Ceftazidime Poloxamer Gel: Expanding the Therapeutic Armamentarium for Ciprofloxacin-Resistant Pseudomonas Mastoid Cavity Otorrhea

Otol Neurotol. 2024 Jul 1;45(6):e490-e493. doi: 10.1097/MAO.0000000000004206. Epub 2024 May 21.

Abstract

Objective: To present and evaluate the treatment of ciprofloxacin-resistant Pseudomonas mastoid cavity otorrhea with a ceftazidime thermosensitive poloxamer gel.

Study design: A retrospective clinical capsule report.

Patients: Three patients diagnosed with ciprofloxacin-resistant Pseudomonas otorrhea in the setting of a previous canal-wall-down mastoidectomy between March 2019 and June 2023 visiting our tertiary care institution were retrospectively reviewed.

Intervention: Application of a 2% ceftazidime thermosensitive poloxamer gel to mastoid cavity.

Main outcome measures: No evidence of disease during microscopic inspection of the ear within a month of initial treatment or bacterial eradication on subsequent culture.

Results: Two patients had complete resolution of symptoms and achieved a safe and dry ear after topical application of the hydrogel. The second patient had pseudomonal eradication on culture, but persistent otorrhea due to other multidrug-resistant bacteria and an anatomically unfavorable mastoid cavity, which ultimately resolved after revision surgery.

Conclusions: This small case series suggests that topical treatment of mastoid cavity otorrhea with a 2% ceftazidime poloxomer gel is a potential therapeutic avenue in patients with ciprofloxacin-resistant Pseudomonas .

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Ceftazidime* / administration & dosage
  • Ceftazidime* / therapeutic use
  • Ciprofloxacin* / administration & dosage
  • Ciprofloxacin* / therapeutic use
  • Drug Resistance, Bacterial
  • Female
  • Gels*
  • Humans
  • Male
  • Mastoid / surgery
  • Middle Aged
  • Otitis Media with Effusion / drug therapy
  • Otitis Media with Effusion / microbiology
  • Otitis Media with Effusion / surgery
  • Poloxamer*
  • Pseudomonas Infections* / drug therapy
  • Pseudomonas Infections* / microbiology
  • Retrospective Studies

Substances

  • Ciprofloxacin
  • Anti-Bacterial Agents
  • Ceftazidime
  • Poloxamer
  • Gels