TREATMENT OF MALIGNANT EXTERNAL OTITIS WITH CIPROFLOXACIN

Malignant external otitis is a serious infection mainly caused by Pseudomonas aeruginosa. Ciprofloxacin, due to its antipseudomonal activity and its good tissue diffusion, is theoretically effective in the treatment of such infection. An overview of publications concerning the use of ciprofloxacin in the treatment of malignant external otitis, is given here. Thirteen studies concerning 84 patients are analyzed : ciprofloxacin, was given orally, in most of the cases, at a dosage of 750 mg twice daily, except for three studies in which dosage was 500 mg b. i.d, In case of intravenous administration, dosage was 200 mg b.i.d. In only one study, ciprofloxacin was associated with rifampicin. The average treatment duration was 3 months. P. aeruginosa was isolated in 82 patients ; no strains was resistant to ciprofloxacin when it was tested (47 strains). Clinical cure rate was 96.4 % (84 patients). Bacteriological eradication rate is close to 100 % in the 76 evaluable patients. At a follow-up ranging from 2 to 44 months, clinical cure and bacteriological eradication persisted in all patients except 2. Ciprofloxacin appears to be a particularly interesting antibiotic in the treatment of malignant external otitis, as a result of its clinical and bacteriological efficiency and its safety.