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At least 199 records · Page 11Linked to original sources
PubMed2000

Otitis externa in a localized area at the South of Jordan.

OBJECTIVE: To investigate the clinical findings and to identify the microorganisms in the pathogenesis of otitis externa. METHODS: The symptoms and signs, as well as the bacterial flora, from the auditory canals of 70 Jordanian patients (94 ears) suffering from otitis externa were studied during the period from February 1999 to February 2000. RESULTS: Pain was the most common symptom (82%). The most common sign was erythema (65%), while oedema was the least common (42%). Pseudomonas aeruginosa was found in 39%, Aspergillus in 27%, Candida albicans in 18%, Staphylococcus aureus in 18% and no growth in 8.5%. Ninety three percent of healthy ears revealed normal skin flora. CONCLUSION: Gram-negative microorganisms (Pseudomonas aeruginosa) were the most frequently isolated pathogenic microorganisms.

Acute Disease↗
PubMed2004

Acute otitis externa: efficacy and tolerability of N-chlorotaurine, a novel endogenous antiseptic agent.

OBJECTIVE: The study's objective was to test the tolerability and efficacy of the endogenous antiseptic N-chlorotaurine (NCT) in comparison with a standard clinical treatment according to a phase IIb clinical trial protocol. STUDY DESIGN: The antimicrobial agent NCT was compared with the antibiotic component drops Otosporin (containing neomycin, polymyxin B, and hydrocortisone) for topical treatment of acute otitis externa in a randomized and rater-blinded clinical study. METHODS: Fifty patients suffering from acute otitis externa were divided into two groups according to a randomized list. The test group was treated with 1 mL of 1% aqueous NCT solution, the reference group with 1 mL of Otosporin. The substances were applied to the external ear canal at one daily session until the signs of infection disappeared. Efficacy and tolerability were evaluated daily by visual analogue scale and a six-step infection score. In addition, smears were analyzed to identify the causative pathogens. RESULTS: Both medications were equally well tolerated by the patients. The treatment was successful for all patients of the NCT group, whereas in one patient from the reference group, the infection did not disappear. The inflammation score improved more rapidly in the NCT group, which resulted in an earlier termination of the therapy. This difference became highly significant on days 4 to 7 (P <.01 each). Time needed for disappearance of inflammation (score 0) was 5.6 +/- 1.6 (mean +/- SD, range 3-9) days in the NCT group and 7.4 +/- 1.6 (range 4-10) days in the Otosporin group (P <.001). As expected, microbiologic cultures from ear swabs revealed Pseudomonas aeruginosa (58%) followed by Staphylococcus aureus (18%) as the main causative pathogens. CONCLUSIONS: NCT appears to be well tolerated and more effective than the therapy using antibiotic component drops. Because of its endogenous nature and its higher efficacy, NCT appears to be a good choice for topical treatment of acute otitis externa.

Acute Disease↗
PubMedDate not supplied

[Otitis externa in industrial workers].

The problem of the therapy of otitis externa in industrial workers is one of the most serious in otiatria. The fact that the disease is caused by various factors is responsible for the low effectiveness of traditional therapy. This paper describes a combined treatment which includes trichopol ointment, drugs that enhance regenerative processes, drugs that decrease sensitization, and elements of chronotherapy. The treatment proved to be effective and can therefore be recommended for clinical application.

Adult↗
PubMed1987

A study of three preparations in the treatment of otitis externa.

Twenty-seven patients with an initial diagnosis of otitis externa, untreated for the previous 2 weeks, were treated with weekly aural suction toilet and a choice of three topical drops. Two contained combinations of antibiotics and steroids, one of which also contained an anti-fungal agent. The third was boric acid in spirit. The patients were assessed at weekly intervals until a remission was established. From this study it would appear that antibiotic-based drops confer no real advantage over boric acid in spirit.

