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PubMed1988

Evaluation of the patient with otitis externa.

This article considers the history, physical examination, cytologic evaluation of smears and fungal and bacterial culture and sensitivity testing, clinical interpretation of information obtained from a biopsy of the external ear canal, and ancillary aids for the evaluation of the patient with otitis externa.

Animals↗
PubMed2003

Etiological significance of Candida albicans in otitis externa.

A study covering 79 patients (42 males, 37 females) of different age groups clinically diagnosed as otomycosis were investigated mycologically to elucidate the role of Candia albicans, an opportunistic polymorphic yeast, in otitis externa. C. albicans was diagnosed as the sole pathogen in two patients (1 male and 1 female) aged 18 and 20 years, respectively. The organism was repeatedly demonstrated in the aural specimens both by direct microscopy as well as culture isolation. Both the patients had unilateral otomycosis and used antibiotic solution and removed wax with wooden stick. The topical application of one per cent clotrimazole lotion showed good response both clinically as well as mycologically. The growing significance of opportunistic fungi emphasizes on comprehensive studies to establish the etiologic role in various clinical disorders in human and animal medicine.

Adolescent↗
PubMed1984

Clinical and bacteriological studies in otitis externa in Dar es Salaam, Tanzania.

The symptoms and signs as well as the bacterial flora from the auditory canals of 54 Tanzanian patients (74 ears) living in Dar es Salaam and suffering from otitis externa were studied. Itching and pain were the most common symptoms and erythema and secretion were the prevalent clinical findings. Pseudomonas aeruginosa was found in 38%, Aspergillus in 24%, Staphylococcus aureus in 18% and Candida albicans in 14%. Bacterial cultures from the auditory canals of 21 healthy subjects revealed only normal skin flora.

Adult↗
PubMed2004

Efficacy and safety of topical ciprofloxacin/dexamethasone versus neomycin/polymyxin B/hydrocortisone for otitis externa.

OBJECTIVES: To compare the efficacy and safety of ciprofloxacin 0.3%/dexamethasone 0.1% (CIP/DEX) otic suspension with that of neomycin 0.35%/polymyxin B 10,000 IU/mL/hydrocortisone 1.0% (N/P/H) otic suspension in patients with acute otitis externa (AOE). STUDY DESIGN: Randomized, observer-masked, parallel-group, multicenter study. Patients were randomized to 7 days treatment with either CIP/DEX 3-4 drops twice daily or N/P/H 3-4 drops three times daily. POPULATION: Patients of either sex and older than 1 year, with a clinical diagnosis of mild, moderate, or severe AOE and intact tympanic membranes were recruited to participate. OUTCOMES MEASURED: Signs and symptoms of AOE, including ear inflammation, tenderness, edema and discharge (assessed on Days 3, 8 [End-of-Therapy] and 18 [Test-of-Cure]); microbiologic eradication (presumed or documented); and frequency of adverse events. RESULTS: Patients enrolled numbered 468. In culture-positive patients who met the inclusion criteria (N = 396), clinical cure rates at Day 18 were significantly higher with CIP/DEX than with N/P/H (90.9% vs. 83.9%; p = 0.0375), as were microbiologic eradication rates (94.7% vs. 86.0%; p = 0.0057). In addition, the clinical response was significantly better with CIP/DEX than with N/P/H at Days 3 and 18 (p = 0.0279 and p = 0.0321, respectively), as was the reduction in ear inflammation at Day 18 (p = 0.0268). Both preparations were well tolerated in pediatric and adult patients. CONCLUSIONS: 7 days treatment with CIP/DEX otic suspension administered twice daily is clinically and microbiologically superior to N/P/H otic suspension administered 3 times daily in the treatment of mild to severe AOE, and is equally well tolerated.

Administration, Topical↗
PubMedDate not supplied

Prophylaxis of predisposed otitis externa.

