A discharging ear is a very common condition for the general
practitioner and the ENT surgeon. Oral and intravenous antibiotics have
potential complications, are costly, and exhibit increasing resistance.
This study explores the advantages and disadvantages of all common otic
preparations and compares effectiveness, safety, cost and complication
rates. In chronic otitis media (chronic discharging ears), topical
antibiotics seem to be the treatment of choice by comparison with oral
or intravenous antibiotics. Cultures and antibiograms do not correspond
directly to clinical efficacy, as laboratory determination of resistance
does not take into account the high concentration of antibiotics in
local preparations. It is safer to use quinolone drops as a first-line
treatment, but it is still possible to use short courses of other drops
if quinolones are either unavailable or contraindicated (e.g. allergy),
or when bacteria are resistant to them. However, in such a situation, a
round window membrane involved in an established inflammatory process
and therefore less permeable to the passage of topical preparations is
the preferred setting, as ototoxicity is a potential complication,
especially in the case of gentamicin, in which case patients should be
warned accordingly.
(EN)
/aggregator-openarchives/portal/institutions/uoa
