[Use of topical ciprofloxacin in chronic suppurating otitis media]

A prospective study is presented. We carry out an analysis of the results obtained after treatment with different protocols of administration of ciprofloxacin, during the active phase in chronic otitis media and in chronic otorrhea.

A multicenter, prospective study is carried out, in 3 ENT departments, corresponding to 3 reference tertiary hospitals. 300 patients were included ranging from 5 to 73 years old, all were diagnosed of chronic disease of the middle ear: simple chronic otitis media (n = 128), chronic otitis with bone reabsorption (n = 57), cholesteatoma infection (n = 42) and postsurgery ear infection (n = 73). Patients were placed in 5 treatment groups: ciprofloxacin (oral administration) (only adults were included), topical ciprofloxacin (0.5%), topical ciprofloxacin (0.2%), topical ciprofloxacin (0.2%) plus oral ciprofloxacin and ciprofloxacin (0.3%) plus topical fluocinolone. There was a control group treated with polimixin plus neomicine and hidrocortison.

The most common isolated bacterias were: Pseudomonas aeruginosa and S. aureus. We found 19 resistant strains to ciprofloxacin. A better therapeutic response was observed in the topical administration groups. In topical administration, a difference was only observed in the cholesteatoma and chronic middle ear infection with bone reabsorption groups, in those patients that were administered the ciprofloxacin with fluocinolone.

Forms of topical treatment, with ciprofloxacin, in active infection of chronic disease of the middle ear, improve the results compared to oral administration. The association with of topical fluocinolone improves the results in the cases with cholesteatoma infection and chronic middle ear infection.