mupirocin and Otitis-Media

To determine whether mupirocin (440 µg/mL) and vancomycin otic drops (25 mg/mL) show evidence of ototoxicity in CBA/J mice immediately following a 7-day course of daily intratympanic (IT) injections and 1 month following treatment.. Nonrandomized controlled trial.. Academic hospital laboratory.. Twenty CBA/J mice.. Mean auditory brainstem response (ABR) thresholds increased in all drug- and saline-treated ears immediately after 7 days of IT injections but returned to baseline for most stimulus frequencies by 30 days later. This finding appeared to be correlated with the presence and subsequent resolution of tympanic membrane (TM) perforations and granulation tissue at the injection sites. Mupirocin-treated ears showed no significant difference in ABR thresholds compared to saline-treated ears. No significant differences were noted between vancomycin- and saline-treated ears, but there was a significant interaction between testing day and stimulus frequency (P < .001). Further analysis revealed that ABR thresholds at 32 kHz remained significantly elevated in vancomycin-treated mice despite the resolution of TM perforations and granulation tissue 30 days after completion of IT injections (95% confidence interval, -13.5 to -5.5, P < .01).. Although IT application of mupirocin solution (440 µg/mL) caused no significant change in the ABR thresholds in a murine model, vancomycin solution (25 mg/mL) resulted in high-frequency threshold elevations in both the ear directly injected and the contralateral ear. Mupirocin solution may be beneficial in managing otitis externa and media caused by resistant pathogens. Further studies of ototopical vancomycin are needed to define parameters governing its safe use.

Topics: Animals; Anti-Bacterial Agents; Evoked Potentials, Auditory, Brain Stem; Female; Granulation Tissue; Injections, Intralesional; Mice; Mice, Inbred CBA; Mupirocin; Otitis Media; Vancomycin

A multiply resistant serotype 23F pneumococcus was cultured from a 3-year-old child with otitis media and five carriers at the child's day-care centre in South Africa. Attempts to eradicate carriage with mupirocin failed. The strains were identical to the Spanish clone of multiply resistant pneumococci by serotype, antimicrobial susceptibility pattern, restriction analysis of the penicillin-binding protein 1A, 2B and 2X genes and by multilocus enzyme electrophoresis. The data suggest that this clone has acquired erythromycin resistance. A possible link between the index case and residence of a family member in Spain was found.

Topics: Adult; Carrier State; Child; Child, Preschool; Cluster Analysis; DNA Fingerprinting; DNA, Bacterial; Drug Resistance, Microbial; Erythromycin; Female; Humans; Infant; Mupirocin; Otitis Media; Pneumococcal Infections; South Africa; Spain; Species Specificity; Streptococcus pneumoniae