Malignant external otitis: The shifting treatment paradigm.

IMPORTANCE: Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat.

OBJECTIVE: Determine if there has been a shift in the microbiology and outcomes of MEO.

DESIGN: A retrospective case series at a tertiary care institution.

SETTING: Inpatient and outpatient tertiary care hospital.

PARTICIPANTS: 12 cases of recent MEO were reviewed.

MAIN OUTCOMES AND MEASURES: The primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO.

RESULTS: Only 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses.

CONCLUSIONS: Select cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.