitis externa with cranial nerve involvement.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1988

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References

Babiatzki, A., and Sadé, J. (1987) Malignant external otitis. Journal of Otolaryngology, 101: 205210.Google Scholar
Chandler, J. R. (1968) Malignant external otitis. Laryngoscope, 78: 12571294.Google Scholar
Cheesman, A. D. (1986) Personal communication.Google Scholar
Cohen, D. and Friedman, P. (1987) Diagnostic criteria of malignant external otitis. Journal of Otolaryngology, 101: 216221.Google Scholar
Cohen, D., Friedman, P. and Elion, A. (1987) Malignant external otitis vs acute external otitis. Journal of Otolaryngology, 101: 211215.Google Scholar
Cohn, A. M. (1974) Progressive necrotizing otitis. Archives of Otolaryngology, 99: 136139.Google Scholar
Damiani, J. M., Damiani, K. K., and Kinney, F. E. (1979) Malignant external otitis with multiple cranial nerve involvement. Americal Journal of Otology, 2: 115120.Google Scholar
Garty, I., Rosen, G. and Holdstein, Y. (1985) The radionuclide diagnosis, evaluation and follow up of malignant external otitis. Journal of Laryngology and Otology, 99: 109115.Google Scholar
Haverkof, H. W., Caparosa, R., Uyu, V. L. and Kamerer, D. (1982) Moxalactam therapy-its use in chronic suppurative otitis media and malignant external otitis. Archives of Otolaryngology, 108: 329333.Google Scholar
John, A. C. and Cheesman, A. D. (1979) Malignant otitis externa. Hospital Update, 5: 589599.Google Scholar
Lancet, (1982) Editorial: Necrotising otitis externa. i, p.207.Google Scholar
McShane, D., Chapnik, J. S., Noyek, A. M. and Vellend, H. (1986) Malignant external otitis. Journal of Laryngology and Otology, 15: 108111.Google Scholar
Meltzer, P. E. and Kelmen, G. (1959) Pyocyaneous osteomyelitis of the temporal bone, mandible and zygoma. Laryngoscope, 69: 13001316.Google Scholar
Meyehoff, W. L., Gates, G. A. and Montalbot, P. J. (1977) Pseudomonas mastoiditis. Laryngoscope, 87: 483492.Google Scholar
Raines, J. M. and Schindler, R. A. (1980) The surgical management of recalcitrant malignant external otitis. Laryngoscope, 90: 369378.Google Scholar
Strauss, M., Abber, R. C., Conner, G. H., Baum, S. and Hershey, P. A. (1982) Malignant external otitis, long term (months) antimicrobial therapy. Laryngoscope, 92: 397404.Google Scholar
Toulmouche, M. A. (1838) Observations d'otorrhee cerebrale: suivis des reflexions. Gazette Medicate de Paris, 6: 422426.Google Scholar
Uri, N., Kitzes, R., Meyer, W. and Schuchman, G. (1984) Necrotising external otitis. The importance of prolonged drug therapy. Journal of Laryngology and Otology, 98: 10831085.Google Scholar
Youngs, R. P. and Bagley, J. (1986) Sphenoidal sinusitis secondary to malignant external otitis. Journal of Laryngology and Otology, 100: 341344.Google Scholar