colistin and Otitis-Media--Suppurative

In chronic otitis, the use of ear drops has certain advantages over the use of systemic antibiotics. The choice of ear drop depends on the condition of the eardrum, microbial pathogens present and the efficacy of the components of the ear drop. Ototoxicity, contact allergy and the development of bacterial resistance have to be taken into account. Ototoxicity is a rare complication of the application of ear drops, most often described when aminoglycosides were applied. Contact allergy is also most often seen in aminoglycoside-containing eardrops. Evaluation of ear swabs demonstrated a 5% resistance of Pseudomonas aeruginosa to ciprofloxacin. The appearance of resistant strains may impede systemic use of fluoroquinolones. Therefore, this class of antibiotics should be considered as reserve medication only. The first choice in local application of antiseptics in case of an open eardrum is aluminium acetotartrate 1.2% and, of a combination preparation, bacitracin-colistin-hydrocortisone. In case of a closed eardrum (external otitis) aluminium acetotartrate 12%--combination preparations with corticosteroids are advised against in these cases.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Bacitracin; Chronic Disease; Colistin; Drug Therapy, Combination; Ear, External; Humans; Hydrocortisone; Netherlands; Otitis Media, Suppurative; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Tartrates

Topics: Achromobacter; Anti-Bacterial Agents; Chronic Disease; Colistin; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacterial Infections; Humans; Middle Aged; Otitis Media, Suppurative

Topics: Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Amoxicillin-Potassium Clavulanate Combination; Bacitracin; Bacterial Infections; Child, Preschool; Colistin; Germany; Humans; Hydrocortisone; Middle Ear Ventilation; Otitis Media, Suppurative; Postoperative Complications; Randomized Controlled Trials as Topic

Antibiotic therapy with colbiocin of chronic purulent mesotympanitis achieved a response rate of 92%, recurrence-free interval reached 6 months in 84% of the treated patients. This allows to recommend colbiocin as a drug of choice in hospital and outpatient treatment of chronic purulent mesotympanitis.

Topics: Chloramphenicol; Chronic Disease; Colistin; Drug Therapy, Combination; Humans; Otitis Media, Suppurative; Tetracycline