A Systematic Review of Antimicrobial Treatment Regimens and their Outcomes in Necrotising Otitis Externa

Sirat Lodhi, Sara Timms, Emma Stapleton

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Abstract

Background: Necrotising otitis externa (NOE) is a serious infection with minimal evidence underpinning its management. This review aims to synthesise published evidence of antimicrobial therapies and their outcomes in NOE. Methods: The review was PROSPERO registered (CRD42022353244) and conducted according to PRISMA guidelines. A robust search strategy filtered 28 manuscripts into the final review. Antimicrobial therapy and clinical outcome data were extracted and analysed. Results: Published studies are heterogeneous, with high risk of bias and low certainty. Reporting of outcomes is poor and extremely variable. First-line therapy is most commonly inpatient (95%) empiric fluoroquinolone (68%) delivered intravenously (82%). The lack of granular data and poor outcome reporting mean it is impossible to correlate treatment strategies with clinical outcomes. Discussion: Robust, consistent outcome reporting with reference to treatments administered is mandatory, to inform clinical management and optimize future research. Optimal antimicrobial choices and treatment strategies require clarification through prospective clinical trials.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalThe Journal of laryngology and otology
Early online date28 Sept 2023
DOIs
Publication statusE-pub ahead of print - 28 Sept 2023

Keywords

  • Otitis externa
  • diabetes mellitus
  • immunosuppression.
  • osteomyelitis

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