Administration, Topical↗
PubMed1998

Otitis externa--the clinical pattern in a tertiary institution in Singapore.

Otitis externa is a common condition in the tropics. Most of the data related to the condition have arisen from Western sources. Locally, the aetiology and the pathogens identified have not been systematically studied. A prospective study involving 107 patients was conducted. Otomycosis was frequently encountered. Coagulase negative Staphylococcus and Aspergillus niger were the most common bacteria and fungus cultured respectively. Gentamicin and polymyxin B were the most effective topical agents against Pseudomonas aeruginosa. Self-cleaning of the ears was the most common predisposing factor.

Adolescent↗
PubMed1983

Treatment of otitis externa with miconazole nitrate. A comparative study involving 85 cases.

The hazards of neomycin in local preparations have recently been re-emphasized. Eighty-five patients with otitis externa were treated with one of two preparations between August 1980 and April 1982 -- 54 were treated with a cream containing miconazole nitrate and hydrocortisone (Daktacort; Janssen) and 31 with a preparation containing neomycin (Kenacomb; Squibb); Sixty eight per cent of the patients were cured within 1 week with both preparations. Most treatment failures were due to a resistant Pseudomonas aeruginosa. The miconazole cream proved as effective as the preparation containing neomycin in the first-line treatment of otitis externa. A gentamicin-containing steroid ointment was effective against the Pseudomonas infection.

Clinical Trials as Topic↗
PubMed2004

Efficacy of ofloxacin otic solution once daily for 7 days in the treatment of otitis externa: a multicenter, open-label, phase III trial.

BACKGROUND: Otitis externa (OE) is an infection of the external auditory canal that is typically treated with topically applied broad-spectrum antibiotics. Twice-daily topical treatment with ofloxacin otic 0.3% solution for 10 days has been reported to be as effective and well tolerated as the standard of care, neomycin sulfate/polymyxin B sulfate/hydrocortisone solution administered 4 times daily for 10 days. OBJECTIVE: This study evaluated the efficacy and safety profile of 7 days of a once-daily regimen of ofloxacin otic 0.3% solution in the treatment of OE. METHODS: This multicenter, open-label, Phase III study was conducted from June 12, 2002, to October 14, 2002. Eligible patients were aged > or = 6 months and had OE of <2 weeks' duration with moderate to severe edema and tenderness involving 1 or both ears and sufficient exudate for microbiologic culture. Ofloxacin otic solution was instilled once daily for 7 days (5 drops for children aged 6 months to <13 years, 10 drops for adolescents/adults aged > or = 13 years). Assessments were conducted at the end-of-treatment visit and 7 to 10 days later (the test-of-cure visit). Medication was supplied free of charge to study participants who incurred no costs for physician visits. RESULTS: Of 489 patients enrolled at 58 sites in 3 countries, 439 were clinically evaluable (173 children, 266 adolescents/adults; 52 % males, 48% females; 47% Hispanic, 45% white; 5% black, and 3% other). The cure rate among clinically evaluable patients was 91% (95% of children, 88% of adolescents/adults); 68% of patients were cured within 7 days. Forty-three potentially pathogenic strains were isolated from 253 microbiologically evaluable patients. Pseudomonas aeruginosa was isolated from 158 (62%) microbiologically evaluable patients and Staphylococcus aureus from 32 (13%). Eradication rates were 96% overall. No serious adverse events were observed. Minor adverse events were experienced by 15 (3%) of 489 patients included in the safety population. The most common adverse events were pruritus (5 patients), increased earache (4 patients), and application-site reactions (3 patients). Overall mean (SD) adherence to therapy was 98% (11.9). CONCLUSIONS: Ofloxacin otic 0.3% solution administered once daily for 7 days was well tolerated and effective in achieving clinical and microbiologic cure of OE. The compliance rates in this study suggests that this regimen may be better accepted by patients than longer, more repetitive regimens.

