NECROTIZING EXTERNAL OTITIS - AMINOGLYCOSIDE AND BETA-LACTAM ANTIBIOTIC-TREATMENT COMBINED WITH SURGICAL-TREATMENT

Necrotizing external otitis is a life-threatening condition that still causes therapeutic problems. A retrospective analysis of 22 patients who were all treated with a short standard course of aminoglycoside an d beta-lactam antibiotic with thorough local debridement was carried o ut; 50% (11/22) had diabetes mellitus, and all had a positive culture of Pseudomonas aeruginosa. The frequency of recurrence was 14% (3/22), and 95% (21/22) were eventually cured. The treatment course lasted 17 days on average. Side effects caused by the drug treatment were seen in 14% (3/22), but they were mild and transient consisting of a revers ible increase of the serum creatinine level. It was concluded that the treatment was short, efficient, safe, and as successful as treatment with quinolones or third-generation cephalosporins which has been repo rted during the past years. In our opinion, therefore, these drugs sho uld be reserved for cases of treatment failure, development of resista nce, or side effects.