ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Preadmission systemic antibiotic treatment in necrotizing otitis externa (NOE).
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeNecrotizing otitis externa (NOE) is a serious life-threatening infection, with Pseudomonas (PA) aeruginosa being the primary causative agent. Over the last two decades the use of systemic anti-PA antibiotics expanded substantially and are now prescribed regularly by physicians. Meanwhile, studies indicate shifting trends in the incidence of the offending pathogen in NOE. The objective of the study is to assess whether preadmission antibiotic treatment influence the incidence offending pathogens and sterile cultures in NOE. Also, we aim to evaluate the effects of preadmission antibiotic treatment on NOE severity and disease progression.
methodsA retrospective case series analysis was performed, including all patients admitted in a single tertiary center due to NOE.
results83 patients were included in the study. Among them 17 patients received no oral antibiotics prior to admission (NoAb-NOE), and 65 patients received systemic antibiotics prior to admission. There was no statistical difference between the groups regarding the incidence of the pathogen or sterile culture. Furthermore, there was no statistical difference regarding duration of hospitalization, need for surgery or readmission.
conclusionPreadmission antibiotic treatment does not influence the incidence of offending pathogens or rate of sterile culture in NOE. Moreso, preadmission antibiotic has no effect on disease progression or severity in NOE. Our findings suggest that sterile culture NOE is probably due to the low sensitivity of superficial swabs and not secondary to partially treated disease. Deep tissue culture should be considered in the setting of NOE patients.
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