Question 1

Q: An old diabetic male presented with rapidly spreading infection of the external auditory canal with involvement of the bone and presence of granulation tissue. The drug of choice for this condition is:

Ciprofloxacin. ***Ciprofloxacin*** - This clinical presentation describes **necrotizing otitis externa (NOE)**, a severe infection predominantly caused by **Pseudomonas aeruginosa**. - **Ciprofloxacin** is the drug of choice due to its excellent anti-pseudomonal activity and good tissue penetration, necessary to treat the extensive infection involving bone. *Penicillin* - **Penicillin** has limited activity against **Pseudomonas aeruginosa**, which is the primary pathogen in necrotizing otitis externa, making it ineffective. - Its spectrum of activity is primarily against gram-positive bacteria and some gram-negative cocci, not the specific atypical gram-negative rods causing this infection. *Second generation cephalosporin* - **Second-generation cephalosporins** generally lack sufficient anti-pseudomonal coverage to effectively treat necrotizing otitis externa. - While they offer broader gram-negative coverage than first-generation agents, they are typically not robust enough for severe Pseudomonas infections, especially those involving bone. *Aminoglycosides* - **Aminoglycosides** are potent against Pseudomonas aeruginosa but are generally administered parenterally and are associated with significant **ototoxicity** and **nephrotoxicity**. - While effective, their side effect profile and the availability of equally effective and safer oral options like ciprofloxacin make them less favorable as a first-line monotherapy for NOE.

Question

An old diabetic male presented with rapidly spreading infection of the external auditory canal with involvement of the bone and presence of granulation tissue. The drug of choice for this condition is:

Accepted Answer

Ciprofloxacin

Answer

Second generation cephalosporin

Answer

Penicillin

Answer

Aminoglycosides

Diseases of the Ear — MCQs

Diseases of the Ear — MCQs

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