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

Abstract

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.

Efficacy of 10% Ichthammol Glycerine Pack and Steroid-antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study.

“…Our study showed acute o s externa more in female than male with incidence of 1.29 mes higher. The result of our study substan ate with the study done by BL Shrestha et al 19 where he also observed incidence higher in female. 20 Jamalullah M et al has male incidence higher than female.…”

Efficacy of Ichthammol Glycerin Pack and Steroid Antibiotic Pack as Initial Treatment of Acute Otitis Externa: A Comparative Study

“…But there was no statistically significant difference in the efficacy of both the groups compared to each other. Although, as discussed already, other similar study by Bhatta et al [20] and by Shrestha et al [14] have shown that steroid-antibiotic pack is better for earlier relief of pain leading to decrease number of hospital visits in the management of acute otitis externa.…”

“…Studies have shown the use of topical antibiotics [10] , topical steroid [11,12] , or a combination of topical antibiotic and steroid [13] as the initial treatment of otitis externa. But very few studies have directly compared the use of glycerol and ichthammol combination with other forms of topical medications [14,15,16] . This prospective randomized study has been undertaken to compare the efficacy of ichthammol glycerin pack with steroid antibiotic pack as the initial treatment for acute otitis externa.…”

A Comparative Study on Efficacy of Polymyxin B, Neomycin and Polymyxin B, Neomycin, Hydrocortisone in the Treatment of Otitis Externa at Nepal Medical College and Teaching Hospital, Kathmandu

“…Shrestha et al in a study observed that steroid -an bio c was more effec ve than 10% icthammol glycerine 18 on seven day visit. The study cured all pa ents within ten days of treatment but no sta s cally significant differences in cure rates were recorded between the two groups.…”

“…Similarly, study conducted by Joseph et al revealed that number of male pa ents was 1.07 mes higher than female pa ents. In a study by Shrestha et al observed that [16][17][18] the incidence was 1.05 mes higher in female pa ents. However, the study of Gercek et al showed no correla on between genders and AOE as the pathology of OE is not 19 influenced by hormones.…”