gramicidin-a and Otitis-Media

In a retrospective study of patients who had undergone myringoplasty at our department within a 12-month period, we assessed the graft take rate using tri-adcortyl ointment (TAO) as ear dressing. Data including age, site and size of perforation, grade of surgeon, surgical approach, use of postoperative ear dressings, complications and audiometric outcome was collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at 6 months) was noted. Seventy-seven patients were operated, but data were complete on 64 patients and these constituted the study population. TAO was used in 95% of the patients and BIPP gauze pack in the remaining 5%. Age ranged from 8 to 63 years (mean 34 years). Mean follow-up period was 13 months. Most of the operations (72.88%) were carried out by consultants with a success rate of 89% and the remaining patients were operated by trainees with a success rate of 88% (P = 1.000). The overall success rate was 89, 90.16% for TAO and 66.66% (2 out of 3) for BIPP (P = 0.298), 95% for small and 86% for subtotal perforations (P = 0.573), 85% for anterior and 100% for posterior perforations (P = 0.240), 91% for adult patients and 88% for children (P = 1.000). TAO is a suitable ear dressing in myringoplasty. Routine use of TAO did not affect the success rate of myringoplasty at our centre.

Topics: Adolescent; Adult; Aged; Audiometry; Child; Drug Combinations; Female; Follow-Up Studies; Gramicidin; Hearing; Humans; Male; Middle Aged; Myringoplasty; Neomycin; Nystatin; Occlusive Dressings; Ointments; Otitis Media; Retrospective Studies; Rupture, Spontaneous; Treatment Outcome; Triamcinolone Acetonide; Tympanic Membrane Perforation

A 24-year-old woman suffering from post-influenza otitis media infection was initially treated with several series of a steroid (Elocon) and a combination of steroids and antibiotics (Atecortin, Dicortineff) without significant medical benefit. The isolated bacterial strains were identified as Staphylococcus homis and Staphylococcus epidermidis. Specific phage therapy applied sequentially over a period of three weeks resulted only in a partial reduction in inflammation and limited improvement in overall health condition. Oral application of lactoferrin (LF; 50-mg daily oral doses for seven days with two-week intervals) led to a complete clearance of both bacterial strains and full recovery of the patient. The recovery was associated with increased myelopoiesis and a sustained elevation of serum endogenous LF. In conclusion, specific bacteriophage therapy combined with the administration of lactoferrin proved to be effective in the treatment of antibiotic-resistant external ear infection.

Topics: Adult; Anti-Bacterial Agents; Antiviral Agents; Bacterial Infections; Drug Combinations; Drug Resistance, Bacterial; Drug Therapy, Combination; Female; Fludrocortisone; Gramicidin; Humans; Lactoferrin; Neomycin; Otitis Media; Penicillin G; Staphylococcus epidermidis; Staphylococcus hominis; Treatment Outcome

Topics: Communicable Diseases; Drug Therapy; Ear Diseases; Gramicidin; Humans; Neomycin; Otitis Externa; Otitis Media; Triamcinolone Acetonide; Tyrothricin