Bacteriophage Therapy for Chronic Mastoiditis

Objective To provide the first description of intratympanic bacteriophage therapy for chronic mastoiditis from multidrug-resistant Pseudomonas aeruginosa in the United States. Patients A 47-year-old woman with chronic mastoiditis in the setting of ciliary dysfunction from cystic fibrosis and immunosuppression from lung transplantation. Interventions Ten concurrent parenteral and intratympanic doses of two custom phages targeting P. aeruginosa followed by IV antibiotic therapy. Main Outcome Measures Resolution of infection confirmed by symptomatology, cultures, and imaging. Results At 5 months after phage treatment, the patient reported resolution of otorrhea, headaches, and hearing impairment. Subsequent cultures showed no growth. Conclusions Bacteriophages can enhance antibiotic activity in cases of drug-resistant chronic mastoiditis.