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Has downs syndrome, perforation of eardrum and sinusitis. Positive with MRSA. Taking gentamicin. Had heart surgery with VSD

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ENT Specialist
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my son is 24 years old and has downs syndrome. he has had repeated perforation of his left eardrum and sinisutis. this has been on going form ear surgery two years ago. my son has been on antibioitics everyday for most of his life he has blocked hair folliciles
inlast week his ear got swabbed and came back positive MRSA .. sensitivities. Gentamicin... and Teicoplan .
he has been started on gentamicin ear drops. and erradiation therapy..
i'm sick with worry... my son had heart surgery as a baby ..for VSD . presently there is minual leaking from the vavle... can I get the MRSA cured . with just topical and erraditiation therapy...
Posted Wed, 22 May 2013 in Ear, Nose and Throat Problems
Answered by Dr. A.K. Srivastava 52 minutes later

I had gone through your query regarding your son having down syndrome and develops repeated infections of ear.

I would like to tell you that children with down syndrome are having increased risk of otitis media due to nasopharynx, narrow oropharyngeal airway and macroglossia. These are the reasons for failure of ear surgeries in these patients.

Culture of ear pus is positive for MRSA and he is now given antibiotic according to sensitivity test. So there are fair chances of your child to get free from infection.

I hope your query is explained.

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Follow-up: Has downs syndrome, perforation of eardrum and sinusitis. Positive with MRSA. Taking gentamicin. Had heart surgery with VSD 3 hours later
thank you..for explaining that to me. my son has only been started on gentamicin ear drops.. and errarditation therapy of bactroban and octesitan wash for 5 days.. the teicoplanin has not been advised as yet..

do you feel that is enough to clear this terrible infection... help me..please.. I've read so much that MRSA is .not curable. and with my sons poor cardiac history / i'm so worried.

thank you
Answered by Dr. A.K. Srivastava 1 hour later

Thanks for writing back.

I have understood about your doubt for eradication of infection in ear of your child. Decision of antibiotic to be use depends on the grading of sensitivity spectrum of antibiotic for that particular infection.

Your child has chronic otitis media, and I would like to tell you that for chronic infection of ear (CSOM )local application of antibiotic is preferred while on the other hand in acute infection of ear (AOM ) one like to use systemic antibiotics.

Thirdly in sensitivity spectrum if one get only two or three antibiotic which are non resistant than always some antibiotic should be kept reserve for future use.

Your child is being given gentamycin ear drop I think that is sufficient but if you want some prompt action than with consent of your treating doctor some other antibiotic or even gentamycin may be given in injectable form.

I hope above explanation answers your query.

Above answer was peer-reviewed by
Follow-up: Has downs syndrome, perforation of eardrum and sinusitis. Positive with MRSA. Taking gentamicin. Had heart surgery with VSD 13 hours later
thank you again for explaining that to me... i'm at my wits end... so worried.... I know that mrsa is not curable ..... and my son's limited antibiotic treatment is worrying me soo much.
I know that MRSA can move around the body from one part to the other.. i'm soo concerned that it will go somewhere you know of any success rates of MRSA in a perforated ear drum has been cured alone with topical gemetmicin and errariadation therapy.
we need three clear swabs... form sites around his body like nose throat groin and ear... is this achieavable alone with ear drops ???
microbiology do not want to go with iv antibioitic therapy as yet....
there is a high risk of reinfection from the MRSA.....
it is said it is difficult to remove MRSA from the body and it can be fatal.
my son has respiratory problems, and cardiac problems... i'm soo worried that this MRSA will takeover his life...

Answered by Dr. A.K. Srivastava 5 hours later
Thanks for writing back

Regarding your query I would like to tell you that it is a problematic infection and difficult to treat. In such case a follow up is necessary and thorough. Depending on the spread of the infection mode of treatment is decided. I do not think it is easy to answer without knowing the extent of spread whether topical ear drops would help or not. So please remain in touch of your treating doctor he will certainly care for spread.

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