A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid–antibiotic therapy

Abelardo, Edgardo; Pope, L. S.; Rajkumar, K; Greenwood, Rosemary; Nunez, Desmond A.

doi:10.1007/s00405-008-0712-y

Cited by 23 publications

(28 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combinations of steroid and antibiotic drops have been shown to be superior to topical steroids alone for symptomatic control of acute otitis externa [6]. Similar studies and meta-analyses corroborate these findings with data suggesting that topical antibiotics are highly effective for acute otitis externa with cure rates of 65-80% within 10 days of therapy [1,[7][8][9].…”

Section: Discussionsupporting

confidence: 60%

The management of otitis externa in UK general practice

Pabla

Jindal

Latif

2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Acute otitis externa is common and provides a heavy workload for general practitioners. We aim to determine the first-line treatment used by general practitioners in the management of otitis externa and subsequent second-line treatment in a hospital ENT clinic. In addition, this study aims to ascertain whether local and national guidelines are being followed appropriately. A prospective observational study on the management of otitis externa in consecutive patients referred to an ENT emergency clinic was undertaken. Data were collected and analysed on symptoms, initial management by general practitioners, findings and treatment in the ENT clinic. A total of 106 patients were studied. The mean duration of symptoms before presentation to clinic was 13 days; 42% of patients received no treatment by their GP prior to referral to the ENT emergency clinic. Only 14% of patients received topical antibiotics alone, whilst 44% received oral antibiotics, either alone or in conjunction with topical antibiotics by their GP. Of the 106 patients, 86% received topical antibiotics in the ENT emergency clinic and oral antibiotics were reserved for those presenting with complicated acute otitis externa. Topical antibiotics are associated with a decrease in disease persistence, whilst oral antibiotics are associated with an increase. However, general practitioners are prescribing oral antibiotics more often than required. There are few regional guidelines and no explicit national guidelines on the management of acute otitis externa for GPs to refer to. We suggest the implementation of national guidelines to aid clinical practice.

show abstract

Section: Discussionsupporting

confidence: 60%

The management of otitis externa in UK general practice

Pabla

Jindal

Latif

2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…Otitis externa is an inflammatory process of the external auditory canal, including the auricle, auditory canal, and eardrum (1,2). The presentation of otitis externa includes otalgia, otorrhea, pruritus, aural fullness, hearing impairment, and tinnitus (3).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Mixed Otitis Externa Using Ceftazidime Powder and Topical Miconazole Versus Topical Miconazole Only

Kiakojuri

Omran

Elahi

et al. 2018

Jundishapur J Microbiol

View full text Add to dashboard Cite

Background: Otitis externa is an inflammatory in external auditory canal, with the presentation of otalgia, otorrhea, and pruritus. Bacteria and fungi are the most causative agents of the disease. Although several antifungal and antibacterial agents are usually used to treat it, combination therapy plays an important role in good treatment efficacy. Objectives: According to the problems associated with the treatment of mixed otitis externa, the current study aimed at evaluating the efficacy of ceftazidime powder and topical miconazole (as the case group) versus topical miconazole only (as the control group) to treat mixed otitis externa. Methods: Seventy-two patients with mixed otitis externa were divided into two groups; the case group was treated with ceftazidime powder and topical miconazole, and the control group was treated only with topical miconazole. Both groups were evaluated after two weeks. The diagnosis of mixed otitis externa was based on signs, symptoms, and the presence of bacterial and fungal elements in direct examination and culture. Results: Swelling, itching, and canal discharge were observed in 67.7%, 64.7%, and 90.3% of the patients, respectively in the case group, and 47.1%, 26.3% and 93.1% of the patients, respectively in the control group. Complete resolution of all clinical signs and symptoms occurred in 23 (67.6%) patients in the case group and 11 (28.9%) patients in the control group (P = 0.001). Staphylococcus epidermidis and Pseudomonas aeruginosa were the most common bacteria, and Aspergillus spp. and Candida spp. were the most common fungi identified in the cultures. Conclusions: According to the complete resolution of clinical signs, the application of ceftazidime powder and topical miconazole was better than topical miconazole to treat mixed otitis externa.

show abstract

“…[5][6][7][8][9][10] Topical antibiotic-steroid combination therapy is superior to steroid therapy alone for symptomatic control of otitis externa. [11,12] We performed this study to observe the effectiveness of treatment for relieving pain and edema by comparing steroid-antibiotic with 10% Ichthammol glycerine. …”

Section: Introductionmentioning

confidence: 99%

Effective Treatment of Acute Otitis Externa: a Comparison of Steroid Antibiotic Versus 10% Ichthammol Glycerine Pack

Shrestha

Amatya

et al. 2010

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

To compare the efficacy of treatment between steroid-antibiotic and 10% Ichthammol glycerine packs (IG packs) in acute otitis externa. A prospective, randomized clinical trial between steroid-antibiotic and 10% IG pack which was performed in department of ENT-HNS, Kathmandu University Hospital, Dhulikhel from July 2009 to December 2009 on 82 patients. Pain was assessed by Numerical Rating Scale (NRS) and edema was assessed by dividing the external auditory canal in four quadrant giving score of 25% for each on the day of presentation and subsequent visits till tragal tenderness and edema subsided. Age group among studied patients ranged from 10 to 60 years, with mean of 23.5 years. Out of which 42 (51.2%) were females and 40 (48.8%) were males. Average number of visits in 10% IG pack group (n = 41) was 5.4 days (2-5 visits) while in steroid-antibiotic group (n = 41) it was 3.5 days (2-5 visits). There was statistically significant decrease in the number of visits in steroid group (P < 0.05). Similarly, decrease in pain score in second visit was statistically significant (P = 0.02) in steroid-antibiotic group as compared to 10% IG pack, while the edema score in second visit while comparing steroid-antibiotic group with 10% IG pack was statistically not significant (P = 0.07), whereas it was statistically highly significant on fourth visit (P = 0.001). Since the control of pain and edema is more and hence the number of visits is significantly less in steroid-antibiotic packing group, so it is worthwhile to use steroid-antibiotic pack for effective treatment of acute otitis externa.

show abstract

A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid–antibiotic therapy

Cited by 23 publications

References 11 publications

The management of otitis externa in UK general practice

The management of otitis externa in UK general practice

Treatment of Mixed Otitis Externa Using Ceftazidime Powder and Topical Miconazole Versus Topical Miconazole Only

Effective Treatment of Acute Otitis Externa: a Comparison of Steroid Antibiotic Versus 10% Ichthammol Glycerine Pack

Contact Info

Product

Resources

About