Aminoglycoside antibiotics can be used successfully in the treatment of otologic infections caused by gram-negative bacteria. They can be particularly valuable, sometimes in combination with a β-lactam antibiotic such as carbenicillin, in malignant external otitis, acute middle ear infections caused by gram-negative organisms, and central nervous system complications of cholesteatomas. On the basis of susceptibility tests and of the pharmacology of these drugs, we administer appropriate therapeutic doses of one of the following antibiotics: Kanamycin, gentamicin, tobramycin, or amikacin. All of these drugs may be ototoxic and nephrotoxic.
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