Malignant external otitis: treatment with fluoroquinolones.

Malignant external otitis (MEO) is still a potentially lethal disease. Early treatment based on a correct diagnosis is the most important single factor in achieving a cure for the disease. The preferred treatment is long-term systemic antibiotics followed by surgical intervention. Hyperbaric oxygen therapy may be supplemented in refractory cases. A new fluoroquinolone, Ciprofloxacin, has been successfully used in four cases of MEO which did not respond to the accepted treatment. Ciprofloxacin is active against a broad spectrum of bacteria, including Pseudomonas aeruginosa, and several clinical studies have demonstrated its efficacy in the treatment of urinary tract and soft tissue infections, osteomyelitis, pneumonia, and gastroenteritis. This report is the first of which we are aware to document the use of Ciprofloxacin in the treatment of MEO.