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  6. Repurposing Povidone-iodine For The Treatment Of Chronic Suppurative Otitis Media In Nigerian Children

Repurposing Povidone-Iodine for the Treatment of Chronic Suppurative Otitis Media in Nigerian Children

Mercy E Jatto1, Adebolajo A Adeyemo1, Ayotunde J Fasunla1

  • 1University College Hospital.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|December 11, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Povidone-iodine ear irrigation is as effective as ciprofloxacin drops for treating chronic suppurative otitis media (CSOM) in children. Oral antibiotics showed negligible benefit, suggesting simpler treatments may suffice for uncomplicated CSOM.

Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Clinical Trials

Background:

  • Chronic suppurative otitis media (CSOM) is a common cause of hearing loss in children.
  • Antibiotic eardrops are the standard treatment, but rising resistance and treatment failures necessitate alternative therapies.
  • Exploring novel treatments is crucial due to increasing antibiotic resistance in CSOM management.

Purpose of the Study:

  • To compare the efficacy of povidone-iodine ear irrigation versus ciprofloxacin ear drops for treating uncomplicated CSOM in children.
  • To evaluate the added benefit of oral antibiotics in conjunction with topical treatments for CSOM.
  • To assess the effectiveness of povidone-iodine irrigation as a standalone treatment for CSOM.

Main Methods:

  • An 18-month randomized clinical trial involving 361 children aged 6 months to 14 years with uncomplicated CSOM.
Keywords:
Chronic suppurative otitis mediaMiddle ear cleftPovidone-iodine

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  • Three intervention groups: (a) povidone-iodine irrigation + oral amoxicillin-clavulanic acid, (b) ciprofloxacin drops + oral amoxicillin-clavulanic acid, (c) povidone-iodine irrigation alone.
  • Treatment duration was 4 weeks, with assessments at 4 weeks and 3 months post-intervention.
  • Main Results:

    • Otorrhea resolution rates were high and comparable across all groups (92.7%-93.7%).
    • Tympanic membrane healing rates were 11.7% (group a), 12.7% (group b), and 15.6% (group c).
    • Pathologic isolates were absent post-treatment in 75% (group a), 80.3% (group b), and 74.5% (group c) of cases.

    Conclusions:

    • 0.5% povidone-iodine aural irrigation is non-inferior to 0.3% ciprofloxacin otic suspension for uncomplicated CSOM.
    • The addition of oral antibiotics (amoxicillin-clavulanic acid) provided negligible additional benefit in treating uncomplicated CSOM.
    • Povidone-iodine ear irrigation represents an effective alternative treatment for uncomplicated CSOM, potentially reducing reliance on oral antibiotics.