Cholesteatoma Medication

Updated: Apr 12, 2022
  • Author: Vijay A Patel, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication Summary

Drug therapy is not currently part of the standard of care for cholesteatoma, with little utility even when lesions become infected. Owing to a lack of blood supply to the cholesteatoma, systemic antibiotics cannot be delivered to its center. Topical antibiotics often surround the cholesteatoma, suppress infection, and penetrate a few millimeters toward its center; however, large infected cholesteatomas are resistant to any type of antimicrobial therapy. Consequently, otorrhea either persists or recurs, despite frequent and aggressive treatment with antibiotics. In the operative setting, it is our practice to place fluoroquinolone and steroid-impregnated topical solution into the middle ear and/or dissected mastoid cavity. Furthermore, after the cholesteatoma is extirpated surgically, it is also our practice to place patients on a 10-day course of antibiotics (ie, penicillin-based antimicrobial).