Adolescent↗
PubMed1997

Ofloxacin otic solution for treatment of otitis externa in children and adults.

OBJECTIVE: To compare the safety and efficacy of ofloxacin otic solution with those of Cortisporin otic solutions (neomycin sulfate, polymyxin B sulfate, and hydrocortisone) in otitis externa in adults and children. DESIGN: Two randomized, evaluator-blind, multicenter trials, 1 each in children and adults. SETTING: Twenty-three primary care and referral ambulatory care sites per trial. PATIENTS: A total of 314 adults (12 years and older) and 287 children (younger than 12 years). Of the total, data for 247 adults and 227 children were considered clinically evaluable (CE), and those for 98 children and 98 adults were microbiologically evaluable (ME). INTERVENTIONS: Ofloxacin (adults, 0.5 mL; children, 0.25 mL) twice daily or Cortisporin (adults, 0.2 mL; children, 0.15 mL) 4 times daily for 10 days. MAIN OUTCOME MEASURES: The CE subjects were cured if all signs and symptoms resolved at posttherapy (days 11-13) and test-of-cure (days 17-20) visits. The ME subjects had microbiological and clinical successes if they were cured and had microbiological eradication or presumed eradication. RESULTS: Cure was observed in 82% and 97% of CE adults and children treated with ofloxacin and 84% and 95% of CE adults and children treated with Cortisporin, respectively. The most common pathogens at the pretherapy visit were Pseudomonas aeruginosa, Staphylococcus aureus, and enteric bacilli. There were no statistically significant differences in clinical or microbiological and clinical cure or in the rates of adverse events between treatment groups. CONCLUSIONS: Ofloxacin given twice daily is as safe and effective as Cortisporin given 4 times daily for otitis externa. The bacteriological findings and treatment responses do not differ between adults and children.

Adult↗
PubMed1978

Incidence and treatment of budding yeasts in canine otitis externa.

Budding yeasts were present in the majority of cases of otitis externa examined. A reddish-brown, dry, waxy discharge was the typical exudate. A successful treatment of yeast-infected ears was multiple otic lavages using a combination of an aqueous solution of poloxamer-iodine and application of an antifungal-antibiotic-corticosteroids ointment.

Animals↗
PubMed1987

Effects of ear type and weather on the hospital prevalence of canine otitis externa.

A retrospective study of 8975 dogs seen at 15 university veterinary medical teaching hospitals in North America (1975 to 1978) found that dogs with pendulous ears and heavy ear canal hair had significantly (P less than 0.01) more otitis externa than dogs with other ear types. Dogs with erect ears, regardless of the amount of ear canal hair, had less risk (P less than 0.01) of the disease than mongrel dogs. Direct evidence is available for the first time showing that monthly variations in ambient temperature, rainfall and relative humidity explain, to a large extent, the monthly variations in the hospital prevalence of canine otitis externa in different geographic regions.

Animals↗
PubMed2000

Antibacterial susceptibility patterns of Pseudomonas strains isolated from chronic canine otitis externa.

Development of antibiotic resistance in bacteria is a problem of great concern. It is important to establish the convenience of antimicrobial susceptibility tests in animal infections. The aim of this study was to test the susceptibility to antibiotics of Pseudomonas strains isolated from chronic canine otitis externa. We tested 23 strains of Pseudomonas: 19 Ps. aeruginosa, three Ps. fluorescens and one Pseudomonas spp. The most effective antibiotics were tobramycin (100% susceptible), marbofloxacin (91.3%) and ceftazidime (91.3%). Ticarcillin and gentamicin, commonly used for the treatment of otitis externa also showed good results (susceptibility of strains was 86 and 65.2% respectively). Lower susceptibility was found using enrofloxacin (52.1%) probably due to its indiscriminate use. We emphasize the need for a rational policy of antibiotic prescribing in order to prevent the selection of resistant strains.

Animals↗
PubMed1992

The general practice 'management of otitis externa'.

