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Standardised treatment protocol for necrotizing otitis externa: retrospective case series and systematic literature review.
Frost, James; Samson, Anda D.
Afiliação
  • Frost J; Hull York Medical School, John Hughlings Building, University Road, Heslington, York YO10 5DD, UK; Hull York Medical School, Allam Medical Building, University of Hull, Hull HU6 7RX, UK; Department of Infection, Hull University Teaching Hospitals, Castle Hill Hospital, Hull, East Yorkshire HU16 5JQ, UK. Electronic address: jameslitongfrost@gmail.com.
  • Samson AD; Hull York Medical School, John Hughlings Building, University Road, Heslington, York YO10 5DD, UK; Hull York Medical School, Allam Medical Building, University of Hull, Hull HU6 7RX, UK; Department of Infection, Hull University Teaching Hospitals, Castle Hill Hospital, Hull, East Yorkshire HU16 5JQ, UK.
J Glob Antimicrob Resist ; 26: 266-271, 2021 09.
Article em En | MEDLINE | ID: mdl-34273591
OBJECTIVES: There is currently no consensus on the most effective treatment protocol for necrotizing otitis externa (NOE). This article aims to produce a NOE treatment protocol from the literature and clinical experience. METHODS: A total of 26 case series from the literature were reviewed in combination with a retrospective case series of inpatients from Hull University Teaching Hospitals NHS Trust from 2013-2018. Over 5 years, 40 patients were identified, with only 29 being analysed due to unavailable or incomplete case notes. RESULTS: In the literature review, the most common bacterial species causing NOE was Pseudomonas aeruginosa. Resistance to ciprofloxacin was prevalent, however multidrug resistance was rare. Ciprofloxacin and ceftazidime were the most widely used antibiotics. No ceftazidime resistance was reported in the literature or in our cohort. The average age of the patients in our cohort was 80 years. Moreover, 62% had either diabetes mellitus or were immunosuppressed. One patient died directly due to NOE-related sepsis. Intravenous ceftazidime monotherapy was mostly used. The duration of treatment was 6-7 weeks, with no relapses documented. CONCLUSION: Ceftazidime monotherapy was an effective empirical treatment in our cohort, and a total duration of 6-7 weeks of antibiotics was sufficient. We have created a standardised treatment protocol based on our findings that will need to be validated in a larger cohort of patients.
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Texto completo: 1 Base de dados: MEDLINE Métodos Terapêuticos e Terapias MTCI: Terapias_biologicas / Aromoterapia Assunto principal: Otite Externa Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Idioma: En Revista: J Glob Antimicrob Resist Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Métodos Terapêuticos e Terapias MTCI: Terapias_biologicas / Aromoterapia Assunto principal: Otite Externa Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Systematic_reviews Idioma: En Revista: J Glob Antimicrob Resist Ano de publicação: 2021 Tipo de documento: Article