Inflammatory diseases of the external ear: place and possibilities of topical therapy
Otitis externa (NO) is manifested by inflammatory changes in the auricle, external auditory canal and epidermal layer of the eardrum. The disease is characterized by a wide prevalence and a continuing increase in morbidity, a persistent, resistant to adequate therapy course and frequent recurrence of the pathological process. For the development of NO, the presence of an etiotropic agent and a violation of the integrity of the epidermal layer of the skin of an endogenous and exogenous nature are necessary. According to the area of distribution and the type of pathological process, limited and diffuse NO are considered. Most often, bacteria act as the causative agents of NO, with diffuse forms Pseudomonas aeruginosa is the leader. The appointment of systemic antibiotics for uncomplicated forms of NO is impractical, it is optimal to use topical combined drugs that have adequate activity against the main pathogens of NO. The advantages of topical therapy in such patients are the rapid accumulation of required active substance concentration in the area of inflammation and almost complete lack of systemic action, minimal risk of development and spread of resistant strains of microorganisms. It is required to use antimicrobial agents that have been shown to be active against the main pathogens of otitis externa. The reduction of inflammation and pain is also an important component of the management of patients with OE. A good option for topical therapy of patients with inflammatory changes in the external ear is a drug with antimicrobial and local anesthetic action containing antibacterial components: aminoglycoside neomycin sulfate and cyclic polypeptide polymyxin B sulfate, and local anesthetic lidocaine hydrochloride. Such agents have a balanced antimicrobial and local anesthetic action, high safety and can be recommended for use in patients with diffuse otitis externa.