Clinical practice guideline: Acute otitis externa

Rosenfeld, Richard M.; Schwartz, Seth; Cannon, C. Ron; Roland, Peter S.; Simon, Geoffrey R.; Kumar, Kaparaboyna Ashok; Huang, William W.; Haskell, Helen; Robertson, Peter J.

doi:10.1016/j.otohns.2006.02.014

Cited by 226 publications

(249 citation statements)

References 106 publications

(136 reference statements)

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“…40 Which topical antibiotic agent is best for external otitis is unclear. 41 High-quality studies that evaluated quinolone versus nonquinolone topical solutions are limited. A systematic review of 13 metaanalyses confirmed that topical antibiotic agents were superior to placebo and noted a statistically significant advantage of quinolone agents over nonquinolone agents in the rate of microbiologic cure (P = .035).…”

Section: External Otitis Tympanostomy Tubeassociated Otorrheamentioning

confidence: 99%

The Use of Systemic and Topical Fluoroquinolones

Jackson¹,

Schutze²

2016

Pediatrics

137

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Appropriate prescribing practices for fluoroquinolones, as well as all antimicrobial agents, are essential as evolving resistance patterns are considered, additional treatment indications are identified, and the toxicity profile of fluoroquinolones in children has become better defined. Earlier recommendations for systemic therapy remain; expanded uses of fluoroquinolones for the treatment of certain infections are outlined in this report. Prescribing clinicians should be aware of specific adverse reactions associated with fluoroquinolones, and their use in children should continue to be limited to the treatment of infections for which no safe and effective alternative exists or in situations in which oral fluoroquinolone treatment represents a reasonable alternative to parenteral antimicrobial therapy.

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Section: External Otitis Tympanostomy Tubeassociated Otorrheamentioning

confidence: 99%

The Use of Systemic and Topical Fluoroquinolones

Jackson¹,

Schutze²

2016

Pediatrics

137

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“…Data are shown as means ± SEM (n = 6) Ear drops containing gentamicin are often used in human and veterinary medicine for the treatment of external otitis since staphylococci and Pseudomonas aeruginosa are frequently present in such conditions. Because of a potential Acta Veterinaria Hungarica 63, 2015 irreversible ototoxic effect (Matz et al, 2004), gentamicin-containing products cannot be used in cases with a perforated tympanic membrane (Rosenfeld et al, 2006). Although the present studies were conducted on monolayer IPEC-J2 cells, our results suggest that gentamicin alone or supplemented with 1% DMSO cannot penetrate through the intact tympanic membrane into the inner ear.…”

Section: Resultsmentioning

confidence: 60%

Gentamicin sulphate permeation through porcine intestinal epithelial cell monolayer

Gyetvai

Jerzsele

Pászti-Gere

et al. 2015

Acta Veterinaria Hungarica

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Gentamicin is an aminoglycoside antibiotic widely used in combination with dimethyl sulphoxide (DMSO) in topical drug formulations. It is not known, however, whether DMSO can enhance the permeation of gentamicin through biological membranes, leading to oto-and nephrotoxic side effects. A simple and reliable high-performance liquid chromatographic (HPLC) method was applied for the quantitative determination of gentamicin collected from the apical and basolateral compartments of the porcine intestinal epithelial cell line IPEC-J2 cell monolayer using fluorometric derivatisation of the analyte with fluorenylmethyloxycarbonyl chloride (FMOC) prior to chromatographic run in the presence and absence of 1% DMSO. The lack of change in transepithelial electrical resistance (TER) demonstrated that gentamicin and 1% DMSO did not affect IPEC-J2 cell monolayer integrity via the disruption of cell membranes. Chromatographic data also ascertained that gentamicin penetration across the cell monolayer even in the presence of 1% DMSO was negligible at 6 h after the beginning of apical gentamicin administration. This study further indicates that the addition of this organic solvent does not increase the incidence of toxic effects related to gentamicin permeation.

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“…Although AOE is primarily a local disease, it may be more severe and invasive in cases where the patients' immune system is suppressed. Edema and sensitivity in the EAC are noted in otoscopic examinations [2] .…”

Section: Introductionmentioning

confidence: 99%

The Role of Topical Thymoquinone in the Treatment of Acute Otitis Externa; an Experimental Study in Rats

et al. 2018

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OBJECTIVE:The aim of this experimental study was to compare the dose-related effect of topical thymoquinone (TQ) with other topical agents used in the management of acute otitis externa (AOE) in a rat model. MATERIALS and METHODS:Forty-eight male Wistar albino rats were divided into six groups each with eight rats per group. Group I was the control group with no external otitis, whereas external otitis were created in the other five groups (study groups). Dexamethasone, 0.1% TQ, 0.4% TQ, ciprofloxacin, and 0.9% saline (NaCl) drops was applied once daily in Groups II-VI, respectively. The treatment was administered regularly for 10 days. Pathologic and microbiologic evaluation were performed. Pathologically, the thicknesses of the stroma and the epithelium in the external auditory canal (EAC) were measured using an occulometer. Edema in the stroma, density of inflammatory cells and blood vessels, presence of fibroblasts, and changes in collagen fibers in the EAC were evaluated in five different areas to obtain the area of highest concentration and classified into four grades (0=no change, 1=mild, 2=moderate, 3=severe). RESULTS:The higher concentration of TQ (0.4%) was more effective than dexamethasone and 0.1% TQ with respect to antibacterial and the anti-inflammatory properties. CONCLUSION:TQ, particularly at a concentration of 0.4%, may be considered for topical application alone in the treatment of AOE, without any requirement for a combined treatment.

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Clinical practice guideline: Acute otitis externa

Abstract: This is the first, explicit, evidence-based clinical practice guideline on acute otitis externa, and the first clinical practice guideline produced independently by the AAO-HNSF.

Cited by 226 publications

References 106 publications

The Use of Systemic and Topical Fluoroquinolones

The Use of Systemic and Topical Fluoroquinolones

Gentamicin sulphate permeation through porcine intestinal epithelial cell monolayer

The Role of Topical Thymoquinone in the Treatment of Acute Otitis Externa; an Experimental Study in Rats

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