Ototoxicity of Topically Applied Chloramphenicol

Abstract

SINCE its introduction in 1948, medical opinion concerning the use of chloramphenicol has fluctuated considerably. However, from 1953 to 1963, this wide spectrum bacteriostatic antibiotic had enjoyed better than a fivefold increase in usage. This was attributed largely to a greater understanding of its hematopoietic reactions and to an increased awareness of the precautions necessary to minimize such complications. Since that time, safer antibiotics with an effective spectrum, somewhat more limited than that of chloramphenicol, have been introduced and have gained popularity, although chloramphenicol is still widely used. Because of its wide spectrum, chloramphenicol has been used systemically by otologists for some resistant cases of otitis media and mastoiditis and postoperatively following tympanomastoid and fenestration operations. Although the drug is often effective systemically in acute infections, many otologists empirically found it to be more effective when applied topically in the middle ear in cases of chronic refractory otitis media and