Evaluation of Topical Povidone-Iodine in Chronic Suppurative Otitis Media

Jaya, Chaturvedi; Job, Anand; Mathai, E; Antonisamy, B.

doi:10.1001/archotol.129.10.1098

Cited by 38 publications

(39 citation statements)

References 13 publications

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“…Povidone-iodinebased antiseptic solution has broad-spectrum action against many organisms that can colonize the middle ear -bacteria, viruses, fungi and protozoa. One randomized controlled trial demonstrated that povidone-iodine had the same efficacy as ciprofloxacin drops in resolving otorrhoea (Jaya et al, 2003). Additionally, it was shown that bacterial resistance rates were much lower for iodine solution than for ciprofloxacin (Jaya et al, 2003).…”

Section: Ototopical Antibioticsmentioning

confidence: 99%

“…One randomized controlled trial demonstrated that povidone-iodine had the same efficacy as ciprofloxacin drops in resolving otorrhoea (Jaya et al, 2003). Additionally, it was shown that bacterial resistance rates were much lower for iodine solution than for ciprofloxacin (Jaya et al, 2003). Further large-scale studies are warranted to confirm the safety and efficacy of these topical agents in CSOM.…”

Section: Ototopical Antibioticsmentioning

confidence: 99%

See 1 more Smart Citation

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Mittal

Lisi

Gerring

et al. 2015

Journal of Medical Microbiology

196

161

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Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. IntroductionOtitis media (OM) refers to a group of complex infectious and inflammatory diseases affecting the middle ear (Dickson, 2014). OM in general is very common, as studies show that around 80 % of children should have experienced at least one episode by their third birthday (Teele et al., 1989). OM has been broadly classified into two main types, acute and chronic. Acute OM (AOM) is characterized by the rapid onset of signs of inflammation, specifically bulging and possible perforation of the tympanic membrane, fullness and erythema, as well as symptoms associated with inflammation such as otalgia, irritability and fever (Pukander, 1983;Harkness & Topham, 1998). Despite appropriate antibiotic therapy, AOM may progress to chronic suppurative OM (CSOM) characterized by persistent drainage from the middle ear associated with a perforated ear drum (Wintermeyer & Nahata, 1994;Harkness & Topham, 1998). When examined by otoscope, the middle ear looks red and inflamed with purulent discharge in CSOM patients (Figs 1 and 2). It is one of the most common chronic infectious diseases worldwide especially affecting children (Roland, 2002; Verhoeff et al., 2006). Hearing impairment is one of the most common sequelae of CSOM (Aarhus et al., 2015). The resultant hearing loss can have a negative impact on a child's speech development, education and behaviour (Olatoke et al., 2008; Khairi Md Daud et al., 2010). Mortality due to complications of CSOM is typically higher than other types of OM (Yorgancilar et al., 2013a;Qureishi et al., 2014). Intracranial complications like brain abscess and meningitis are the most common causes of death in CSOM patients (Dubey et al., 2010;Chew et al., 2012;Sun & Sun, 2014).In this article, the rec...

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Section: Ototopical Antibioticsmentioning

confidence: 99%

Section: Ototopical Antibioticsmentioning

confidence: 99%

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Mittal

Lisi

Gerring

et al. 2015

Journal of Medical Microbiology

196

161

View full text Add to dashboard Cite

show abstract

“…aluminium acetate, boric acid, iodine powder, and povidone-iodine are commonly used for CSOM because of their low cost and availability [81][82][83]. Eardrops containing antimicrobial agents either with or without an anti-inflammatory component have been promoted as an effective therapy for CSOM since the 1950s [84][85][86].…”

Section: Topical Treatmentmentioning

confidence: 99%

Chronic suppurative otitis media: A review

Verhoeff

Veen

Rovers

et al. 2006

International Journal of Pediatric Otorhinolaryngology

282

229

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“…Topical antibiotic ear drops have been the mainstay in the medical management of actively discharging CSOM; however, with increasing clinical usage, resistance has been reported, especially following long-term therapy [15]. Therefore, a more cost-eVective, nonantibiotic preparation with eVective antimicrobial properties but with no potential to develop drug resistance and ototoxicity would be an ideal alternative in the treatment of CSOM.…”

Section: Discussionmentioning

confidence: 99%

“…Past experiences showed that clinically, topical Povidone (polyvinyl pyrrolidone)-iodine was as eVective as topical antibiotic (ciproXoxacin) drop, with a superior advantage of having no in vitro drug resistance and a reduced cost of therapy [15]. Another important aspect of these "alternative" treatments (povidone-iodine, Lantigen B) is the ability to avoid prolonged antibiotic therapy, especially in cases of bacterial resistance, resulting in reduced costs: these treatments are capable of reducing expenditure associated with treatment of recurrent acute infection and allows achievement of substantial savings in terms of cost, time, and loss of productivity.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a topical suspension of bacterial antigens for the management of chronic suppurative otitis media

Mora

Salzano

Mora

et al. 2011

Eur Arch Otorhinolaryngol

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The aim of this study was to compare the efficacy and safety of a topical suspension of bacterial antigens for the management of chronic suppurative otitis media (CSOM). Two-hundred ten patients with CSOM were enrolled in this study. The patients were divided into two numerically equal groups and randomized to receive a topical suspension of bacterial antigens, Lantigen B (group A), or placebo (group B), according to the following protocol: 5 drops thrice a day for 12 consecutive weeks in the external acoustic duct. The topical suspension of bacterial antigens and placebo were administered by identical, anonymous dispensers in order to maintain double-blind conditions. Before, at the end and 3 months, and after the end of the treatment, all patients who entered in the study underwent pure tone audiometry, microscopic examination of ears, microbiological examination of the ear swab, aural suctioning and subjective assessment of symptoms by visual analog scale. In group A, we saw a statistically significant improvement in the different items measured. A topical suspension of bacterial antigens was significantly more effective than placebo in the treatment of CSOM.

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Evaluation of Topical Povidone-Iodine in Chronic Suppurative Otitis Media

Cited by 38 publications

References 13 publications

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

Chronic suppurative otitis media: A review

Efficacy of a topical suspension of bacterial antigens for the management of chronic suppurative otitis media

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