Novel therapy for malignant otitis externa: A comprehensive review of garenoxacin therapy

ABSTRACT Background: Malignant Otitis Externa (MOE) presents a formidable challenge in the domain of otorhinolaryngology, characterized by aggressive pathology with potential for severe complications like cranial nerve paralysis (skull base osteomyelitis) and mortality if not attended to initially. Methods: A Non interventional retrospective study done in patients attending ENT Outpatient department at NRI General Hospital, Mangalagiri, Andhra Pradesh between December 2014 and May 2024. 64 patients were included in the study. Patients received only medical management, with no surgical interventions employed. All medical and surgical data were reviewed and documented. Results: Ear pain was the common complaint for all the patients which was a throbbing type, aggravated at night (SEVERE NOCTURNAL OTALGIA), not relieved by oral analgesics that obliged frequent administration of intravenous analgesics (tramadol thrice per day) and mean VAS score 7. By the last follow-up visit, all patients were free of pain. Otorrhoea was not observed in any patients on follow-up visits. Tinnitus intensity and number of episodes were lowered but persisted in few patients and were managed symptomatically. Conclusions: Garenoxacin demonstrates exceptional antimicrobial coverage against key pathogenic bacteria, along with superior safety profile offering a convenient once-daily dosage regimen for 3 to 6 weeks. This not only enhances patient compliance but also positions as a judicious and viable therapeutic option in the management of malignant otitis externa, especially where otolaryngologists have limited alternatives.