Standardised treatment protocol for necrotizing otitis externa: retrospective case series and systematic literature review

Frost, James; Samson, Anda D.

doi:10.1016/j.jgar.2021.06.015

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…quinolones and Ceftazidime, monotherapy with Ceftazidime, or Piperacillin with Fluoroquinolones. 11 Antimicrobials were changed when indicated by culture (Table 1). Pseudomonas aeruginosa was the usual organism cultured (34%), followed by fungus (21%).…”

Section: Discussionmentioning

confidence: 99%

Role of surgery along with antimicrobials in refractory skull base osteomyelitis—A prospective observational study

Faizal,

Nair,

Pavithran

et al. 2024

Clinical Otolaryngology

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IntroductionStudy aimed to ole of surgery along with antimicrobials to improve clinical outcomes in treating refractory cases of skull base osteomyelitis (SBO).MethodsA prospective observational study in a tertiary care centre with 70 SBO patients meeting eligibility criteria. The study population comprised 35 patients refractory to systemic antimicrobials of at least 4 weeks duration who later underwent surgery in addition to medication (surgical group). They were compared with a medical group that responded to medications alone. The outcome variables studied were the resolution of clinical features (pain, discharge, radiology, and inflammatory markers), culture yield, and total duration of treatment.ResultsAccording to our study, relief of pain was faster in the surgical group (1.66 against 4.57 months) with statistical significance (p < 0.001). Relief of symptoms (p < 0.001), radiological improvement (p = 0.001), and normalising of inflammatory markers (p < 0.001) were better in the surgical group than in the medical group. The duration of treatment was an average of 9.2 months in the surgical group compared to 11.3 months in the medical group (p = 0.019). Microbial culture from deep tissue sampling was positive in 24 surgical patients (68.57%).ConclusionsThe treatment response in selected patients of refractory SBO who underwent surgery along with antimicrobials was better than the group who responded to antimicrobials alone. Surgery provided higher microbial yield resulting in culture‐specific antimicrobials. The surgical group observed faster relief of symptoms, reduced hospital stay, and total treatment duration.

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Section: Discussionmentioning

confidence: 99%

Role of surgery along with antimicrobials in refractory skull base osteomyelitis—A prospective observational study

Faizal,

Nair,

Pavithran

et al. 2024

Clinical Otolaryngology

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“…P. aeruginosa is the most common causative pathogen, 5 although infections caused by Staphylococci , Streptococci , and gram-negative bacilli (e.g., Klebsiella , Escherichia ) have also been described. 6 - 8 Recent reports have stressed the occurrence of fungal pathogens that account for 5%-20% with Aspergillus species being the most common. 7 , 36 Six weeks or longer of culture-directed antibiotic therapy is the current standard of treatment.…”

Section: Discussionmentioning

confidence: 99%

“… 2 , 5 A reported incidence of facial nerve (FN) palsy in the course of MEO ranges from 10% to 70%. 1 - 8 The FN paresis may be detected at presentation and may develop despite the treatment. The question arises of how to treat these patients.…”

Section: Introductionmentioning

confidence: 99%

Is Facial Nerve Decompression Justified in Malignant External Otitis? Literature Review and Own Experience

Marszał¹,

Wierzbicka²,

Bartochowska³

2023

Int Adv Otol

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Objective: The aim of the study was to present the indications for facial nerve decompression in malignant external otitis, to analyze the results of such treatment, and to describe own experience in that field. Methods: A search in the PubMed and Google Scholar databases for English language articles published between 1968 and May 2022 was performed. We focused on papers describing patients with malignant external otitis and facial nerve palsy treated by decompression. Moreover, retrospective analysis of 24 consecutive patients with malignant external otitis hospitalized in our department in the past 10 years was performed. Results: In the literature, 48 cases with malignant external otitis and facial nerve paresis treated by decompression were identified. In total, 41 patients recovered (85.42%), 4 died (1 due to exacerbation of the disease, 2 for pneumonia, and 1 for heart failure), and in 3 cases the final outcome was not presented. In most cases (24; 50%), facial nerve function did not improve after decompression, in 8 patients (16.67%) partial recovery was observed, in 11 cases (22.92%) full improvement was observed, and data were not given for 5 patients. In only one case, the spread of infection and deterioration of local and general patient states were noted. In our material, we identified 13 patients with malignant external otitis and facial nerve palsy. Two of them were treated surgically, of which only one had facial nerve decompression. Partial improvement of facial nerve function was observed after 6 months of rehabilitation. Conclusion: The management of malignant external otitis is still difficult and not well defined. Facial nerve decompression seems justified in selected cases of malignant external otitis not responding to conservative treatment.

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“…As another clinical experience, dual‐antibiotic treatment can be used to treat infections by antibiotic‐resistant bacteria with less chance upon stimulating the development of resistant bacteria. [ 14 ] Here too, nanotechnology offers opportunities to combine currently used antibiotics with new antimicrobials against which bacteria may be unable to develop resistance.…”

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin‐Loaded, pH‐Responsive PAMAM‐Megamers Functionalized with S‐Nitrosylated Hyaluronic Acid Support Infected Wound Healing in Mice without Inducing Antibiotic Resistance

Jiang,

Wu,

Liu

et al. 2023

Adv Healthcare Materials

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Antimicrobial‐resistant bacterial infections threaten to become the number one cause of death by the year 2050. Since the speed at which antimicrobial‐resistance develops is exceeding the pace at which new antimicrobials come to the market, this threat cannot be countered by making more, new and stronger antimicrobials. Promising new antimicrobials should not only kill antimicrobial‐resistant bacteria, but also prevent development of new bacterial resistance mechanisms in strains still susceptible. Here, PAMAM‐dendrimers are clustered using glutaraldehyde to form megamers that are core‐loaded with ciprofloxacin and functionalized with HA‐SNO. Megamers are enzymatically disintegrated in an acidic pH, as in infectious biofilms, yielding release of ciprofloxacin and NO‐generation by HA‐SNO. NO‐generation does not contribute to the killing of planktonic Gram‐positive Staphylococcus aureus and Gram‐negative Pseudomonas aeruginosa, but in a biofilm‐mode of growth short‐lived NO‐assisted killing of both ciprofloxacin‐susceptible and ciprofloxacin‐resistant bacterial strains by the ciprofloxacin released. Repeated sub‐culturing of ciprofloxacin‐susceptible bacteria in presence of ciprofloxacin‐loaded and HA‐SNO functionalized PAMAM‐megamers does not result in ciprofloxacin‐resistant variants as does repeated culturing in presence of ciprofloxacin. Healing of wounds infected by a ciprofloxacin‐resistant S. aureus variant treated with ciprofloxacin‐loaded, HA‐SNO functionalized megamers proceed faster through NO‐assisted ciprofloxacin killing of infecting bacteria and stimulation of angiogenesis.

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Standardised treatment protocol for necrotizing otitis externa: retrospective case series and systematic literature review

Cited by 6 publications

References 18 publications

Role of surgery along with antimicrobials in refractory skull base osteomyelitis—A prospective observational study

Role of surgery along with antimicrobials in refractory skull base osteomyelitis—A prospective observational study

Is Facial Nerve Decompression Justified in Malignant External Otitis? Literature Review and Own Experience

Ciprofloxacin‐Loaded, pH‐Responsive PAMAM‐Megamers Functionalized with S‐Nitrosylated Hyaluronic Acid Support Infected Wound Healing in Mice without Inducing Antibiotic Resistance

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