Document Detail


A randomized controlled trial of active chronic otitis media comparing courses of eardrops versus one-off topical treatments suitable for primary, secondary and tertiary healthcare settings.
MedLine Citation:
PMID:  22804826     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:  Primary: to compare one-off administration of boric acid powder with courses of 1% acetic acid and ciprofloxacin eardrops in treating active chronic otitis media. Secondary: to evaluate the effectiveness of Quadriderm® cream in resistant active chronic otitis media; and to document side effects of these treatments, especially hearing loss. Study design:  Randomised controlled trial. Setting:  Outpatient department of a tertiary ENT unit. Participants:  159 patients over 6 years old with active chronic mucosal (without cholesteatoma) otitis media randomized to receive one of the 3 primary agents. Method:  All techniques employed were suitable for primary health care givers as well as specialists. After confirming eligibility patients were randomly allocated to treatment. All ears underwent toilet with irrigation using clean water, a syringe and ambient light, with or without dry mopping, until the perforation was visible. The randomized solution was flushed through the middle ear and Eustachian tube using a "tragal pump" technique: saline was used as the solution for flushing in the boric acid powder arm. Patients allocated topical ear medication were given a bottle of eardrops to administer (6 drops twice daily, "pumped in") until finished. Those allocated boric acid powder had the external ear canals filled as a one-off treatment. Patients were followed up monthly thereafter. Outcome measures:  Primary: Dry (inactive) middle ears as assessed by the doctor. Secondary: Patient assessment of success; microbiologic culture and sensitivity; audiologic changes due to treatment; complications of treatment; costs of therapies. Results:  Ciprofloxacin eardrops and boric acid powder were statistically superior to 1% acetic acid eardrops in rendering active chronic otitis media inactive (73% dry ears for ciprofloxacin; 67% for boric acid powder; and 24% for acetic acid). There was no difference between the success rates of ciprofloxacin eardrops and boric acid powder. Quadriderm cream was effective in 85% of patients failing first-line therapy. No agent caused significant complications, and specifically no hearing loss. Conclusions:  This study showed a single application of boric acid powder following external auditory canal irrigation until the perforation was visible to be as effective as the current best practice of topical quinolone eardrops in active chronic otitis media. Boric acid powder is inexpensive and does not require patient compliance. Boric acid powder is a viable, less costly alternative to topical antibiotic/steroid ear drops in the developing world for active chronic otitis media. Acetic acid eardrops1%, are ineffective. Quadriderm cream, given as a one off therapy, also appears to be effective. © 2012 Blackwell Publishing Ltd.
Authors:
J W Loock
Related Documents :
15857456 - Hyaluronic acid: a unique topical vehicle for the localized delivery of drugs to the skin.
2434556 - Regional differences in quantities of histochemically detectable mucosubstances in nasa...
22733276 - Quantitative imaging of electron transfer flavoprotein autofluorescence reveals the dyn...
22780216 - Purification and characterization of prophenoloxidase from galleria mellonella l.
8109746 - Analysis of 2- and 3-series prostanoids by post-hplc elisa.
22230896 - Direct visualization of retinoic acid in the rat hypothalamus: an immunohistochemical s...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-16
Journal Detail:
Title:  Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery     Volume:  -     ISSN:  1749-4486     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101247023     Medline TA:  Clin Otolaryngol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Division of Otorhinolaryngology, Faculty of Health Sciences, University of Stellenbosch/Tygerberg Hospital, Cape Town, South Africa.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  HuPho: the human phosphatase portal.
Next Document:  Trying to predict the future of ex-preterm infants: who benefits from a brain MRI at term?