Evolving resistant pseudomonas to ciprofloxacin in malignant otitis externa
Evolving resistant pseudomonas to ciprofloxacin in malignant otitis externa
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DOI：
10.1097/00005537-200209000-00017
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发表时间：
2002-09-01
期刊：
影响因子：
2.6
通讯作者：
Harell, M
中科院分区：
文献类型：
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作者：
Berenholz, L;Katzenell, U;Harell, M
Objective.确定耐环丙沙星的假恶性外耳炎是否增加，以及这是否增加了疾病的发病率。研究设计回顾性。设置.三级转诊中心。患者13年内的28名患者。结果回顾性分析1988 ~ 2001年收治的28例恶性外耳道炎患者的临床资料。7例患者在医院培养和敏感性试验中发现环丙沙星耐药假单胞菌。7例耐药病例中有5例出现在过去3年中，而7例中有2例出现在该时期之前的10年中。在我们的系列研究中，假单胞菌对环丙沙星治疗的耐药性有随时间推移而发展的显著趋势。与其余对环丙沙星敏感的患者相比，在环丙沙星耐药假单胞菌组中未发现发病率或死亡率增加。结论.在我们的系列研究中，恶性外耳炎患者对环丙沙星的耐药性随着时间的推移而增加。这可能会对过去十年中这些患者相对成功的门诊治疗产生影响。这些患者需要恢复住院或门诊静脉治疗，使用第三代头孢菌素/抗假单胞菌青霉素，并进行更频繁的清创。
Objective. To determine whether there has been an increase in ciprofloxacin-resistant pseudomonas malignant otitis externa, and if this has increased the morbidity of the disease. Study Design Retrospective. Setting. Tertiary referral center. Patients. Twenty-eight patients over 13 years. Results. The records of a total of 28 patients who were admitted between 1988 and 2001 with the diagnosis of malignant otitis externa were reviewed. Seven patients had ciprofloxacin-resistant pseudomonas on their hospital culture and sensitivity test. Five of the 7 resistant cases appeared in the last 3 years, as opposed to 2 of the 7 who appeared in the 10 years before that period. In our series, there is a significant trend developing over time of pseudomonas resistant to treatment with ciprofloxacin. No increased morbidity or mortality was found in the ciprofloxacmiresistant pseudomonas group compared with the remaining patients who were sensitive to ciprofloxacin. Conclusions. In our series, resistance to ciprofloxacin in patients with malignant otitis externa is increasing over time. This may have an impact on the relatively successful outpatient treatment of these patients in the past decade. A return to inpatient or outpatient intravenous treatment with third-generation cephalosporins/antipseudomonal penicillins and more frequent debridement will be required in these patients.