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Topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations
C A Macfadyen1, J M Acuin, C Gamble
1Liverpool School of Tropical Medicine, International Health Research Group, Pembroke Place, Liverpool, UK L3 5QA. carolynm@liv.ac.uk
The Cochrane Database of Systematic Reviews
|October 20, 2005
Summary
Topical quinolone antibiotics effectively treat chronic suppurative otitis media (CSOM) by clearing ear discharge compared to no treatment or antiseptics. Further research is needed to clarify non-quinolone antibiotic efficacy and safety.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pharmacology
Background:
- Chronic suppurative otitis media (CSOM) is characterized by persistent ear discharge and hearing impairment.
- Effective management of CSOM is crucial to prevent complications and improve patient quality of life.
Purpose of the Study:
- To evaluate the efficacy of topical antibiotics, excluding steroids, for treating CSOM.
- To compare different topical antibiotic classes and their effectiveness against no treatment or antiseptics.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, LILACS, AMED, and CINAHL.
- Included trials comparing topical antibiotics (without steroids) to placebo, antiseptics, or other antibiotics in CSOM patients.
Main Results:
- Topical quinolone antibiotics demonstrated superior efficacy in clearing ear discharge compared to no treatment or antiseptics.
- No significant difference was observed between quinolone and non-quinolone topical antibiotics (without steroids) in clearing discharge.
- Evidence regarding the safety of topical antibiotics for CSOM was limited.
Conclusions:
- Topical quinolone antibiotics are effective for managing ear discharge in CSOM.
- Further high-quality trials are recommended to assess non-quinolone antibiotic efficacy, long-term outcomes, and safety profiles, including ototoxicity.
- Clarifying differences between quinolone and non-quinolone antibiotics requires more research.