Surgical outcome of otitis media caused by MRSA infection

• Published in: Otology Japan Vol. 11; no. 5; pp. 573 - 576
• Main Authors: Shimizu, Asako, Kawano, Atushi, Shimizu, Shigetaka, Inagaki, Taro, Suzuki, Mamoru
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Otological Society 2001
• Subjects: MRSA; Otitis media; Tympanoplasty; Vancomysin
• ISSN: 0917-2025; 1884-1457
• DOI: 10.11289/otoljpn1991.11.573

Increase in methicillin-resistant Staphylococcus aureus (MRSA) infection has been a serious issue in otorhinolaryngological practice. It is still controversial how to cope with this condition. The outcome of tympanoplasty performed on MRSA infected chronic ears was studied. Eighteen ears operated from January 1997 to April 2000 were analyzed. These cases included 12 ears with chronic suppurative otitis media, 5 ears with cholesteatoma and 1 ear with adhesive otitis media. MRSA was detected in all cases prior to surgery. It was confirmed that the MRSA was sensitive to vancomycin (VCM) and arbekacin (ABK). After surgery VCM, ABK, minocycline or teicoplanin was administered with cephem or broad spectrum penicillin in most cases. The post-operative course was uneventful in 16 out of 18 ears which resulted in well healed dry ear drum. Regarding the remaining 2 ears, otorrhea occurred after surgery which could be controlled by repeated local lavage and administration of antibiotics. Our keys for surgical success are, topical lavage before and after sugery, administration of appropriate antibiotics, usage of pedicled flaps for canal reconstruction and eradication of the disease.