Topical Therapy Failure in Chronic Suppurative Otitis Media is Due to Persister Cells in Biofilms

Conclusions: Higher percentages of persister cells in clinical CSOM isolates are associated with resistance to ototopicals. Current ototopicals, except povo-iodine, have limited clinical effectiveness; however, it is unknown what the maximum achievable concentration is and there are ototoxicity concerns. Fluoroquinolones, while successful in producing inactive disease in the short term, have the potential to encourage antimicrobial resistance and disease recalcitrance and do not achieve a permanent remission. Given these limitations, clinicians should consider surgery earlier or use of clinically safe concentrations of povo-iodine earlier into the treatment algorithm.
Source: Otology and Neurotology - Category: ENT & OMF Tags: MIDDLE EAR AND MASTOID DISEASE Source Type: research