tetracycline and Otitis-Externa

Topics: Acute Disease; Anti-Bacterial Agents; Bacitracin; Bronchitis; Chloramphenicol; Chronic Disease; Ear Diseases; Humans; Labyrinth Diseases; Laryngitis; Neomycin; Novobiocin; Otitis Externa; Otitis Media; Penicillins; Pneumococcal Infections; Polymyxins; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Tonsillitis; Tracheal Diseases

A new preparation containing clobetasol propionate, tetracycline and nystatin was compared with Otosporin in the the treatment of otitis externa. Thirty-two patients with bilateral disease and seventeen with unilateral disease completed the trial. Signs and symptoms were assessed by the clinician initially and at varying times after treatment. Both preparations were effective in relieving the symptoms with the majority of patients noticing improvement within seven days. Clobetasol propionate ear drops were significantly better than Otosporin when assessed on the patient's last visit to the hospital (p less than 0.05). There were less relapses in the clobetasol propionate group than in the Otosporin group.

Topics: Adolescent; Adult; Aged; Betamethasone; Child; Clinical Trials as Topic; Clobetasol; Double-Blind Method; Drug Combinations; Female; Humans; Hydrocortisone; Male; Middle Aged; Neomycin; Nystatin; Otitis Externa; Polymyxins; Random Allocation; Tetracycline

Tetracyclines are less cytotoxic to tympanic membrane (TM) fibroblasts than quinolones.. Use of quinolone ear drops after tympanostomy tube placement and for acute otitis externa has been linked to an increased risk of TM perforation. This has been verified in animal models. Cell culture studies have shown quinolones to be highly toxic to TM fibroblasts. Tetracyclines are a potential alternative to quinolones as they have been used to treat acute otitis externa and are thought to be nontoxic to the inner ear. We aimed to determine if tetracyclines are cytotoxic to TM fibroblasts.. Human TM fibroblasts were treated with 1:10 dilutions of ofloxacin 0.3%, ciprofloxacin 0.3%, doxycycline 0.3 and 0.5%, minocycline 0.3 and 0.5%, tetracycline 0.3 and 0.5%, or dilute HCl (control), twice within 24 hours or four times within 48 hours. After 2 hours of treatment, cells were returned to growth media. Cells were observed with phase-contrast microscopy until cytotoxicity was measured.. Fibroblasts had lower survival with ciprofloxacin 0.3% and doxycycline 0.5% treatment compared with the control after 24 and 48 hours (all p < 0.0001). Fibroblasts treated with minocycline 0.5% had increased cell survival after 24 hours. Minocycline 0.3 and 0.5% showed increased TM fibroblast survival after 48 hours (all p < 0.0001). Phase-contrast images mirrored the cytotoxicity findings.. Tetracyclines are less toxic to cultured TM fibroblasts than ciprofloxacin. Fibroblast tetracycline toxicity is drug and dose specific. Minocycline shows the most promise for possible otic applications in which fibroblast toxicity is a concern.

Topics: Animals; Anti-Bacterial Agents; Ciprofloxacin; Doxycycline; Fibroblasts; Humans; Minocycline; Otitis Externa; Quinolones; Tetracycline; Tympanic Membrane

Methicillin-resistant Staphylococcus aureus (MRSA) is causing growing concern in hospitals. There has been a steady increase in the number of cases of nosocomial MRSA infections recently and this will no doubt apply to otitis externa, one of the most common ENT infections. The total number of cases of otitis externa presenting to the Accident and Emergency Department over a 3-month period was recorded and the offending microbes cultured and tested for drug sensitivities. Although Pseudomonas aeruginosa was the most frequent organism, 30% of patients grew S. aureus. Of these, 6% (15 patients) were MRSA cultures. The contact histories, antibiotic sensitivities and treatment of these 15 patients were studied. Recommendations as a result of this study include the routine culture and sensitivity in otitis externa and where MRSA is cultured, a full contact history should be elicited and appropriate precautions taken. Specifically, a history of hospital contact should be sought. Treatments used successfully in the treatment of MRSA otitis externa were aural toilet and fucidic acid-betamathasone 0.5% wicks where the organism was gentamycin-resistant (GMRSA), whereas aural toilet with aminoglycoside-steroid drops was sufficient if it was gentamycin-sensitive.

Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Female; Gentamicins; Humans; Methicillin Resistance; Microbial Sensitivity Tests; Middle Aged; Otitis Externa; Staphylococcal Infections; Staphylococcus aureus; Teicoplanin; Tetracycline

Topics: Administration, Oral; Cephaloridine; Child; Child, Preschool; Chloramphenicol; Dosage Forms; Erythromycin; Female; Furunculosis; Humans; Infant; Male; Microbial Sensitivity Tests; Nose Diseases; Otitis Externa; Otitis Media; Penicillin G; Sinusitis; Staphylococcus; Streptococcus pneumoniae; Streptomycin; Tetracycline; Tonsillitis

Topics: Ampicillin; Anti-Bacterial Agents; Humans; Otitis Externa; Otitis Media; Otorhinolaryngologic Diseases; Penicillins; Sinusitis; Tetracycline; Tonsillitis

Topics: Ampicillin; Baths; Cross Infection; Female; Humans; Iatrogenic Disease; Infant Care; Infant, Newborn; Infant, Newborn, Diseases; Otitis Externa; Otitis Media; Penicillins; Pregnancy; Pseudomonas aeruginosa; Pseudomonas Infections; Steroids; Sweden; Tetracycline

Topics: Anti-Bacterial Agents; Bacteria; Bacteriological Techniques; Biomedical Research; Chloramphenicol; Humans; Neomycin; Otitis Externa; Polymyxins; Pseudomonas Infections; Staphylococcal Infections; Tetracycline