Effects of betamethasone dipropionate plus an antihistamine in patients with external otitis

Emgrd, Per; Hellström, Sten; Ohlander, B; Wennmo, Carsten

doi:10.1016/s0011-393x(99)80014-9

Cited by 3 publications

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References 13 publications

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“…10 Interestingly, in this context, both clinical and experimental studies, in human investigations and in animals, indicate that a steroid solution used alone is as effective for curing EO as a steroid solution containing antibiotic components. 11,12 In view of the risk of promoting microbial resistance, sensibility reactions of the ear-canal skin 13 and ototoxicity, [14][15][16][17][18] the question arises as to whether a steroid solution without antibiotics should be chosen to treat human EO regardless of whether there is an infection or not. Another factor that should guide the selection of such a drug is that solutions of steroids alone are less expensive than steroids combined with other drugs.…”

Section: Introductionmentioning

confidence: 99%

A group III steroid solution without antibiotic components: an effective cure for external otitis

Emgård

Hellström

2005

J. Laryngol. Otol.

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The present study was undertaken to compare the clinical benefits of prescribing ear drops containing 0.05% solution of betamethasone dipropionate (BD), and ear drops containing hydrocortisone with oxytetracycline hydrochloride and polymyxin B (HCPB), for topical treatment of external otitis. Fifty-one patients were enrolled in this open randomized, parallel-group, multicentre study, performed in eight different ENT departments. The patients were randomly assigned to one of the two treatment groups: BD (n = 26) and HCPB (n = 25). Only ENT specialists investigated the patients. Bacterial and fungal cultures were raised on days 1 and 11, using swabbed material from ear canals. Twice daily the patients recorded their symptoms during the acute phase, using special diary cards.BD proved a significantly more effective cure than HCPB during the acute phase of external otitis and afforded a lower relapse frequency during a six-month follow-up period. The patients of the BD group were significantly less troubled by itching (p < 0.01) than those in the HCPB group. On day 11, at the end of the acute phase, growth of bacteria (p = 0.03) and fungi (p < 0.01) was less frequent in the BD group than in the HCPB group. No serious adverse events occurred, and those minor events observed were comparable between the two groups.Our conclusion is that the group III steroid solution, BD, cured the external otitis more effectively than did the HCPB solution, whether infected by bacteria or by fungi. No difference was evident regarding adverse effects. Furthermore, price favours a solution without any antibiotic component. In view of these observations, a group III steroid solution ought to be the preferred remedy for external otitis, whether infected or not.

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Section: Introductionmentioning

confidence: 99%

A group III steroid solution without antibiotic components: an effective cure for external otitis

Emgård

Hellström

2005

J. Laryngol. Otol.

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Interventions for acute otitis externa

Kaushik

Malik

Saeed

2010

Cochrane Database of Systematic Reviews

102

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There is a paucity of high quality trials evaluating interventions for acute otitis externa. The results of this systematic review are largely based on odds ratios calculated from single trials, most of which have very broad 95% confidence intervals because of small to modest sample sizes. The findings may not be wholly generalisable to primary care for a variety of reasons; only two of the 19 trials included in the review were conducted in a primary care population setting, and in 11 of the 19 trials ear cleaning formed part of the treatment (an intervention unlikely to be available in primary care). Despite these reservations, some meaningful conclusions can be drawn from the evidence available:Topical treatments alone, as distinct from systemic ones, are effective for uncomplicated acute otitis externa. In most cases the choice of topical intervention does not appear to influence the therapeutic outcome significantly. Any observed differences in efficacy were usually minor and not consistently present at each follow-up visit. Acetic acid was effective and comparable to antibiotic/steroid at week 1. However, when treatment needed to be extended beyond this point it was less effective. In addition, patient symptoms lasted two days longer in the acetic acid group compared to antibiotic/steroid.The evidence for steroid-only drops is very limited and as yet not robust enough to allow us to reach a conclusion or provide recommendations. Further investigation is needed.Given that most topical treatments are equally effective, it would appear that in most cases the preferred choice of topical treatment may be determined by other factors, such as risk of ototoxicity, risk of contact sensitivity, risk of developing resistance, availability, cost and dosing schedule. Factors such as speed of healing and pain relief are yet to be determined for many topical treatments and may also influence this decision.Patients prescribed antibiotic/steroid drops can expect their symptoms to last for approximately six days after treatment has begun. Although patients are usually treated with topical medication for seven to 10 days it is apparent that this will undertreat some patients and overtreat others. It may be more useful when prescribing ear drops to instruct patients to use them for at least a week. If they have symptoms beyond the first week they should continue the drops until their symptoms resolve (and possibly for a few days after), for a maximum of a further seven days. Patients with persisting symptoms beyond two weeks should be considered treatment failures and alternative management initiated.

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Cochrane review: Interventions for acute otitis externa

Kaushik

Malik

Saeed

2011

Evid.‐Based Child Health

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Novel electrochemical behavior of silk protein to generate an adhesive electrogel is reported. The biomimetic system demonstrates reversible adhesive properties (see image) and functions on both hydrated and dry surfaces. Further, the system utilizes all‐biocompatible components and functions in an all‐aqueous process at ambient conditions. Potential applications in medical devices and in environmentally compatible material systems are described.

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Effects of betamethasone dipropionate plus an antihistamine in patients with external otitis

Cited by 3 publications

References 13 publications

A group III steroid solution without antibiotic components: an effective cure for external otitis

A group III steroid solution without antibiotic components: an effective cure for external otitis

Interventions for acute otitis externa

Cochrane review: Interventions for acute otitis externa

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