Topical antibiotics 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 discharge and hearing loss.
• Topical antibiotics are a common treatment, aiming to eradicate causative microorganisms.
• This review is an update evaluating non-surgical interventions for CSOM.

Purpose of the Study:

• To assess the benefits and harms of topical antibiotics (without steroids) for CSOM patients.
• To compare topical antibiotics against placebo or no intervention.
• To compare different topical antibiotic agents.

Main Methods:

• Included randomized controlled trials (RCTs) with at least one week follow-up.
• Interventions involved topical antibiotics (drops, powders, irrigations) for CSOM with persistent discharge.
• Outcomes included discharge resolution, quality of life, ear pain, hearing, and complications.

Main Results:

• Topical ciprofloxacin may increase discharge resolution compared to placebo (very low-certainty evidence).
• Topical antibiotics plus systemic antibiotics may improve discharge resolution versus systemic antibiotics alone (low-certainty evidence).
• Evidence is very uncertain regarding comparisons between different topical antibiotic classes (e.g., quinolones vs. aminoglycosides).

Conclusions:

• Effectiveness of topical antibiotics for CSOM is uncertain due to limited, low-certainty evidence.
• Topical antibiotics show potential benefits when used with placebo or systemic antibiotics.
• Further research is needed to clarify comparative effectiveness and safety profiles.