Document Detail


Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial.
MedLine Citation:
PMID:  12914507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare the effectiveness of ototopical ciprofloxacin (0.3%; CIP) with framycetin (0.5%), gramicidin, dexamethasone (FGD) eardrops (5 drops twice daily for 9 days) together with povidone-iodine (0.5%) ear cleaning as treatments for chronic suppurative otitis media (CSOM) in Aboriginal children. DESIGN AND PARTICIPANTS: Aboriginal community-controlled, community-based, multicentre, double-blind, randomised controlled trial in eight Aboriginal Community Controlled Health Services across northern Australia, involving 147 Aboriginal children with CSOM. MAIN OUTCOME MEASURES: Resolution of otorrhoea (clinical cure), proportion of children with healed perforated tympanic membrane (TM) and improved hearing, 10-21 days after starting treatment. RESULTS: 111 children aged 1-14 years (CIP, 55; FGD, 56) completed treatment. CSOM cures occurred in 64% (CIP, 76.4%; FGD, 51.8%), with a significantly higher rate in the ciprofloxacin group (P = 0.009, absolute difference of 24.6% [95% CI, 15.8%-33.4%]). TM perforation size and the level of hearing impairment did not change. Pseudomonas aeruginosa was the most common bacterial pathogen (in 47.6%), while respiratory pathogens were rare (in 5.7%). CONCLUSIONS: Twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.
Authors:
Sophie Couzos; Traven Lea; Reinhold Mueller; Richard Murray; Margaret Culbong
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  179     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-13     Completed Date:  2003-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Affiliation:
National Aboriginal Community Controlled Health Organisation, PO Box 168, Deakin, ACT 2600, Australia. scouzos@tpgi.com.au
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adolescent
Anti-Infective Agents / administration & dosage*
Child
Child, Preschool
Chronic Disease
Ciprofloxacin / administration & dosage
Community Health Services
Dexamethasone / administration & dosage
Drug Administration Schedule
Female
Framycetin / administration & dosage
Gramicidin / administration & dosage
Humans
Infant
Male
Oceanic Ancestry Group
Otitis Media, Suppurative / drug therapy*,  pathology
Povidone-Iodine / administration & dosage
Queensland
Treatment Outcome
Western Australia
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 119-04-0/Framycetin; 1405-97-6/Gramicidin; 25655-41-8/Povidone-Iodine; 50-02-2/Dexamethasone; 85721-33-1/Ciprofloxacin
Comments/Corrections
Comment In:
Med J Aust. 2004 Jul 19;181(2):84   [PMID:  15257644 ]
Med J Aust. 2004 Jan 19;180(2):91-2; author reply 92-3   [PMID:  14768072 ]
Med J Aust. 2004 Jan 19;180(2):91; author reply 92-3   [PMID:  14723593 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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