Cjw. Vanginkel et al., ALLERGY DUE TO TOPICAL MEDICATIONS IN CHRONIC OTITIS-EXTERNA AND CHRONIC OTITIS-MEDIA, Clinical otolaryngology and allied sciences, 20(4), 1995, pp. 326-328
Thirty-four patients suffering from chronic otorrhoea were tested for
delayed type contact allergy. Patch testing showed a relevant positive
reaction in 19 patients (56%). The most frequent allergens were amino
glycosides with neomycin and framycetin as major offenders. Other anti
microbial agents (clioquinol, polymyxin B), cream bases (lanolin) and
corticosteroids (tixocortol) were less common allergens encountered. T
hese results indicate that it is almost obligatory to perform patch te
sting in any patient with long-standing otitis which does not respond
to local therapy, Scoring of the patch tests has to be extended to 7 d
ays, as notably the aminoglycosides and corticosteroids only become po
sitive after such a long interval. Because of the high risk of sensiti
zation, topical preparations containing neomycin and framycetin should
not be used routinely. We recommend the use of either a topical antis
eptic or a topical antibiotic with low allergenic potential for the in
itial treatment of otorrhoea.