Role of Topical Application of Fosfomycin in Treatment of Chronic Suppurative Otitis Media

Abstract

Objective: To ind out the eficacy of topical application of 3% Fosfomycin in cases of Chronic Suppurative Otitis Media (CSOM).

Methods: This prospective study was conducted from January 2016 to December 2017 in the Department of ENT, Head & Neck Surgery, Dow University of Health Sciences & Dr. Ruth K.M. Pfau Civil Hospital Karachi, Pakistan. All patients had clinical diagnosis of CSOM. Fosfomycin 3% was given topical treatment in ear drop three times daily for one week. Amount given in each dose was 2  drops or 0.1 ml. A complete audiological assessment was conducted by an audiologist at day 7 and  outcome of the treatment was noted as resolved (complete dry ear), Improved, Not-changed or  Worsened. 

Results: Out of 172 patients, 65 (37.8%) had pseudomonas Aeroginosa, 49 (28.5%) had Staphylococcus Aureus, 37 (21.5%) had Proteus Mirabilis, 6 (3.5%) had E Coli, 6 (3.5%) had Klebsiella Pneumoniae, 4 (2.3%) had Enterobacter species whereas 5 (2.9%) patients had miscellaneous organisms on culture of ear swab. The mean duration of discharge was 7.23 ±5.78 years. The outcome showed that majority of the patients 144 (83.7%) had completely dry ear after one week of treatment with 3% fosfomycin. Other 17 patients (9.9%) had improvement with decrease in amount of ear discharge. Nine patients (5.2%) had no change in ear discharge and in 2 cases (1.2%) amount of ear discharge increased.

Conclusion: The inding of this study depicted that topical application of 3% fosfomycin can be very beneicial in cases of CSOM. Overall response to treatment was good and no otoxicity was noted.