Adverse drug reactions due to prolonged antibiotic therapy for malignant external otitis.

BACKGROUND: Malignant external otitis (MEO) is a life-threatening infection requiring prolonged antibiotic therapy. Adverse drug reactions (ADR) occur frequently in patients treated with long-term antibiotics, often limiting treatment effectiveness. We attempted to identify and categorize the frequency and type of ADR in patients undergoing treatment for MEO in an attempt to improve overall treatment of individuals with this disorder. METHODS: Twenty-one patients with MEO who were treated during a 10-year period at our institution were identified retrospectively. Records were reviewed to determine demographic and clinical information as well as laboratory data. RESULTS: Overall, ADR occurred in six individuals (26.8%). Of the 15 patients who received ciprofloxacin therapy, none experienced ADR. In contrast, six of the nine patients who were treated with beta-lactam antibiotics experienced ADR including urticaria, elevated serum transaminase levels and neutropenia. CONCLUSIONS: Prolonged antibiotic therapy for MEO with beta-lactam antibiotics is more likely to be complicated by ADR and requires careful monitoring.