Bezpieczeństwo miejscowego dousznego stosowania leków w różnych sytuacjach klinicznych

Abstract

Drugs administered directly into the ear canal are used for otitis externa, chronic chronic otitis media and, in some cases, acute inflammation of the middle ear in children with eardrum grommets. In some clinical conditions eardrum is incomplete or absent, or, at the preserved/reconstructed tympanic membrane, the rear wall of the ear canal is open to the antrum. Drugs applied topically to the external auditory canal are acidifying preparations, antiseptic substances and antibacterial or antifungal antibiotics, steroids and also heavy metals in colloidal form. Aminoglycosides, formerly appearing as the most common component of these drugs, because of the very high potential for ototoxicity, gradually disappear from the group of fluoroquinolone antibiotics. Numerous clinical studies have shown high therapeutic efficacy of these compounds in the absence of ototoxicity. In view of the possibility of obtaining a high concentration of antibiotic in the site of infection, and the absence of adverse effects, typical for systemic administration of the drug, they are recommended as monotherapy in chronic otitis externa, exacerbated chronic otitis media, and in cases of acute otitis media in children with grommets.