Evaluation, in the guinea pig ear, of fourteen water repellent or therapeutic compounds has resulted in the recommended use of 360 Medical Fluid as a prophylactic agent for those persons with a high risk of otitis externa. This compound was found to adhere well, be easy to apply and was nonirritating. Use of this material prevented adverse bacterial growth in ear canals exposed to water for up to seven days. The significance of maintaining the normal Gram positive bacterial flora in the external ear canal and the role of cerumen in maintaining a healthy meatal surface is discussed. A system for monitoring the health of the ear canal through measurement of the Gram positive/Gram negative bacterial ratio is suggested.

1-Propanol↗
PubMed1984

Relapse of acute myelogenous leukemia presenting as acute otitis externa. A case report.

The association of leukemia with auditory complications is an obscure, though an important one, especially from the therapeutic point of view. A case is presented of a relapse of acute myelogenous leukemia presenting as an acute otitis externa. The leukemic infiltrates in the external auditory canal are demonstrated by both light and electron microscopy. The otologic lesions in leukemias are reviewed and the importance of early diagnosis is emphasized, since the aural involvement may precede the clinical relapse of the leukemia, as in the current case. The value of computerized axial tomography of the ear and of tissue biopsy for diagnosis is stressed. The recognition of the presence of leukemic infiltrates in the ear causing otologic symptoms allows for the prompt institution of appropriate therapy.

Adult↗
PubMed2005

A comparative study of two antimicrobial/anti-inflammatory formulations in the treatment of canine otitis externa.

The efficacy and tolerability of a marbofloxacin-clotrimazole-dexamethasone otic suspension (MCD) was compared with a standard topical treatment using a phase III clinical trial protocol. In a total of 140 dogs with clinical signs of acute or subacute otitis externa, Staphylococcus, Pseudomonas, Enterobacteriaceae and Malassezia were isolated from samples taken at inclusion to identify the causative pathogen; a further sample was collected in the event of failure or relapse, and from dogs (at day 14) for which Pseudomonas species had been isolated at inclusion. One group received MCD (10 drops per affected ear) once daily and a second received Surolan (containing polymyxin B, miconazole and prednisolone) (5 drops per affected ear), twice daily. Each group received treatment for 7 or 14 days according to the clinical outcome on day 7. Efficacy and tolerability were evaluated on days 7, 14 and, if necessary, 28 for dogs treated for 14 days. The trial demonstrated equivalence of both treatments in terms of efficacy, with a cure rate of 58.3% for MCD and 41.2% for Surolan. Both medications were equally well tolerated by dogs, but MCD was superior in terms of pain relief, decrease in pus quantity and smell, response rate and investigator's assessment on day 14.

Administration, Topical↗
PubMed1990

A general practice study to compare the efficacy and tolerability of a spray ('Otomize') versus a standard drop formulation ('Sofradex') in the treatment of patients with otitis externa.

In an open, multi-centre study in general practice, a comparison was made of the efficacy, tolerability and acceptability of a neomycin/dexamethasone preparation administered by metered-dose spray ('Otomize') and a framycetin/gramicidin/dexamethasone preparation ('Sofradex') administered as drops in 60 patients with otitis externa. Patients were allocated at random to receive one or other preparations 3-times daily for 10 days and were followed-up again 14 days after cessation of therapy. Clinical assessments were carried out under observer blind conditions on entry (Day 0) and on Days 10 and 24 of the severity of erythema, swelling and debris in the affected ear(s). A global assessment of clinical outcome was made by the doctor on Day 10. There were no significant differences in the two groups at the start of treatment. Significant improvement occurred in both groups from Day 0 to Day 10 and from Day 10 to Day 24 in all symptoms, with the proportion symptom-free in the 'Otomize' group significantly greater than in the 'Sofradex' group at 24 days, and approaching significance at 10 days. Significantly more patients in the 'Otomize' group were rated as having a good clinical outcome by the physician, and fewer patients experienced discomfort on application. Few side-effects were reported by either treatment group, none necessitating discontinuation of therapy.

Adolescent↗
PubMed1990

Comparative efficacy and tolerability of two antibacterial/anti-inflammatory formulations ('Otomize' spray and 'Otosporin' drops) in the treatment of otitis externa in general practice.

