International Journal of Otolaryngology and Head & Neck Surgery, 2023, 12, 92-98 https://www.scirp.org/journal/ijohns ISSN Online: 2168-5460 ISSN Print: 2168-5452 DOI: 10.4236/ijohns.2023.123010 May 15, 2023 92 Int. J. Otolaryngology and Head & Neck Surgery Persistent Pseudomonas Infection Mastoiditis—Local Antibiotic Treatment Is Superior than Systemic Siti Aisyah Mohamed 1,2 , Roslim-Siti Norain 1 , Shahrul Hitam 1 , Asma Binti Abdullah 2 1 Department of Otorhinolaryngology, Hospital Ampang, Selangor, Malaysia 2 Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Abstract Mastoiditis is a common complication of acute otitis media. It is common in younger age compared to adulthood. Mastoiditis occurs when an otitis media infection spread directly to involve the bone of mastoid air cell causing ostei- tis. Cholesteatoma can contribute to the development of mastoiditis. This typically leads to breakdown of some of the fine bony trabeculae of mastoid cells producing a coalescent mastoiditis with an emphyema in mastoid an- trum. Cholesteatoma can contribute to the development of mastoiditis. The common treatment for mastoiditis is intravenous antibiotic. Our cases show that local antibiotic treatment is superior compared to systemic antibiotic in treating multi-drug resistant chronic. Pseudomonas mastoiditis compared to intravenous antibiotic. However, if it presents together with cholesteatoma the main treatment is still early mastoidectomy. Keywords Antibiotic, Cholesteatoma, Drug-Resistant, Mastoidectomy, Mastoiditis 1. Introduction Mastoiditis is defined as inflammation of a portion of the temporal bone re- ferred to as the mastoid air cells. The mastoid air cells are epithelium lined bone septations that are continuous with the middle ear cavity. Mastoiditis is a com- mon complication of acute otitis media [1]. It is common in younger age com- pared to adulthood [2]. Mastoiditis occurs when an otitis media infection spread directly to involve the bone of mastoid air cell causing osteitis. This typically leads to breakdown of some of the fine bony trabeculae of mastoid cells produc- How to cite this paper: Mohamed, S.A., Norain, R.S., Hitam, S. and Abdullah, A.B. (2023) Persistent Pseudomonas Infection Mastoiditis—Local Antibiotic Treatment Is Superior than Systemic. International Journal of Otolaryngology and Head & Neck Sur- gery, 12, 92-98. https://doi.org/10.4236/ijohns.2023.123010 Received: February 23, 2023 Accepted: May 12, 2023 Published: May 15, 2023 Copyright © 2023 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access