The appropriate medical management of methicillin-resistant Staphylococcus aureus in chronic suppurative otitis media.
CONCLUSIONS
Methicillin-resistant Staphylococcus aureus (MRSA) was the most prevalent species (28.1%) in the bacteriological study of 577 patients with chronic suppurative otitis media (CSOM). Frequent and appropriate aural cleansing and irrigation using diluted acetic acid or other solutions such as Burow's solution can be an effective method for the medical treatment of MRSA in CSOM.


OBJECTIVE
To investigate the bacteriological results of 577 patients with CSOM and the medical treatment results of 91 non-cholesteatomatous MRSA patients and to consider the most appropriate medical treatment modality for MRSA in patients with CSOM.


METHODS
This study was conducted retrospectively from January 2005 through July 2008 using the medical records of 577 patients with otorrhoea caused by CSOM. We analyzed the bacteriological results by dividing all patients into cholesteatomatous CSOM and non-cholesteatomatous CSOM and investigated the medical treatment results of 91 non-cholesteatomatous MRSA patients. We used three treatment modalities: aural cleansing and irrigation (50 cases), intravenous injection of teicoplanin (22 cases) and intravenous injection of vancomycin (15 cases).


RESULTS
Overall, MRSA (28.1%) was the most prevalent species, followed by methicillin-susceptible Staphylococcus aureus (MSSA) (20.4%), Pseudomonas (18.6%) and coagulase-negative staphylococci (CNS) (15.0%). In non-cholesteatomatous MRSA treatment for dry ear, there were no significant differences between the three groups. The results showed that 79.5% of the group treated with aural cleansing and irrigation succeeded in achieving dry ears in 19.0 days. Similarly, 78.9% of another group with intravenous injection of teicoplanin eventually had dry ears, taking 16.0 days. Finally, the number of patients with dry ear in the group treated with intravenous injection of vancomycin was up to 80% of the total in 15.2 days.
Department of Otolaryngology HNS, College of Medicine, Catholic University of Korea, Seoul, Korea.
Hyeog Gi
HG
Choi
Kyoung Ho
KH
Park
Shi Nae
SN
Park
Beom Cho
BC
Jun
Dong Hee
DH
Lee
Sang Won
SW
Yeo
D019342:Acetic Acid / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D002908:Chronic Disease; D004424:Ear Canal; D004432:Ear, Middle; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010035:Otitis Media, Suppurative / Q000188:drug therapy*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy*; D017334:Teicoplanin / Q000008:administration & dosage*; D007507:Therapeutic Irrigation; D014640:Vancomycin / Q000008:administration & dosage*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D017334:Teicoplanin; D014640:Vancomycin; D019342:Acetic Acid