An open, multi-centre study was carried out in general practice to compare the efficacy, tolerability and acceptability of a neomycin/dexamethasone preparation administered by spray ('Otomize') and neomycin/polymyxin B/hydrocortisone administered as drops ('Otosporin') in the treatment of 187 patients with otitis externa. Patients were allocated at random to receive one or other preparation 3-times daily for 10 days irrespective of response and were followed up again 14 days after cessation of therapy. Assessments were made on entry and at Days 10 and 24 of the severity of erythema, swelling and debris. A global assessment of clinical outcome was made by the doctor on Day 10. There were no significant differences between the two groups at the start of treatment. Significant improvement occurred in both groups from Day 0 to Day 10 and from Day 10 to Day 24 in all symptoms, but no statistically significant differences were recorded between the two drugs. However, significantly more patients in the 'Otomize' group were rated as having a good clinical outcome by the physicians, and a highly significant number of patients, with previous experience of the use of ear drops, expressed a preference for the spray preparation. Few side-effects were reported by either treatment group, none necessitating discontinuation of therapy.

Administration, Topical↗
PubMed2003

[Necrotizing otitis externa caused by Stenotrophomonas maltophilia].

The gram-negative bacterium Stenotrophomonas maltophilia is feared, especially in intensive care wards, as a nosocomial opportunistic pathogen causing fulminant septicemia and organ failure in immunosuppressed patients. A patient with chronic lymphocytic leukemia developed a cutaneous infection with the clinical pattern of necrotizing otitis externa.

Anti-Infective Agents↗
PubMed1976

[Progressive necrotizing otitis externa in diabetics with disorders of the cerebral nerves (author's transl)].

The disease occurs without exception in elderly diabetics. Pseudomonas aeruginosa (pyocyaneus) is always found in the secretion. In our reported case of a 71-year old man appeared in addition to a fetid, festering, granulating otitis externa, disturbances of swallowing, hoarseness and severe occipital headaches appear after five months. Neurologically, the N. glossopharyngeus, the N. recurrens and the N. hypoglossus were shown to be paretic. The inflammatory process has pushed forward via the bone of the auditory meatus on to the base of the skull to the jugular foramen and the foramen lacerum. Surgical removal of the inflammatory changes and subsequent treatment with carbenicillin is recommended as the treatment of choice.

Aged↗
PubMed1977

Acute otitis externa in divers working in the North Sea: a microbiological survey of seven saturation dives.

Saturation diving is an important and widely used technique in the Offshore Oil Industry. During 1974-5 two saturation dives in the North Sea were terminated because of outbreaks of incapacitating otitis externa, and others were disrupted. Pseudomonas aeruginosa was consistently isolated from the ears of affected divers. Because complex work schedules were threatened seven subsequent dives were subjected to microbiological monitoring and control. Colonization of ear canal with P. aeruginosa or with other gram-negative bacilli occurred in 39 (67%) of the 58 divers studied, usually within 7 days of starting the dive. Data obtained by serotyping this isolations of P. aeruginosa suggested that a single infected diver may be the source of organisms which rapidly spread to his colleagues and throughout the living chambers, that the living chambers may constitute a reservoir of infection during and between dives, and that certain serotypes of P. aeruginosa are more likely than others to colonize the ear canal in the conditions of a saturation dive. The control measures used during the dives were only partially effective, but none of the divers suffered severe pain and all the dives were an operational success.

Corynebacterium↗
PubMed1994

Absence of toxicity in patients with malignant otitis externa following long-term treatment with high dosage tobramycin.

An in-vitro model of aminoglycoside dosing was used to demonstrate that the bactericidal activity of tobramycin against Pseudomonas aeruginosa is directly related to the peak concentration of the drug. In addition, six patients who were being treated for malignant otitis externa with long-term, high dosage tobramycin were monitored for oto- and nephro-toxicity; the only adverse effects were transient increases in the serum creatinine concentration in two patients.

Aged↗