Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T04:32:55.119Z Has data issue: false hasContentIssue false
  • English
  • Français

A double-blind comparative study of ofloxacin otic drops versus neomycin-polymyxin B-hydrocortisone otic drops in the medical treatment of chronic suppurative otitis media

Published online by Cambridge University Press:  29 June 2007

Michael C. F. Tong ,
John K. S. Woo  and
C. Andrew van Hasselt
Michael C. F. Tong
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
John K. S. Woo
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
C. Andrew van Hasselt*
Affiliation:
Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
*
Address for correspondence: Professor C. A. van Hasselt, Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Fax: (852) 2646-6312
Get access Rights & Permissions [Opens in a new window]

Abstract

Active chronic suppurative otitis media poses a management problem when patients are being considered for surgical treatment. Topical antibiotics have demonstrated varying degrees of success in the management of discharging ears. The introduction of quinolones has revived interest in these topical agents. This double-blind study compares two antibiotics, namely ofloxacin and neomycin-polymyxin B, with similar in vitro sensitivities to Gram positive and Gram negative organisms. Fifty-two patients were selected randomly and the results show that ofloxacin eardrops have marginal benefits in symptomatic improvement (89 per cent versus 79 per cent, p = 0.27) and bacterial eradication (81 per cent versus 75 per cent, p = 0.81) in active chronic suppurative otitis media. Significantly fewer patients (seven per cent versus 29 per cent, p = 0.04) in the ofloxacin group had active disease at the end of the two-week treatment. We recommend the use of ofloxacin eardrops in managing active chronic suppurative otitis media since it has high clinical efficacy, contains no steroid component and has no demonstrated risk of ototoxicity.

Keywords

Otitis media, chronic suppurativeDrug therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 4 , April 1996 , pp. 309 - 314
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baba, S. (1990a) A clinical study of ofloxacin otic solution on suppurative otitis media and otitis externa in children. Proceedings 3rd International Symposium on New Quinolones,Vancouver,European Journal of Clinical Microbiology and Infectious Diseases, pp 59–60.Google Scholar
Baba, S. (1990b) A double-blind clinical trial of ofloxacin otic solution for the treatment of chronic suppurative otitis media and its acute exacerbations. Proceedings 3rd International Symposium on New Quinolones,Vancouver,European Journal of Clinical Microbiology and Infectious Diseases, pp 60–61.Google Scholar
Browning, G. G., Picozzi, G. L., Calder, I. T., Sweeney, G. (1983) Controlled trial of medical treatment of active chronic otitis media. British Medical Journal 287: 1024.Google Scholar
Browning, G. G., Gatehouse, S., Calder, I. T. (1988) Medical management of active chronic otitis media: A controlled study. Journal of Laryngology and Otology 102: 491–495.Google Scholar
Crowther, J. A., Simpson, D. (1991) Medical treatment of chronic otitis media: Steroid or antibiotic with steroid eardrops? Clinical Otolaryngology 142–144.CrossRefGoogle ScholarPubMed
Deguchi, K., Yokota, N., Koguchi, M., Suzuki, Y., Suzuki, K., Fukayama, S., Ishihara, R., Oda, S. (1992) Bacteriological evaluation of ofloxacin otic solution. Japanese Journal of Antibiotics (Japan) 45(10): 342–355.Google Scholar
Esposito, S., D'Errico, G., Montanaro, C. (1990) Topical and oral treatment of chronic otitis media with ciprofloxacin. Archives of Otolaryngology, Head and Neck Surgery 116: 557–559.Google Scholar
Esposito, S., Noviello, S., D'Errico, G., Montanaro, C. (1992) Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media. Archives of Otolaryngology, Head and Neck Surgery 18: 842–844.Google Scholar
Fairbanks, D. N. F. (1984) Antimicrobial therapy for chronic suppurative otitis media. Annals of Otology, Rhinology and Laryngology 90(suppl): 58–62.Google Scholar
Gyde, M. C. (1981) A double-blind comparative study of trimethoprim-polymyxin B versus trimethoprim-sulfacetamide-polymyxin B otic solutions in the treatment of otorrhoea. Journal of Laryngology and Otology 251–259.Google Scholar
Hooper, D. C., Wolfson, J. S. (1991) The quinolones: Mode of action and bacterial resistance. In Antibiotics in Laboratory Medicine (Lorian, V., ed.). 3rd Edition, Williams & Wilkins, Baltimore, pp 655–690.Google Scholar
Ikeda, K., Takasaka, T. (1993) In vitro activity of ototopical drops against middle ear pathogens. American Journal of Otology 14(2): 170–171.Google Scholar
Kellerhals, B. (1978) Horschaden durch ototoxische ohrtropfen. Ergebnisse Einer Umfrage. [Risk of inner ear damage from ototoxic eardrops.] HNO (Berlin) 26(2): 49–52.Google Scholar
Kilcoyne, A. G. (1973) Gentamicin-hydrocortisone ear-drops in chronic infections. The Practitioner 91–92.Google Scholar
Mendonca, D. (1969) The topical use of gentamicin in otorrhoea. The Practitioner 203: 786–788.Google Scholar
Morizono, T. (1990) Toxicity of ototopical drugs: Animal modeling. Annals of Otology, Rhinology and Laryngology 99(suppl): 42–45.Google Scholar
Murphy, K. W. R. (1970) Deafness after topical neomycin-Correspondence. British Medical Journal 2(701): 114.CrossRefGoogle Scholar
Nobori, T., Hanamure, Y., Matuzaki, T., Miyazaki, Y., Kouno, M., Imamura, Y., Usigai, M., Nisizono, H., Watanabe, S., Matuzaki, N., Ohyama, M. (1988) A study of the influence of ofloxacin on the cochlea after topical administration into the middle ear cavity. Otologica Fukuoka 34: 1028–1034.Google Scholar
Ohyama, M., Nobori, T., Shima, T. (1990) Clinical efficacy of ofloxacin otic solution in paediatric patients with otitis media et externa. Proceedings 3rd International Symposium on New Quinolones,Vancouver,European Journal of Clinical Microbiology and Infectious Diseases, pp 58–59.Google Scholar
Reilly, G., Skinner, D. W. (1990) Antibiotic/steroid ear drop preparations: a cost-effective approach to their use. Journal of Laryngology and Otology 862–864.CrossRefGoogle ScholarPubMed
Spandow, O. (1992) Are glucocorticoids in ear drops ototoxic? Ada Oto-Laryngologica 493(suppl): 89–91.Google Scholar
Supance, J. S., Bluestone, C. D. (1983) Medical management of the chronic draining ear. Laryngoscope 661–663.Google Scholar
Todd, P. A., Faulds, D. (1991) Ofloxacin. A reappraisal of its antimicrobial activity, pharmacology and therapeutic use. Drugs 42(5): 825–876.Google Scholar
Wright, C. G., Meyerhoff, W. L. (1984) Ototoxicity of otic drops applied to the middle ear in the chinchilla. American Journal of Otolaryngology 5: 166–176.CrossRefGoogle Scholar
Yuen, P. W., Lau, S. K., Chau, P. Y., Hui, Y., Wong, S. F., Wong, S., Wei, W. I. (1994) Ofloxacin eardrop treatment for active chronic suppurative otitis media. Prospective randomized study. American Journal of Otology 15(5): 670–673.Google Scholar