Keywords: Malignant external otitis, diabetis, treatment

Abstract: Malignant External Otitis (MEO) is a severe disease affecting patients who are usually elderly, diabetic and vascularly compromised in whom Pseudomonas aeruginosa causes an osteomylitis of the base of thc skull, using the external ear canal as a port of entry. In the past, successful treatment was achieved using 6 to 12 weeks of high doses of parenteral aminoglycosides associated to extended-spectrum penicillins and local aural debridement, with all the costs and side effects inherent to such regimen. After the advent of oral fluorquinolones, semi-ambulatory treatment was made possible with a mean 6-week duration. The authors report 5 cases of MEO treated with 1.5g/day of oral ciprofloxacin for a minimum period of 4 weeks and a maximum period of 20 weeks. All patients had a favorable outcome. The authors also discuss the pathogenesis of the disease, as well as its outcome and some pharmacokinetic aspects of the fluorquinolones.