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September 1987

Malignant External Otitis: Comparison of Monotherapy vs Combination Therapy

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine (Drs Meyers, Mendelson, and Hirschman), and the Department of Otolaryngology (Dr Parisier), Mount Sinai School of Medicine, New York. Dr Parisier is now with the Manhattan Eye, Ear, and Throat Hospital, New York.

Arch Otolaryngol Head Neck Surg. 1987;113(9):974-978. doi:10.1001/archotol.1987.01860090072022

• Twenty patients with adult-onset diabetes mellitus and malignant external otitis (MEO) were treated at the Mount Sinai Medical Center, New York, over a seven-year period (August 1976 to October 1983). A retrospective analysis compared patients who received an antipseudomonal cephalosporin as monotherapy (group A) with those who received conventional antipseudomonal therapy (group B). Pseudomonas aeruginosa was isolated in all patients. Differences (group B > group A) included insulin dependence, underlying vascular disease, total number of cranial nerve palsies or paresis, and surgical procedures. The overall clinical outcome was similar in both groups; 64% of patients in group A (7/11) and 70% in group B (7/10) were cured at a follow-up period of five to 57 months. A more favorable outcome was found in patients with less extensive infection in both groups. Monotherapy compared favorably with conventional antipseudomonal therapy for the treatment of patients with MEO and moderate infection.

(Arch Otolaryngol Head Neck Surg 1987;113:974-978)

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