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October 1997

Chronic Otitis Media Treated Topically With Ciprofloxacin or Tobramycin

Author Affiliations

From the Departments of Otolaryngology—Head and Neck Surgery (Drs Fradis, Brodsky, Ben-David, and Podoshin), Microbiology (Dr Srugo), and Pharmacy (Mr Larboni), Bnai Zion Medical Center; and The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology (Drs Fradis, Ben-David, Srugo, and Podoshin), Haifa, Israel.

Arch Otolaryngol Head Neck Surg. 1997;123(10):1057-1060. doi:10.1001/archotol.1997.01900100031003

Objective:  To evaluate the efficacy of ciprofloxacin compared with tobramycin and placebo ear drops in the treatment of chronic suppurative otitis media without cholesteatoma.

Design:  Sixty ears (in 51 patients) were randomly divided into 3 treatment groups: ciprofloxacin hydrochloride, tobramycin, and placebo interventions.

Setting:  The otolaryngology department of a university teaching hospital.

Intervention:  All ears were treated topically for 3 weeks.

Main Outcome Measures:  Each patient received a small, numbered bottle and was instructed to instill 5 drops 3 times daily for 3 weeks. The final clinical and bacteriologic assessment was made after 3 weeks.

Results:  The organism most commonly isolated from the ear discharge was Pseudomonas aeruginosa. Its sensitivity to ciprofloxacin and tobramycin was 94.2% and 70.6%, respectively. The clinical response was 78.9%, 72.2%, and 41.2% in the ciprofloxacin, tobramycin, and placebo groups, respectively. The bacteriologic response rate was 66.7% for the ciprofloxacin and tobramycin groups and 20% for the placebo group. Treatment with ciprofloxacin ear drops seemed to be as effective as treatment with tobramycin.

Conclusion:  While the lack of ototoxicity of ciprofloxacin was not tested in our study, this treatment may be considered as a potential topical therapy for cases of chronic suppurative otitis media.Arch Otolaryngol Head Neck Surg. 1997;123:1057-1060