Topical antiseptics for chronic suppurative otitis media

Area of Science:

• Otolaryngology
• Infectious Diseases
• Pharmacology

Background:

• Chronic suppurative otitis media (CSOM) is a persistent middle ear infection characterized by ear discharge and hearing loss.
• Topical antiseptics are a potential treatment for CSOM, aiming to inhibit infection-causing microorganisms.
• Concerns exist regarding antiseptic-induced local irritation and potential ototoxicity.

Purpose of the Study:

• To evaluate the effects of topical antiseptics in managing chronic suppurative otitis media (CSOM).
• To assess the resolution of ear discharge, health-related quality of life, and adverse effects associated with antiseptic use.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted, searching multiple databases up to April 2019.
• Included studies involved patients with chronic ear discharge (CSOM) treated with topical antiseptics compared to placebo or other antiseptics.
• Primary outcomes included resolution of ear discharge, quality of life, and ear pain; secondary outcomes included hearing and ototoxicity.

Main Results:

• Evidence from five included studies was of very low certainty, making it difficult to draw firm conclusions.
• Uncertainty exists regarding the effectiveness of boric acid antiseptic drops compared to no treatment for ear discharge resolution.
• Limited data comparing different antiseptics showed uncertainty in efficacy for discharge resolution and ear discomfort.

Conclusions:

• The available evidence on the effectiveness and safety of topical antiseptics for CSOM is insufficient.
• Paucity of high-quality studies and very low certainty of existing evidence necessitate further research.
• The clinical utility of topical antiseptics in CSOM treatment remains uncertain.