Clinical confusion, treatment failure and recurrence commonly plague the Management of Otitis Externa. The aim of this study was to investigate the clinical attitudes and habits of army general practitioners and to review the recent literature. The results of a questionnaire survey showed that although all the respondents agreed that aural toilet was important, only 50% felt confident in performing aural toilet and packing. There also appeared to be much greater scope for the use of astringents and effective preventative measures in addition to aural toilet. The discussion emphasises and need for careful selection of the most appropriate topical agent, whilst highlighting the roles of practical procedures, bacteriology and prevention. A practical guide to diagnosis and management is offered with the aid of illustrations and an algorithm.

Administration, Topical↗
PubMed2002

Malignant otitis externa--a high index of suspicion is still needed for diagnosis.

Malignant otitis externa is a destructive inflammatory process of the petrous temporal bone which if untreated leads to osteomyelitis of the skull base and can be fatal. It is more common in immunocompromised and elderly insulin-dependant diabetic patients and is caused by infection with Pseudomonas species. Despite a range of laboratory and radiological tests it still remains difficult to diagnose, particularly in the early stages when it can be treated medically. We describe three cases which presented to this department in the past twelve months. In all cases the diagnosis was made clinically and confirmed per-operatively. Interestingly all three cases were relatively young patients who did not have an immunocompromised status and were not diabetic.

Adult↗
PubMed1999

Necrotizing otitis externa caused by Staphylococcus epidermidis.

We present a case of malignant necrotizing otitis externa (MNOE) caused by Staphylococcus epidermidis, which is usually a non-pathogenic microorganism. The patient is an otherwise healthy, nondiabetic 58-year-old white man. Contributory history began in 1994 after surgery for bilateral exostoses of the external auditory canals. Between April 1994 and May 1998 persistent otalgia occurred, with progressive mixed hearing losses, purulent discharge from both ears, spontaneous perforations of the tympanic membranes and ulceration of canal wall skin. From the beginning, Staph. epidermidis was isolated in all but one culture, but was not recognized as the pathological agent because of the presence of other more frequently involved bacteria and fungi. After multiple intravenous and oral antibiotics and antifungal treatments failed, further management involved frequent debridement of both external auditory canals and tympanic membranes, right tympanoplasty, bilateral mastoidectomy, revision tympanomastoidectomies and left modified radical mastoidectomy. Antistaphylococcal therapy including ceftazidime, vancomycin, teicoplanin, clindamycin and rifampicin was tried. Following the modified radical radical mastoidectomy, normalization of the status of his ears took approximately 2 months and has since remained stable to date. His left ear is deaf because of vancomycin administration, while magnetic resonance imaging and gallium scintigraphy have shown persistent inflammation of the skull base.

Aminoglycosides↗
PubMed1995

[Malignant otitis externa: apropos of 19 cases].

In the Anglo-Saxon literature, necrotizing otitis in the diabetic patient, known as malignant otitis externa (MOE), represents a specific and in many ways serious entity. We report on our personal experience with 19 cases of MOE with hospitalization and a 9-year follow-up. Our diagnostic criteria are as follows: all our patients are diabetic (with diabetes revealed twice by the MOE). Otalgia is a predominant feature of the clinical picture, with facial palsy being recorded in practically all our patients. A pyocyanic germ was responsible in 16 cases. The use of CT instead of Tc99 scintigraphy enabled the assessment of the extent of the complaint. Surgical treatment (mastoidectomy), recommended for our first patients, is now considered pointless due to its lack of efficacy against an already extensive process, and with the arrival on the market of new families of ATB's, in particular the quinolones. It would appear that this general treatment, combined with local treatment, provides a better control of the evolution of the MOE, which nonetheless carries a high mortality rate estimated at 18%. On the basis of this series, we present the data in the literature, recalling the diagnostic criteria, the value of skull base imaging and the criteria of recovery.

4-Quinolones↗