A 65 year old man, who has diabetes mellitus for 1 - cecile

[ArchivalUser]

A 65 year old man, who has diabetes mellitus for 12 years, comes to your office because of right ear pain and decreased hearing during the last 24 hours. Temperature is 38.3 C (101.0 F). The right pinna is erythematous and tender; the external auditory canal is erythematous and swollen, and a small amount of debris and greenish, malodorous exudates around the external meatus. The right cervical lymph nodes are tender and enlarged. Leucocyte count is 14,000/cu mm with 70% segmented neutrophils, 10% band forms, 10% lymphocytes, 3% eosinophils, 3% basophils, and 4% monocytes.

Which of the following is the most appropriate treatment?
a. Polymixin B sulfate, neomycin sulfate, hydrocortisone otic drops
b Amoxicillin clavulanate
c. Ampicillin
d. Ceftazidime
e. Cephalexin

[ArchivalUser]

B p auruginosa

[ArchivalUser]

_ AAA

[ArchivalUser]

theres a systemic leucocytosis.its looks like malignant otitis externa. i would think ceftazidime or piperacillin tazobactam, with ENT referral to asses requirement for debridement.so, of all the options here, ceftazidime looks right. anyone who differs in opinion can please post it with a logical explanation....

[ArchivalUser]

ceftazidine




diabetes>ear, elderly> malignant otitis externa>pseudomonas>ceftazidine


Harrison's 17th:

Table 145-2 Antibiotic Treatment of Infections Due to Pseudomonas aeruginosa and Related Species


Bone infection, malignant otitis externa Cefepime or ceftazidime at the same dosages as for bacteremia; aminoglycosides not a necessary component of therapy; ciprofloxacin (500“750 mg q12h PO) may be used Duration of therapy varies with the drug used (e.g., 6 weeks for a -lactam agent; at least 3 months for oral therapy except in puncture-wound osteomyelitis, for which the duration should be 2“4 weeks).

[ArchivalUser]

DDD : ceftazidime

[ArchivalUser]

dd anti psudomonal