Necrotizing external otitis: Aminoglycoside and beta-lactam antibiotic treatment combined with surgical treatment

Necrotizing external otitis is a life-threatening condition that still causes therapeutic problems. A retrospective analysis of 22 patients who were all treated with a short standard course of aminoglycoside and beta-lactam antibiotic with thorough local debridement was carried out; 50% (11/22) had diabetes mellitus, and all had a positive culture of Pseudomonas aeruginosa. The frequency of recurrence was 14% (3/22), and 95% (21/22) were eventually cured. The treatment course lasted 17 days on average. Side effects caused by the drug treatment were seen in 14% (3/22), but they were mild and transient consisting of a reversible increase of the serum creatinine level. It was concluded that the treatment was short, efficient, safe, and as successful as treatment with quinolones or third-generation cephalosporins which has been reported during the past years. In our opinion, therefore, these drugs should be reserved for cases of treatment failure, development of resistance, or side effects.