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Antiseptics to combat otorrhea in the era of antibiotic resistance

Reviewed by Patrick Spielmann

This nice scientific paper pits various antiseptic solutions against each other to determine which has the most bactericidal properties. Five different antiseptics were applied to MRSA and quinolone-resistant pseudomonas species, which are both difficult to treat with conventional ototoxic medications. Burow’s solution (100% or 50%), acetic acid, vinegar/water and boric acid were compared, 100% Burow’s solution came out on top. I had not come across this before: it was described by Karl August von Burow in the late 19th century and consists of 13% aluminium acetate (pH 3.06). Burow’s solution was particularly effective against MRSA when compared with the other solutions. Given the strong acidic nature of 100% Burow’s solution and the ototoxic side-effects, a diluted 50% solution may be used with similar effects and a pH near 4, which is more acceptable to the inner ear. Burow’s solution has been shown to be effective in up to 80% of chronic otologic infections in vivo. So, how to combat the rise of the ear super bugs? 50% Burow’s solution is certainly worth thinking about when faced with that chronically draining ear and drug-resistant bacteria. 

Comparative antibacterial activity of topical antiseptic eardrops against methicillin-resistant Staphylococcus aureus and quinolone-resistant Pseudomonas aeruginosa.
Youn CK, Jang S-J, Jo E-R, et al.
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY
2016;85:80-3.
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