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 causing ear discharge and hearing loss.
• Topical antiseptics are a potential treatment, but their efficacy for CSOM remains unclear.
• This review is an update assessing non-surgical interventions for CSOM.

Purpose of the Study:

• To evaluate the effectiveness of topical antiseptic agents for treating chronic suppurative otitis media.
• To compare topical antiseptics against placebo, no treatment, or other topical antiseptics.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) including adults and children with CSOM.
• Searched multiple databases up to June 2022.
• Primary outcomes included resolution of ear discharge and health-related quality of life; secondary outcomes included hearing and complications.

Main Results:

• Evidence is very uncertain regarding topical antiseptics versus placebo/no treatment due to low-certainty evidence.
• Boric acid in alcohol ear drops showed potential benefit for discharge resolution compared to dry mopping alone.
• Topical povidone iodine with oral antibiotics may increase discharge resolution compared to placebo with antibiotics.

Conclusions:

• The overall evidence for topical antiseptics in CSOM is of very low certainty, limiting definitive conclusions.
• Boric acid and povidone iodine show some promise in specific contexts.
• Insufficient evidence exists to assess harmful effects; further research is needed.