Die Behandlung des MRSA besiedelten Mittelohres; eine Fallbeschreibung und Literaturübersicht

G. Senska; D. Rüsing

doi:10.1055/s-0030-1249674

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Laryngorhinootologie 2010; 89(7): 404-408
DOI: 10.1055/s-0030-1249674

Übersicht

Die Behandlung des MRSA besiedelten Mittelohres; eine Fallbeschreibung und Literaturübersicht

The Treatment of MRSA Colonized Middle Ear; Case Report and Literature ReviewG. Senska¹ , D. Rüsing²

¹Marienhospital Gelsenkirchen, HNO, Gelsenkirchen
²Marienhospital, Apotheke, Gelsenkirchen

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Publication History

Publication Date:
08 July 2010 (online)

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Zusammenfassung

Hintergrund: Die Behandlung des MRSA (Methocillin resistenter Staphylokokkus aureus) besiedelten Mittelohrs ist problematisch. Nach den vorhandenen Leitlinien sollte ein lediglich mit MRSA besiedelter Patient systemisch antibiotisch generell nicht behandelt werden. Bei der topischen Behandlung stellt sich jedoch das Problem der Ototoxizität fast aller verwendeten antiseptischen und antibiotischen Substanzen.

Methode: Auswertung einer selektiven Literaturrecherche unter Hinzuziehung eigener klinischer Erfahrung.

Ergebnis und Schlussfolgerung: Als antibiotische Behandlung kommen wässrige Tetracyclin Tropfen, Chloramphenicol Tropfen sowie Chinolon Ohrentropfen (leider ist der MRSA meist resistent) in Betracht. Antiseptisch ohne ototoxische Wirkung sind die Burow'sche Lösung, Povidonjodlösungen, Essigsäurelösungen sowie wässrige Dequalinium Lösungen.

Abstract

The Treatment of MRSA Colonized Middle Ear; Case Report and Literature Review

Background: The treatment of MRSA (methocillin resistant staphylococcus aureus) colonized middle ear is difficult. According to the guidelines, a MRSA colonized Patient is not to be treated with systemic antibiotics. The topical treatment shows the problem of the ototoxicity of most of the used antiseptic as well as antibiotic substances.

Method: Selective literature review and consideration of the author's own clinical experience.

Results and conclusions: Antibiotic treatment options include aequeous Tetracyclin drops, aequeous chloramphenicol drops and quinolon ear drops (unfortunately the MRSA is resistent mostly). Antiseptics without ototoxic effects are the Burow's solution, Povidone-iode, acetic acid solutions and aequeous dequalinium solutions.

Schlüsselwörter

MRSA - Mittelohr - Ototoxizität - Lokaltherapie - Trommelfelldefekt

Key words

MRSA - middle ear - ototoxicity - local therapy - ear drum perforation

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Korrespondenzadresse

Dr. Götz Senska

Marienhospital Gelsenkirchen HNO

Virchowstraße 135

45886 Gelsenkirchen

Email: goetzsenska@arcor.de

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